Volume 177 - Issue 6
Communication loads on clinical staff in the emergency department
Authors: Alan E O'Connor, Antony Nocera, Thomas Hamilton and Enrico W Coiera
Med J Aust 2002; 177 (6): 333-335. || doi: 10.5694/j.1326-5377.2002.tb04803.x
Published online: 16 September 2002
Published online: 16 September 2002
To the Editor: I would like to compliment Coiera et al for their very interesting article about communication in an emergency department.1 Nearly a third of communication events were classified as interruptions, thus having an adverse effect on communication within the department.
In trying to reduce this level of interruption, perhaps it is time to rethink the role of the on-call emergency physician in an emergency department. In most large Australian emergency departments, the emergency physician is also the admitting officer, who is responsible for coordinating the non-elective admissions of the day. This involves being readily available for external and internal phone calls, usually by mobile phone. Thus, as well as the normal clinical workload of an emergency physician, he or she needs to respond immediately to the summons of a mobile phone — a recipe for interruptions and less efficient communication.
It is not optimal for the person who has clinical responsibility for the emergency department to also be the person through whom most of the communication is channelled. One possible solution is to channel calls about patients whom the referring doctor considers definitely need assessment in the emergency department to non-medical clerical staff. They could enter the details in a computerised "expected patients" database, which would be available for viewing by emergency department staff. Only calls about patients where there is some uncertainty, and advice calls, would be channelled to the emergency physician on call. This would facilitate both planning of the emergency department workload and also provide access to advice for the referring doctor. This change in process would reduce the number of phone calls received by the on-call emergency physician — and thus the number of interruptions — and improve overall communication within the emergency department.
References
- Coiera EW, Jayasuriya RA, Hardy J, et al. Communication loads on clinical staff in the emergency department. Med J Aust 2002; 176: 415-418.<eMJA full text>
- Coiera WE, Jayasuriaya RA, Hardy J, et al. Communication workloads on clinical staff in the emergency department Med J Aust 2002; 176: 415-418. <eMJA full text>
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- Coiera EW, Jayasuriya RA, Hardy J, et al. Communication loads on clinical staff in the emergency department. Med J Aust 2002; 176: 415-418. <eMJA full text>
- Vincent C, Wears RL. Communication in the emergency department: separating the signal from the noise [editorial]. Med J Aust 2002; 176: 409-410. r2
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- Coiera, WE, Jayasuriaya RA, Hardy J, et al. Communication workloads on clinical staff in the emergency department Med J Aust 2002; 176: 415-418.<eMJA full text>