A Team Approach to Patient-Centered Communication in the Emergency Department.

Abstract

Patient-centered communication (PCC) underpins high-quality medical care, yet its traditional dyadic, longitudinal models are ill-suited to the emergency department (ED). In the ED, visits are brief, unpredictable, and often involve clinicians and patients with no prior relationship. This mismatch creates a paradox: the fast-paced, high-uncertainty environment heightens the need for PCC while simultaneously impeding its enactment. Drawing on the science of teamwork, we propose conceptualizing PCC as a team process. Our approach reconceptualizes communication as a coordinated, interdisciplinary process. In this model, an ED PCC team-comprising physicians, nurses, ancillary staff, and the patient (and caregivers when appropriate)-functions as a "swift-starting action team," required to achieve high-stakes goals shortly after formation. By integrating teamwork constructs, including the input-process-outcome-input model and the consideration of team cognition, our proposed conceptualization expands the scope of PCC research and creates a pathway to design interventions that facilitate PCC in the fast-paced ED setting. This opens new avenues for research, education, and quality improvement across emergency settings.