Purpose
The purpose of this study is to explore the potential impacts of visibility on face-to-face communication among medical staff in community hospital emergency departments (EDs). Also, the researchers investigated how different types of visibility can increase/decrease the efficiency of EDs’ medical staff.
Design/methodology/approach
This study used an exploratory approach to investigate the role of visibility in enhancement of medical staff communication in four EDs within the same hospital system. Overall, 12 semi-structured interviews and 48 h of observation were manually conducted.
Findings
The findings suggest that communication among medical staff can be improved by enhancement of different types of visibility (general and staff-to-staff) in EDs. Also, visibility facilitates patient assessments, overall supervision, comfort and asking for help while reducing stress and distractions.
Practical implications
The results of this investigation can inform hospital managers and healthcare designers about one of the important ways to improve registered nurses and physicians’ performance through environmental architectural design in the enhancement of communication.
Originality/value
Understanding the importance of visibility as a design element would provide a crucial principle for future ED designs. Although research has been conducted with different focuses and methods in other hospital departments, nothing similar to the current study in EDs was available in the healthcare design published literature.
Background: Limited research has characterized team-based models of home palliative care and the outcomes of patients supported by these care teams. Case presentation: A retrospective case series describing care and outcomes of patients managed by the London Home Palliative Care Team between May 1, 2017 and April 1, 2019. Case management: The London Home Palliative Care (LHPC) Team care model is based upon 3 pillars: 1) physician visit availability 2) active patient-centered care with strong physician in-home presence and 3) optimal administrative organization. Case outcomes: In the 18 month study period, 354 patients received care from the London Home Palliative Care Team. Most significantly, 88.4% ( n = 313) died in the community or at a designated palliative care unit after prearranged direct transfer; no comparable provincial data is available. 21.2% ( n = 75) patients visited an emergency department and 24.6% ( n = 87) were admitted to hospital at least once in their final 30 days of life. 280 (79.1%) died in the community. These values are better than comparable provincial estimates of 62.7%, 61.7%, and 24.0%, respectively. Conclusion: The London Home Palliative Care (LHPC) Team model appears to favorably impact community death rate, ER visits and unplanned hospital admissions, as compared to accepted provincial data. Studies to determine if this model is reproducible could support palliative care teams achieving similar results.
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