aEmergency Department, Derriford Hospital bPlymouth University Peninsula School of Medicine and Dentistry, Plymouth cAcademic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK.
Eur J Emerg Med. 2017 Dec;24(6):e1-e5. doi: 10.1097/MEJ.0000000000000395.
Identifying weaknesses in emergency department (ED) communication may highlight areas where quality improvement may be beneficial. This study explores whether the Communication Assessment Tool-Team (CAT-T) survey can identify communication strengths and weaknesses in a UK setting.
This study aimed to determine the frequency of patient responses for each item on the CAT-T survey and to compare the proportion of responses according to patient and operational characteristics.
Adults presenting to the minors area of a semi-urban ED between April and May 2015 were included. Those lacking capacity or in custody were excluded. Multivariate analysis identified associations between responses and demographic/operational characteristics.
A total of 407/526 eligible patients responded (77.3%). Respondents were mostly White British (93.9%), with a median age of 45 years. Most responses were obtained during daytime hours (84.2% between 08 : 00 and 18 : 00). The median reported times to triage, assessment and disposition were 15, 35 and 90 min, respectively. Items most frequently rated as 'very good'/'excellent' (strengths) were 'ambulance staff treated me with respect' (86.7%), ED staff 'let me talk without interruptions' (85%) and 'paid attention to me' (83.7%). Items most frequently rated as 'poor'/'fair' (weaknesses) were 'encouraged me to ask questions', 'reception treated me with respect' (10.4%) and 'staff showed an interest in my health' (6.8%). Arrival time, analgesia at triage and time to assessment were associated with significantly increased odds of positive perception of team communication for a range of items.
The CAT-T survey may be used within a UK setting to identify discrete strengths and weaknesses in ED team communication.
识别急诊科（ED）沟通中的弱点可以突出可能有利于质量改进的领域。本研究探讨了沟通评估工具-团队（CAT-T）调查是否可以在英国环境中识别沟通的优势和劣势。
本研究旨在确定 CAT-T 调查中每个项目的患者回答频率，并比较根据患者和运营特点的响应比例。
纳入 2015 年 4 月至 5 月期间在半城市 ED 未成年人区就诊的成年人。排除无能力或被拘留的患者。多变量分析确定了响应与人口统计学/运营特征之间的关联。
共有 407/526 名符合条件的患者（77.3%）做出了回应。受访者主要为白种英国人（93.9%），中位年龄为 45 岁。大多数回应发生在白天时段（08：00 至 18：00 之间占 84.2%）。报告的分诊、评估和处置中位数时间分别为 15、35 和 90 分钟。最常被评为“非常好”/“优秀”（优势）的项目是“救护人员对我很尊重”（86.7%）、ED 工作人员“让我畅所欲言而不打断”（85%）和“关注我”（83.7%）。最常被评为“差”/“一般”（劣势）的项目是“鼓励我提问”、“接待人员对我很尊重”（10.4%）和“工作人员对我的健康表示关心”（6.8%）。到达时间、分诊时的镇痛和评估时间与一系列项目中对团队沟通的积极感知显著相关。
CAT-T 调查可在英国环境中用于识别 ED 团队沟通中的离散优势和劣势。
