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Patient treatment in ED hallways and patient perception of clinician-patient communication

Published:March 02, 2016DOI:https://doi.org/10.1016/j.ajem.2016.02.074
      In the setting of high patient volumes and boarding times across many emergency departments (EDs), clinicians are increasingly tasked with the challenge of managing patients in nonconventional care areas [
      • Rabin E.
      • Kocher K.
      • McClelland M.
      • Pines J.
      • Hwang U.
      • Rathlev N.
      • et al.
      Solutions to emergency department ‘boarding' and crowding are underused and may need to be legislated.
      ]. The use of hallway care areas, locations where patients are in close proximity to one another with little or no structural partitions separating them, has increased [
      • McNaughton C.
      • Self W.H.
      • Jones I.D.
      • Arbogast P.G.
      • Chen N.
      • Dittus R.S.
      • et al.
      ED crowding and the use of nontraditional beds.
      ,
      • Schuur J.D.
      • Venkatesh A.K.
      The growing role of emergency departments in hospital admissions.
      ]. Several negative consequences of ED hallway care have been noted, including patient perceptions of compromised care [
      • Pines J.M.
      • Garson C.
      • Baxt W.G.
      • Rhodes K.V.
      • Shofer F.S.
      • Hollander J.E.
      ED crowding is associated with variable perceptions of care compromise.
      ] and poor infection prevention practices among staff [
      • Carter E.J.
      • Wyer P.
      • Giglio J.
      • Jia H.
      • Nelson G.
      • Kauari V.E.
      • et al.
      Environmental factors and their association with emergency department hand hygiene compliance: an observational study.
      ]. However, the impact of hallway care on clinician-patient communication has not been studied. Clinician-patient communication is an important aspect of care associated with decreased patient anxiety and patient satisfaction [
      • Stewart M.A.
      Effective physician-patient communication and health outcomes: a review.
      ]. Clinician-patient communication may be particularly important for patients evaluated for potentially life-threatening conditions such as acute coronary syndrome (ACS). Our study examined the association between hallway care during ED evaluation for ACS and patients' perception of clinician-patient communication. We hypothesized that hallway care would be associated with poorer perception of clinician-patient communication compared with patients receiving care in curtained or divided rooms.
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      References

        • Rabin E.
        • Kocher K.
        • McClelland M.
        • Pines J.
        • Hwang U.
        • Rathlev N.
        • et al.
        Solutions to emergency department ‘boarding' and crowding are underused and may need to be legislated.
        Health Aff. 2012; 31: 1757-1766
        • McNaughton C.
        • Self W.H.
        • Jones I.D.
        • Arbogast P.G.
        • Chen N.
        • Dittus R.S.
        • et al.
        ED crowding and the use of nontraditional beds.
        Am J Emerg Med. 2012; 30: 1474-1480
        • Schuur J.D.
        • Venkatesh A.K.
        The growing role of emergency departments in hospital admissions.
        N Engl J Med. 2012; 367: 391-393
        • Pines J.M.
        • Garson C.
        • Baxt W.G.
        • Rhodes K.V.
        • Shofer F.S.
        • Hollander J.E.
        ED crowding is associated with variable perceptions of care compromise.
        Acad Emerg Med. 2007; 14: 1176-1181
        • Carter E.J.
        • Wyer P.
        • Giglio J.
        • Jia H.
        • Nelson G.
        • Kauari V.E.
        • et al.
        Environmental factors and their association with emergency department hand hygiene compliance: an observational study.
        BMJ Qual Saf. 2015; ([bmjqs-2015])
        • Stewart M.A.
        Effective physician-patient communication and health outcomes: a review.
        CMAJ. 1995; 152: 1423-1433
        • Stewart A.L.
        • Nápoles-Springer A.M.
        • Gregorich S.E.
        • Santoyo-Olsson J.
        Interpersonal processes of care survey: patient-reported measures for diverse groups.
        Health Serv Res. 2007; 42: 1235-1256
        • Lévesque J.F.
        • Pineault R.
        • Haggerty J.L.
        • Burge F.
        • Beaulieu M.D.
        • Gass D.
        • et al.
        Respectfulness from the patient perspective: comparison of primary healthcare evaluation instruments.
        Healthc Policy. 2011; 7: 167-179
        • Beaulieu M.D.
        • Haggerty J.L.
        • Beaulieu C.
        • Bouharaoui F.
        • Lévesque J.
        • Pineault R.
        • et al.
        Interpersonal communication from the patient perspective: comparison of primary healthcare evaluation instruments.
        Healthc Policy. 2011; 7: 108
        • PIette J.D.
        • Schillinger D.
        • Potter M.B.
        • Heisler M.
        Dimensions of patient-provider communication and diabetes self-care in an ethnically diverse population.
        J Gen Int Med. 2003; 18: 624-633
        • Eagle K.A.
        • Lim M.J.
        • Dabbous O.H.
        • Pieper K.S.
        • Goldberg R.J.
        • Van de Werf F.
        • et al.
        A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry.
        JAMA. 2004; 291: 2727-2733
        • Charlson M.
        • Szatrowski T.P.
        • Peterson J.
        • Gold J.
        Validation of a combined comorbidity index.
        J Clin Epidemiol. 1994; 47: 1245-1251
        • Edmondson D.
        • Shimbo D.
        • Ye S.
        • Wyer P.
        • Davidson K.W.
        The association of emergency department crowding during treatment for acute coronary syndrome with subsequent posttraumatic stress disorder symptoms.
        JAMA Intern Med. 2013; 173: 472-475
        • Pines J.M.
        • Iyer S.
        • Disbot M.
        • Hollander J.E.
        • Shofer F.S.
        • Datner E.M.
        The effect of emergency department crowding on patient satisfaction for admitted patients.
        Acad Emerg Med. 2008; 15: 825-831