Handling communication challenges at the emergency department entry: Insights from a Belgian hospital.

Abstract

Effective communication at the emergency department (ED) is essential for quality care and a positive patient experience. While prior research has focused on communication in clinical encounters, the ED entry and its staff remain understudied. This study explores the communication challenges faced by staff at the ED entry and the strategies they use to handle them. This study is part of a larger linguistic ethnographic study in a Belgian hospital's ED. Ethnographic observations informed 11 semi-structured interviews with ED entry staff (medical administration staff, dispatching staff, and triage nurses). A thematic analysis was conducted on the interview transcripts to determine recurring themes. Participants identified communication challenges due to (1) linguistic differences, (2) patients' mental or physical distress, and (3) insufficient information exchange within the hospital. Strategies to handle these challenges included (1) language mediation, via translation apps, patient companions, and multilingual staff as informal interpreters, and professional interpreters, and (2) adaptations in communication style, including use of non-verbal cues, clear communication, and positive mindset. Communication challenges at the ED entry are multifaceted and not limited to linguistic differences. Staff frequently rely on pragmatic strategies to 'manage communication'. However, these are not the ideal solution as they risk creating false fluency and can potentially compromise patient safety and positive patient experience. This study suggests that there is a need for a better understanding of the ED entry and the specific requirements of the context and the staff who work there. Effective communication and knowledge of the necessary resources for effective communication are essential for delivering high-quality care and safeguarding patient safety and experience.