Experts urge switch to shared space in emergency rooms for teams of shifting staff. | Monkey Business Images/Shutterstock
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John Breslin | Dec 20, 2016

Experts encourage switch to shared space in emergency rooms for shifting staff teams

Fast-paced communication on the fly among shifting partners in care -- all reporting to a central command post -- is the way to overcome the inability to form standing, stable teams and better manage often chaotic emergency departments, two leading experts argue. 

The pod system, which allows a team to gather and care for a particular group of patients, has been shown to significantly decrease through-put time in emergency departments, according to the co-authors of a number of studies in this area.

It is about acting as a team even if that team is made up of different personnel at different times, Melissa Valentine, professor at Stanford University’s Management Science and Engineering Department, said.

Furthermore, it is a shared space where doctors and nurses engage with each other, resulting in more effective communication, she told Patient Daily.

One study reported the switch from role-based coordination to a more accountable and communication-friendly method decreases the average through-put time for patients from eight to five hours.

Spending less time waiting for care and moving through the system is good for patients, Valentine told Patient Daily.

“Patients like the idea that it is easier to identify and get in touch with the team looking after them,” she said. “Now, that group is accountable to those patients.”

Valentine and Amy Edmondson, the Novartis Professor of Leadership and Management at Harvard Business School, have carried out a number of studies into how best to manage emergency departments.

However, the idea of creating a space where a constantly changing team is responsible for particular tasks -- in addition to caring for a set number of patients -- can work across the health care system.

“For our research, we look at the hardest situation, and the emergency department is the most extreme situation,” Valentine said. “But the idea of care teams, I think, can work generally in health care.”

A shared work space is crucial for this time of management structure to work, but it will not work alone. To explain, Valentine cited a study of the workings of one hospital with a shared space but no set group of patients to look after.

Despite being in close contact, they did not speak to one another and were not accountable, the management expert said.

Setting aside these areas of shared space does not mean emergency departments need to expand, Valentine added. Instead, management can demarcate an existing space.

While the idea of using a core space to coordinate a team of shifting personnel has been in practice for some time -- and more hospitals and other health care providers are utilizing the system -- it is not yet the standard. Many still use role-based coordination.

This model assumes that role responsibilities and boundaries are clear, and that crucial interdependencies between roles are sufficiently scripted to unfold appropriately, which in practice does not always work, Valentine and Edmondson said in a piece published in the Harvard Business Review.

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