Making the Communication-Quality Care Link

Rapid fire delivery of critical information between clinicians is commonplace in the ED, but most departments rarely plan and assess the effectiveness of their communication methods. Research has indicated that more than half of all sentinel events—death or permanent injury due to treatment delays—occur in EDs, according to the Joint Commission. Analyses have shown that communication is the root cause for the majority of these events. “Few investigations have looked into how communication of information within the ED can be optimized,” says Shari Welch, MD, FACEP. In an effort to examine communication practices within the ED and assess strategies that may improve these efforts, the Emergency Department Benchmarking Alliance, which comprises 412 EDs in the United States, began to study its member’s communication strategies. The initiative demonstrated that most EDs use a variety of low and high-tech methods for communication (Table 1). In the 1980s, the whiteboard was commonly used to display and convey information within the ED. Now, that trend has given way to computerized systems, according to Dr. Welch. “Physicians and nurses could circle something on a whiteboard to denote importance, but the tracking screens that are used frequently now do not give the same visual cues.” Many EDs have begun using overhead paging more frequently. However, in the average ED, according to the World Health Organization, the decibel level of noise is often too high, causing stress for both staff and patients. Emergency Department Size & Needs “Smaller EDs are much more efficient with their communications than larger ones,” Dr. Welch says. “Larger EDs can be burdened by their structure. Many have long hallways, no central...