Investigating the Role of the Physical Environment on Communication Patterns in Emergency Departments During Caregiving for Pediatric Mental and Behavioral Health Patients

ObjectiveThis study investigates how the physical environment influences communication dynamics among staff members, pediatric mental and behavioral health (MBH) patients, and their families in the emergency department (ED).BackgroundThe United States faces a public health challenge as MBH conditions in school-age children contribute to an increasing number of ED visits. Effective communication plays a pivotal role in pediatric MBH caregiving, where challenges often arise due to the sensitive nature of these conditions.MethodsThis qualitative study involved observations and semistructured interviews with 55 care providers across four hospital-based EDs in the southeastern United States.ResultsQualitative thematic analysis of the interviews identified physical environment impacts on communication at three scales: unit, staff workstation, and patient care space. This study identified aspects of the physical environment, such as proximity, visibility, crowding, and privacy as influential factors in communication patterns for the MBH care process in ED.ConclusionsThe physical environment has an essential impact on communication patterns and care delivery for the increasing number of pediatric MBH patients in the ED.