• Kailey Tindle, Allison David, Stephanie Carlisle, Billie Faircloth, J Matthew Fields, Geoffrey Hayden, and Bon Ku.
• J Emerg Nurs. 2020 Jul 1; 46 (4): 440-448.

IntroductionThe physical layout of the emergency department affects the way in which patients and providers move within the space and can cause substantial changes in workflow and, therefore, affect communication patterns between providers. There is no 1 ED design that enables the best patient care, and quantitative studies looking at ED design are limited. The goal of this study was to examine how different ED designs, centralized and decentralized, are associated with communication patterns among health care professionals.MethodsA task performance, direct observation time study was used. By developing a novel tablet-based digital mapping tool using a cloud-based mapping platform (ArcGIS), data on provider actions and interactions were collected and mapped to a precise location within the emergency department throughout an entire nursing shift.ResultsThe difference in the duration of nurse-physician interactions between the 2 ED designs was statistically significant. Within the centralized design, nurse-physician interactions totaled 14 minutes and 38 seconds compared with 30 minutes and 11 seconds in the decentralized design (t = 2.31, P = 0.02). More conversations between nurses and physicians occurred inside the patient's room in the decentralized design.DiscussionOur findings suggest that the ED design affects communication patterns among health care providers and that the design has the potential to affect the quality of patient care.Copyright © 2020 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

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