The influence of visibility on staff face-to-face communication and efficiency in emergency departments

How Visibility May Reduce Security Issues in Community Hospitals' Emergency Departments

This research explored the relationship between visibility and the level of security risks as perceived by nurses and physicians in emergency departments (EDs). Security in EDs has been reported as a major global concern, and visibility has been identified as a design factor impacting behavior. However, few previous studies have rigorously investigated the role of visibility in reduction of ED security risks with evidence-based design approach. There is a lot of significant questions about how visibility impacts the reduction of security issues in EDs.

METHODS

How visibility may influence ED security was explored via qualitative methods in five EDs using semi-structured one-on-one interviews with 17 clinical staff and 48 hr of field observations. The coding process for both interviews and observational notes followed the principles of naturalistic inquiry.

RESULTS

The findings suggest security risks can be decreased by improving visibility. Medical staff (registered nurses and physicians) felt more secure in the EDs with higher visibility.

DISCUSSION

This study provides a framework to identify preferable levels of visibility in EDs and proposes design strategies to minimize security issues. Registered nurses and physicians can improve their team's sense of security by considering visibility throughout their daily practices.

The Representational Function of Clinic Design: Staff and Patient Perceptions of Teamwork

OBJECTIVE

This study empirically investigates the relationships between visibility attributes and both patients' and staff members' teamwork experiences.

BACKGROUND

Teamwork among healthcare professionals is critical for the safety and quality of patient care. While a patient-centered, team-based care approach is promoted in primary care clinics, little is known about how clinic layouts can support the teamwork experiences of staff and patients in team-based primary clinics.

METHODS

This article measured teamwork perceptions of staff members and patients at four primary care clinics providing team-based care. Visual access to staff workstations from both staff and patient perspectives was analyzed using VisualPower tool(version 21). The relationships between teamwork perception and visibility attributes were analyzed for each entity: staff members and patients.

RESULTS

The results showed that the visual relationships among staff members and those between staff members and patients have significant associations with overall perceptions of teamwork. While clinics providing more visual connections between staff workstations reported higher teamwork perception of staff members, patient perceptions of staff teamwork were inversely related to the number of visual connections between patients and staff workstations.

CONCLUSIONS

The findings of the study provide implications for designing team-based primary care clinics to enhance the teamwork experience of both staff members and patients, which is also applicable to teamwork perceptions in other settings where both inhabitants and visitors are main user groups of the spaces. This study illustrates the representational function of space: Organizations can emphasize their values via layout design by regulating what they show to inhabitants or visitors.

The Correlation Between Visibility and Medical Staff Collaborative Communication in Emergency Departments

OBJECTIVES

This study empirically investigates the correlation between visibility and nurses and physicians' collaborative communication in emergency departments (EDs). The researchers hypothesized that higher visibility levels in EDs are associated with higher collaborative communication among nurses and physicians.

BACKGROUND

The review of related literature addresses the role of communication in EDs, and more specifically, how visibility has been found to affect nurse and physician behavior in healthcare facilities.

METHOD

The visibility levels in four EDs within the same hospital system were quantitatively measured in this study. Also, the communication levels among medical staff were explored by two methods. Data collection included computerized floor plan analyses, observations, and surveys.

RESULTS

The researchers found statistically significant relationships between several underlying dimensions of ED visibility and collaborative communication among the medical staff members.

CONCLUSION

Understanding the role of visibility provides a critical design principle for future EDs. The enhancement of ED design helps nurses and physicians to benefit from supportive environments.

A Conceptual Visibility Framework for Linking Spatial Metrics With Experience and Organizational Outcomes

Visibility enables or prohibits healthcare professionals' ability to monitor, control, or manage situations in healthcare settings. Visibility has a significant impact on patient safety, including patient fall rates and mortality rates, and on the performance of healthcare professionals, including situational awareness and communication. This article provides a conceptual visibility framework synthesizing visibility analysis models, tools, and metrics. The framework uses four dimensions that capture the experiential phenomena of users, such as visual relationships between specific sets of users/targets, how the orientation of the seeing entity changes visibility patterns, and the unequal visibility levels of seeing and being seen. The framework particularly focuses on how the layout and the resulting patterns of visibility reflect and influence the user experience and organizational functions. By illustrating the similarities and differences of various models in the framework according to the dimensions, this article describes how various visibility analysis models, tools, and metrics can be applied to design and research.

The Influence of Visibility on Medical Teamwork in Emergency Departments: A Mixed-Methods Study

AIM

This mixed-methods study delivers empirical evidence on the influence of visibility on healthcare teamwork in Emergency Departments (EDs). This study researchers hypothesized that with changes of visibility in EDs, teamwork among medical staff members will be impacted.

BACKGROUND

Prior research results suggest that visibility can influence health-setting efficacy. Teamwork is one of the components of each healthcare system that can be supported by environmental design.

METHOD

Visibility in four subject sites from the same healthcare system was objectively measured by morphology plan analyses. Teamwork among medical staff members was the behavioral variable of interest and explored through field observations, interviews, and surveys.

RESULTS

The qualitative outcomes demonstrated that teamwork can be enhanced by improved visibility, while the quantitative findings supported the idea that some specific measures of visibility were correlated with teamwork.

CONCLUSION

This study provides a model for future research on the association between healthcare staff behavior and ED plan configuration. The enhancement of ED design, considering the significance of visibility, enhances the perceptions of nurses and physicians in terms of teamwork.

Impacts of Nursing Unit Design on Visibility and Proximity and Its Influences on Communication, Privacy, and Efficiency

OBJECTIVES

This study examines the role of visibility and proximity on nurse communication patterns, perception of privacy, and efficiency in double-corridor nursing units.

BACKGROUND

Nurses are extremely important for the quality of healthcare. The literature suggests that visibility and proximity have a substantial impact on the delivery of care and staff experience. However, few studies have empirically examined nursing units in China.

METHOD

Questionnaire surveys, observations, and simulations of medication administration tasks were employed.

RESULTS

Visibility and proximity influenced communication patterns, perceptions of privacy, and efficiency. The type of wall in the medication room could impact nurses' perception of privacy and efficiency. A partial glass wall in the medication room could achieve balance between privacy and visibility. A medication room that is adjacent to and is easily accessed from the nurse station (NS) could provide efficient communication and efficient work. The partition type between the NS and the doctor's office and the layout of the medication room could impact communication patterns. The relative position of the NS, medication room, and disposal room could influence the flow of medication administration tasks, and a geographically contiguous spatial layout could enhance work efficiency.

CONCLUSIONS

The findings contribute to the body of knowledge on the impact of visibility and proximity on nurses' communication patterns, perception of privacy, and efficiency. Recommendations to improve the design of double-corridor nursing units are also provided.