The Impact of Environmental Design on Teamwork and Communication in Healthcare Facilities: A Systematic Literature Review

Abstract

The purpose of this systematic review is to investigate the current knowledge about the impact of healthcare facility design on teamwork and communication by exploring the relevant literature. Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Searches were conducted in PubMed and Google Scholar databases in addition to targeted design journals including Health Environmental Research & Design, Environment and Behavior, Environmental Psychology, and Applied Ergonomics. Inclusion criteria were (a) full-text English language articles related to teamwork and communication and (b) involving any healthcare built environment and space design published in peer-reviewed journals between 1984 and 2017. Studies were extracted using defined inclusion and exclusion criteria. In the first phase, 26 of the 195 articles most relevant to teamwork and 19 studies of the 147 were identified and reviewed to understand the impact of communication in healthcare facilities. The literature regarding the impact of built environment on teamwork and communication were reviewed and explored in detail. Eighteen studies were selected and succinctly summarized as the final product of this review. Environmental design, which involves nurses, support staff, and physicians, is one of the critical factors that promotes the efficiency of teamwork and collaborative communication. Layout design, visibility, and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities.

The physical environment and multi-professional teamwork in three newly built stroke units

“…The physical environment was not always designed based on existing evidence about factors considered to facilitate teamwork, e.g. a design that facilitates face-to-face communication and appropriate spaces to allow the members to work together [4]. This observations of the physical environment and the multi-professional teamwork should lead to careful consideration, since the importance of multi-professional team-based care and rehabilitation has been emphasised repeatedly in stroke guidelines [3,10,22] and acts as unequivocal evidence of improved outcomes [2,3,29].…”

“…In some cases, the rooms were small, and their primary function seemed to be as a workplace designed for 2-3 people. In a newly published review [4], visual connectivity and the size of a space, such as the presence of large rooms with space for all team members, was shown to strengthen communication between the team members.…”

“…A stroke unit is defined as an identifiable geographic area in hospitals that is devoted to people who have a stroke, and it is staffed by a multi-professional team with specialist knowledge of stroke care [3]. Multi-professional teamwork means that professionals from different disciplines benefit from each other's skills and work towards common patient goals [4]. Teamwork has been shown to improve satisfaction with care [5] and the quality of care for persons with complex needs, such as the period after a stroke [6].…”

“…Generally, efforts to make the environment supportive of patient needs must also consider the needs of the staff. For instance, the physical environment could include spaces designed to allow team members to work together, face to face, and to accommodate supplies nearby, such as rooms for medical products and storage facilities [4]. Ulrich et al [13] found that the physical environment can contribute to staff stress, fatigue and ineffectiveness in delivering care, which may influence patient safety, health outcomes, and the overall quality of the healthcare.…”

“…Ulrich et al [13] found that the physical environment can contribute to staff stress, fatigue and ineffectiveness in delivering care, which may influence patient safety, health outcomes, and the overall quality of the healthcare. Recently, a systematic review [4] of the impact of a well-functioning physical environment on teamwork and communication demonstrated that both layout and spatial arrangement influenced all aspects of communication in healthcare facilities.…”