The purpose of this systematic review is to investigate the current knowledge about the impact of healthcare facility design on teamwork and communication by exploring the relevant literature. Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Searches were conducted in PubMed and Google Scholar databases in addition to targeted design journals including Health Environmental Research & Design, Environment and Behavior, Environmental Psychology, and Applied Ergonomics. Inclusion criteria were (a) full-text English language articles related to teamwork and communication and (b) involving any healthcare built environment and space design published in peer-reviewed journals between 1984 and 2017. Studies were extracted using defined inclusion and exclusion criteria. In the first phase, 26 of the 195 articles most relevant to teamwork and 19 studies of the 147 were identified and reviewed to understand the impact of communication in healthcare facilities. The literature regarding the impact of built environment on teamwork and communication were reviewed and explored in detail. Eighteen studies were selected and succinctly summarized as the final product of this review. Environmental design, which involves nurses, support staff, and physicians, is one of the critical factors that promotes the efficiency of teamwork and collaborative communication. Layout design, visibility, and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities.
AjeigbeD.McNeese-SmithD.LeachL. S.PhillipsL. R. (2013). Nurse-physician teamwork in the emergency department: Impact on perceptions of job environment, autonomy, and control over practice. Journal of Nursing Administration, 43(3), 142–148.
2.
BaggsJ. (1994). Development of an instrument to measure collaboration and satisfaction about care decisions. Journal of Advanced Nursing, 20(1), 176–182.
3.
BartlettJ.CameronP.CiseraM. (2002). The Victorian emergency department collaboration. International Journal for Quality in Health Care, 14(6), 463–470. doi:10.1093/intqhc/14.6.463
4.
BayramzadehS.AlkazemiM. (2014). Centralized vs. decentralized nursing stations: An evaluation of the implications of communication technologies in healthcare. Health Environments Research & Design Journal, 7(4), 62–80.
5.
BeckerF. (2007). Nursing unit design and communication patterns: What is “real” work?Health Environments Research & Design Journal, 1(1), 58–62.
6.
BeckettC.KipnisG. (2009). Collaborative communication: Integrating SBAR to improve quality/patient safety outcomes. Journal for Healthcare Quality, 31(5), 19–28.
7.
BoschS.GharaveisA. (2017). Flying solo: A review of the literature on airport wayfinding for older adults and persons with visual or cognitive disabilities. Applied Ergonomics, 58(2), 327–333.
8.
BoyleD.KochindaC. (2004). Enhancing collaborative communication of nurse and physician leadership in two intensive care units. The Journal of Nursing Administration, 34(2), 60–70.
9.
BrownT.BoyleM.WilliamsB.MolloyA.McKennaL.PalermoC.MolloyL. (2013). Factor structure of the communicator styles measure (CSM) when used with undergraduate health science students. Scandinavian Journal of Caring Sciences, 27(2), 363–372.
10.
CaiH.ZimringC. (2011). Stay connected in decentralized nurse station: The impact of nurse station typology on nurses’ informal communication and learning. World Health Design, 1, 60–67.
11.
CartmellK. (2000). Self-directed work teams in a health care environment. Home Health Care Management & Practice, 12(6), 38–40.
12.
ChanD. C. (2016). Teamwork and moral hazard: Evidence from the emergency department. Journal of Political Economy, 124(3), 734–770.
13.
CoieraE.JayasuriyaR. A.HardyJ.AiveenB.ThropeM. E. (2002). Communication loads on clinical staff in the emergency department. The Medical Journal of Australia, 176(1), 415–418.
14.
CooperS.CantR.PorterJ.SellickK.SomersG.KinsmanL.NestelD. (2010). Simulation and education: Rating medical emergency teamwork performance: Development of the Team Emergency Assessment Measure (TEAM). Resuscitation, 8(1), 446–452.
15.
CorwinL.CorbinJ. H.MittelmarkM. B. (2012). Producing synergy in collaborations: A successful hospital innovation. Innovation Journal, 17(1), 2–16.
16.
CroninJ.WrightJ. (2005). Rapid assessment and initial patient treatment team—A way forward for emergency care. Accident & Emergency Nursing, 1 (3), 87–92. doi:10.1016/j.aaen.2004.12.002
17.
