The workstation needs climate control and 24-hour variable lighting to accommodate the variety of providers who work that area. This space should allow for snacks and drinks. A good workstation will make the physician’s work and patient interaction more professionally satisfying. It would also facilitate a better work environment, less physical stress, and more use of computer assistance for improved quality of care and risk mitigation.

Communication Systems

An asynchronous communication channel is one where each party is contributing at different times, as opposed to a synchronous channel, which is direct, in person communication in which the information is being shared real-time. Integration of an electronic messaging system within the emergency department is an example of an asynchronous communication channel.

In an emergency department, synchronous interruptions regularly affect the emergency physician. Ratwani et al found that 75.4 percent of interruptions resulted in providers leaving their current task to address an interruption.¹² The urgency may or may not directly correlate with the importance of the interruption. The integration of asynchronous interruptions with electronic messaging software may disrupt the timeliness of responses.

Both synchronous and asynchronous ED communication systems would be of value to prevent a negative effect on patient care. Many situations will still arise where staff must communicate immediately and directly with the clinician for an urgent response. However, the importance of reducing non-emergent interruptions is necessary when promoting physician and APP effectiveness.

Many providers report satisfaction and efficiency through using a secure, electronic messaging system as a platform for communication. There are several brands that offer a secure, confidential, and HIPAA-compliant messaging system. A program can run in the background of the desktop that relays information between staff and providers but allows an individual provider to concentrate on a single task at a time. Many of these messaging systems also allow ECGs and radiologic images to be transmitted to consultants.

Communication tools should have input and listening components fitted to each provider. There may be a broad array of phones, radios, and telehealth devices for provider use. The workstation should be lined with surfaces that are noise absorbing so that dictation and physician-to-physician conversations can occur while respecting privacy.

Some modalities are available through mobile phone applications. Accessibility to other staff eases stress on all involved and is more useful in addressing urgent patient needs efficiently. A separate study demonstrated that messaging media, such as an electronic whiteboard, can reduce the number of interruptions that are experienced at the workstation.¹¹ Regardless of the platform chosen, the goal to decrease interruptions by implementing a better communication model between staff members would benefit all involved.⁵

Conclusion

Emergency physicians’ and APPs’ practice styles are as variable as the departments in which they work. A unifying factor is that emergency practitioners need a comfortable and efficient workspace with a more streamlined communication system that maintains their focus. Interruptions and poorly designed work areas add unnecessary tension. Provider queries suggest that a refined work area geared toward optimal clinician health and an effective environment for interacting with the digital health record and other electronic inputs would result in a more effective patient care environment.

References

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