Understanding team, interpersonal and situational factors is essential for routine communication with patients in the emergency department (ED): A scoping literature review and formation of the ‘T.IP.S’ conceptual framework

Abstract

Introduction Most patient–provider communication skills frameworks focus on interpersonal behaviours within the context of a single consultation. In contrast, Emergency Department (ED) patient encounters consist of many new interactions with different professionals over a short time period. Additionally, ED care often occurs in a chaotic, unpredictable, and overcrowded environment. While these factors are recognised to present a major challenge to effective patient–provider communication in the ED, there is no accepted framework to guide how professionals or teams should approach and optimise communication with patients in the ED. Objectives This review aims to identify the current literature relating to routine patient provider communication processes in the ED and synthesise a new framework to enhance understanding of routine patient-provider communication processes in the ED. Methods Searches of Scopus, Medline, EMBASE and CINAHL were conducted to identify literature written between 2000 and 2016 using the terms ((communication OR consultation OR health literacy) AND (patient) AND (emergency medicine OR emergency department)). Results Fifty-five relevant articles were selected for final inclusion. A qualitative synthesis was conducted and content interpreted as either facilitating factors or obstacles to routine ED communication were coded and grouped into three overarching themes. These were Team, Interpersonal and Situational factors, which together form the basis of the proposed T.IP.S framework. Conclusion T.IP.S is the first framework for patient-provider communication specific to the ED setting. The T.IP.S framework may be utilised to evaluate communication strengths and vulnerabilities, identify training requirements professionals, and ultimately improve patient experience and outcomes in the ED.