Communicating in hospital emergency departments

Abstract

Ineffective communication has been identified as the major cause of critical incidents in public hospitals in Australia. Critical incidents are adverse events leading to avoidable patient harm. This article discusses a study that focused on spoken interactions between clinicians and patients in the emergency department of a large, public teaching hospital in New South Wales, Australia. The purpose of the study was to identify successful and unsuccessful communication encounters. It combined two complementary modes of analysis: qualitative ethnographic analysis of the social practices of emergency department healthcare and discourse analysis of the talk between clinicians and patients. This allowed the researchers to analyse how talk is socially organised around healthcare practices and how language and other factors impact on the effectiveness of communication. The complex, high stress, unpredictable and dynamic work of emergency departments constructs particular challenges for effective communication. The article analyses patient–clinician interactions within the organisational and professional practices of the emergency department and highlights some systemic and communication issues. It concludes with some implications for the professional development of clinicians and an outline of ongoing research in emergency departments.10 page(s