DijkstraK.PieterseM.PruynA. (2006). Physical environmental stimuli that turn healthcare facilities into healing environments through psychologically mediated effects: Systematic review. Journal of Advanced Nursing, 56(2), 166–181. doi:10.1111/j.1365-2648.2006.03990.x
18.
DoughertyM. B.LarsonE. L. (2010). The nurse-nurse collaboration scale. Journal of Nursing Administration, 40(1), 17–25.
19.
FernandezR.KozlowskiS. J.ShapiroM. J.SalasE. (2008). Toward a definition of teamwork in emergency medicine. Academic Emergency Medicine, 15(11), 1104–1112.
20.
FrykmanM.HassonH.AthlinA.SchwarzU. (2014). Functions of behavior change interventions when implementing multi-professional teamwork at an emergency department: A comparative case study. BMC Health Services Research, 14(2), 34–45.
21.
GeversJ.van ErvenP.de JongeJ.MaasM.de JongJ. (2010). Effect of acute and chronic job demands on effective individual teamwork behaviour in medical emergencies. Journal of Advanced Nursing, 66(7), 1573–1583.
22.
GharaveisA.ShepleyM.GainesK. (2016). The role of daylighting in skilled nursing short-term rehabilitation facilities. Health Environments Research & Design Journal, 9(2), 105–118.
23.
GordonJ.SheppardL. A.AnafS. (2010). The patient experience in the emergency department: A systematic synthesis of qualitative research. International Emergency Nursing, 1(8), 80–88. doi:10.1016/j.ienj.2009.05.004
24.
GriffithsD.MorphetJ.InnesK.CrawfordK.WilliamsA. (2014). Communication between residential aged care facilities and the emergency department: A review of the literature. International Journal of Nursing Studies, 51(11), 1517–1523.
25.
Gurascio-HowardL.MallochK. (2010). Centralized and decentralized nurse station design: An examination of caregiver communication, work activities, and technology. Health Environments Research & Design Journal, 1(1), 44–57.
26.
HamiltonD. K.ShepleyM. M. (2010). Design for critical care: An evidence-based approach. Boston, MA: Elsevier/Architectural Press.
27.
HatchM.CunliffeL. (2012). Organization theory: Modern, symbolic, and postmodern perspectives. New York, NY: Oxford University Press.
28.
HuaY.BeckerF.WurmserT.Bliss-HoltzJ.HedgesC. (2012). Effects of nursing unit spatial layout on nursing team communication patterns, quality of care, and patient safety. Health Environments Research & Design Journal, 6(1), 8–38.
29.
HughesB.FitzpatrickJ. (2010) Nurse-physician collaboration in an acute care community hospital. Journal of Interprofessional Care, 24(6), 625–632.
JohanesM. J.AtmodiwirjoP. (2015). Visibility analysis of hospital inpatient ward. International Journal of Technology, 6(3), 400–409.
32.
JonesF.PodilaP.PowersC. (2013). Creating a culture of safety in the emergency department. Journal of Nursing Administration, 43(4), 194–200. doi:10.1097/NNA.0b013e31828958 cd
33.
KaissiA.JohnsonT.KirschbaumM.S. (2003). Measuring teamwork and patient safety attitudes of high-risk areas. Nursing Economy, 21(5), 211–218.
34.
KhademianZ.SharifF.TabeiS.BolandparvazS.AbbasiH. (2013). Teamwork improvement in emergency trauma departments. Iranian Journal of Nursing Midwifery Research, 18(4), 333–339.
35.
KhanM. M.LodhiS. A.Majid MakkiM. A. (2010). Team implicit coordination and emergency team performance. Pakistan Journal of Commerce & Social Sciences, 4(2), 166–172.
36.
KilnerE.SheppardL. A. (2010). The role of teamwork and communication in the emergency department: A systematic review. International Emergency Nursing, 1(8), 127–137.
37.
KorkmazM.TunaH. İ. (2014). The nurse-patient communication in critical care units. International Refereed Academic Journal of Sports, Health & Medical Sciences, 11(4), 14–23.
38.
LambrouP.PapastavrouE.MerkourisA.MiddletonN. (2015). Professional environment and patient safety in emergency departments. International Emergency Nursing, 23(2), 150–155.
39.
