UBC Graduate Research

Physician-nurse collaboration for safe and efficient care of patients with prolonged time-to-disposition in the Emergency Department Geiger-Whitlock, Anna


Background: Patients with complex stories or challenging diagnoses often face long wait times in the Emergency Department (ED) due to a lack of collaboration between nurses and physicians in establishing a plan of care and disposition. This integrated literature review looked at how physicians, residents, and nurses in the ED can best collaborate to ensure safe and efficient management of patients with prolonged time-to-disposition. Disposition is defined as the decision on the patient’s destination: home, admission, or transfer to another facility. Methodology and Methods: This integrated review used the constant comparison method to identify main themes to communication and the specific content of the communication. Literature searches were conducted in CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Medline databases and additional reference searching was completed. The literature search yielded fourteen studies. Results: Six significant themes related to communication in the ED were identified: the ED environment, transfer of information, role awareness, synchronous communication, contextual awareness, and kind culture. Four main areas of communication content were identified, including patient assessment, patient status, workflow, and clinical support. Nine recommendations for improving communication regarding patients with prolonged time-to-disposition were suggested. Conclusion: Good communication across the multidisciplinary team can lead to better health outcomes, accurate diagnosis, and correct disposition. Improving communication within the ED can enhance the efficiency of patient disposition and the safety of patient care.

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