Journal Article

Spatial Influences on Team Awareness and Communication in Two Outpatient Clinics: a Multiple Methods Study

Lim, Lisa, Stroebel, Robert, Zimring, Craig M, Moore, Matthew, Obeidat Bushra, DuBose, Jennifer R

2020

Overview

BackgroundHealthcare organizations are moving their primary care teams out of private offices into shared workspaces for many reasons, including teamwork improvement and cost reduction.ObjectiveIdentify the specific aspects of layout and design that enable two fundamental processes of high-functioning teams: communication and situation awareness.DesignThis was a multi-method study employing qualitative interviews, floor plan analysis, observations, behavior mapping, and surveys.ParticipantsTwo primary care clinics in a large, integrated healthcare system in the upper Midwest, with Clinic S in a suburban location and Clinic A in a rural setting. In the two clinics, a total of 36 staff members were interviewed, 57 (66% response rate) staff members were surveyed, and 2013 individual-points were recorded during 63 behavior mapping observations.Main MeasuresCommunication encounters, team members’ perception of the environment and teamwork, visibility, distance, functional pathways, and self-reported mode and frequency of staff communication.Key ResultsObservations, interviews, and surveys identified environmental factors that predict staff awareness and communication patterns. Visibility impacts situation awareness. Frequency of face-to-face communication increases with visibility and proximity between workstations (e.g., Clinic A nurses’ intra-role communication without workstation proximity vs inter-role communication with workstation proximity: 22.6% [11.4, 33.9] vs 77.4% [66.1, 88.6], p = 0.001) and with staff members’ functional paths. Visual exposure to patients predicts staff’s concerns about their communication (Clinic S: 2.29 ± 0.81 vs Clinic A: 3.20 ± 0.84, p < 0.001).ConclusionsDesign and layout of team spaces have important influences on the way that team members work together. The organizational goals of the healthcare system, particularly which staff members need to work together most frequently, should drive the specific design solution.

• Publisher: Springer Nature B.V
• Subject: Clinics / Communication / Depth perception / Design / Environmental factors / Floorplans / Health care / Internal medicine / Layouts / Mapping / Polls & surveys / Primary care / Proximity / Qualitative analysis / Situational awareness / Teams / Teamwork / Work stations / Workstations