LazureP.St-GermainF.GryfeR.TrudeauM.HayesS. M. (2014). Communication—The foundation for collaborative relationships amongst providers, and between providers and patients: A case in breast and colorectal cancer. Journal of Communication in Healthcare, 7(11), 41–56.
40.
LuY.ZimringC. (2012). Can intensive care staff see their patients? An improved visibility analysis methodology. Environment and Behavior, 44(6), 861–876. doi:10.1177/0013916511405314
41.
MartinH. A.CiurzynskiS. M. (2015). Situation, background, assessment, and recommendation-guided huddles improve communication and teamwork in the emergency department. Journal of Emergency Nursing, 41(6), 484–488. doi:10.1016/j.jen.2015.05.017
42.
MazurenkoO.HearldL. (2015). Environmental factors associated with physician’s engagement in communication activities. Health Care Management Review, 40(1), 79–89.
43.
MiwaY.HanyuK. (2006). The effects of interior design on communication and impressions of a counselor in a counseling room. Environment & Behavior, 38(4), 484–502.
44.
MoreyJ. C. (2002). Error reduction and performance improvement in the emergency department through formal teamwork training: Evaluation results of the MedTeams project. Health Services Research, 37(6), 1553–1581.
45.
MorrishS. (2013). Streaming in the emergency department: An innovative care delivery design. Canadian Journal of Emergency Nursing (CJEN), 36(1), 11–13.
46.
PatiD. (2011). A framework for evaluating evidence in evidence-based design. Health Environments Research & Design Journal, 4(3), 50–71.
47.
PatiD.HarveyT.PatiS. (2014). Physical design correlates of efficiency and safety in emergency departments. Critical Care Nursing Quarterly, 8(2), 299–316.
48.
PatiD.HarveyT.ReddenP.SummersB.PatiS. (2015). An empirical examination of the impacts of decentralized nursing unit design. Health Environments Research & Design Journal, 8(2), 56–70.
49.
PersonJ.SpivaL.HartP. (2013). The culture of an emergency department: An ethnographic study. International Emergency Nursing, 2(1), 222–227. doi:10.1016/j.ienj.2012.10.001
50.
PolitiM. C.StreetR. L. (2011). The importance of communication in collaborative decision making: Facilitating shared mind and the management of uncertainty. Journal of Evaluation in Clinical Practice, 17(4), 579–584. doi:10.1111/j.1365-2753.2010.01549.x
51.
RashidM. (2009). Hospital design and face-to-face interaction among clinicians: A theoretical model. Health Environments Research & Design Journal, 2(4), 62–84.
52.
RashidM.KampschroerK.WinemanJ.ZimringC. (2006). Spatial layout and face-to-face interaction in offices- a study of the mechanisms of spatial effects on face-to-face interaction. Environment & Planning B: Planning & Design, 33(6), 825–844.
53.
RealK.BardachS. H.BardachD. R. (2016). The role of the built environment: How decentralized nurse stations shape communication, patient care processes, and patient outcomes. Health Communication, 1, 1–14.
54.
RisserD. T.RiceM. M.SalisburyM. L.SimonR.JayG. D.BernsS. D., & The MedTeams Research Consortium. (1999). The potential for improved teamwork to reduce medical errors in the emergency department. Annals of Emergency Medicine, 34(3), 373–383.
55.
RitcheyT.PatiD. (2008). Establishing an acute care nursing bed unit size: Employing a decision matrix framework. Health Environments Research & Design Journal, 1(4), 122–132.
56.
RixonS.BraafS.WilliamsA.LiewD.ManiasE. (2015). Pharmacists’ interprofessional communication about medications in specialty hospital settings. Health Communication, 30 (11), 1065–1075. doi:10.1080/10410236.2014.919697
57.
RobinsonF.GormanG.SlimmerL.YudkowskyR. (2010) Perceptions of effective and ineffective nurse-physician communication in hospitals. Nursing Forum, 45(3), 206–216.
58.
RosensteinA. H. (2002). Nurse-physician relationships: Impact on nurse satisfaction and retention. American Journal of Nursing, 102(6), 26–34.
59.
SalasE.RosenM. A.KingH. (2007). Managing teams managing crises: Principles of teamwork to improve patient safety in the Emergency Room and beyond. Theoretical Issues in Ergonomics Science, 8(5), 381–394.
60.
SchmutzJ.HoffmannF.HeimbergE.ManserT. (2015). Effective coordination in medical emergency teams: The moderating role of task type. European Journal of Work & Organizational Psychology, 24(5), 761–776. doi:10.1080/1359432X.2015.1018184
61.
ShapiroM. J.MoreyJ. C.SmallS. D.LangfordV.KaylorC. J.JagminasL.…JayG. D. (2004). Simulation based teamwork training for emergency department staff: Does it improve clinical team performance when added to an existing didactic teamwork curriculum. Quality & Safety in Health Care, 13(6), 417–421.
62.
SlovisT. L. (2008). The art of communication: Strategies to improve patient and information flow: Radiology perspective. Pediatric Radiology, 38(Suppl 4), S651–S654. doi:10.1007/s00247-008-0856-3
63.
SpencerR.CoieraE.LoganP. (2004). The practice of emergency medicine: Variation in communication loads on clinical staff in the emergency department. Annals of Emergency Medicine, 4(4), 268–273. doi:10.1016/j.annemergmed.2004.04.006
64.
SteinkeC. (2015). Assessing the physical service setting a look at emergency departments. Health Environments Research & Design Journal, 8(2), 31–42.
65.
SuryantoN. M.VirginiaP.BeverleyC. (2016). Collaboration between nurses and physicians in an Indonesian emergency department. Australasian Emergency Nursing Journal, 19 (2), 82–89.
66.
SuterE.ArndtJ.ArthurN.ParboosinghJ.TaylorE.DeutschlanderS. (2009). Role understanding and effective communication as core competencies for collaborative practice. Journal of Interprofessional Care, 23(1), 41–51. doi:10.1080/13561820802338579
67.
TrzpucS. J.MartinC. S. (2010). Application of space syntax theory in the study of medical-surgical nursing units in urban hospitals. Health Environments Research & Design Journal, 4(1), 34–55.
68.
UlrichR. S. (2003, 10). Creating a healing environment with evidence-based design. Paper presented at the American Institute of Architects Academy of Architecture for Health Virtual Seminar Healing Environments.
69.
UlrichR.ZimringC.ZhuX.DuBoseJ.SeoH.ChoiY.…JosephA. (2008). A review of the research literature on evidence-based healthcare design. Health Environments Research & Design Journal, 1(3), 61–125.
70.
ValentineM. A.NembhardI. M.EdmondsonA. C. (2015). Measuring teamwork in health care settings: A review of survey instruments. Medical Care, 53(4), e16–e30.
71.
van der VoordtT. (2015). Pre-occupancy evaluation of patient satisfaction in hospitals. Health Environments Research & Design Journal, 9(1), 110–124.
72.
WalshM.KnottJ. (2010). Satisfaction with the emergency department environment decreases with length of stay. Emergency Medicine Journal, 27(11), 821–828. doi:10.1136/emj.2009.079764
73.
WatkinsN.KennedyM.LeeN.O’NeillM.PeaveyE.DuCharmeM.PadillaC. (2012). Destination bedside: Using research findings to visualize optimal unit layouts and health information technology in support of bedside care. Journal of Nursing Administration, 42 (5), 256–265. doi:10.1097/NNA.0b013e3182480918
74.
WelchS. J. (2012). Using data to drive emergency department design: A metasynthesis. Health Environments Research & Design Journal, 5(3), 26–45.
75.
WellerJ.BoydM.CuminD. (2014). Teams, tribes and patient safety: Overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 89(1061), 149–154.
76.
WilliamsonA.KivesA. (1991). Nurse-physician collaboration in emergency services. Topics in Emergency Medicine, 13(3), 1–12.
77.
YiL.YijiaW. (2014). Design characteristics of acute care units in China. Health Environments Research & Design Journal, 8(1), 81–93.
78.
YingH.BeckerF.WurmserT.Bliss-HoltzJ.HedgesC. (2012). Effects of nursing unit spatial layout on nursing team communication patterns, quality of care, and patient safety. Health Environments Research & Design Journal, 6(1), 8–38.
79.
ZborowskyT.Bunker-HeilmichL.MorelliA.O’NeillM. (2010). Centralized vs. decentralized nursing stations: Effects on nurses’ functional use of space and work environment. Health Environments Research & Design Journal, 3(4), 19–42.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
