Morgan Sonya, Pullon Susan, McKinlay Eileen, Garrett Susan, Kennedy Jonathan, Watson Bruce
Department of Primary Health Care and General Practice, University of Otago Wellington, New Zealand.
Faculty of Built Environment, 7800University of New South Wales, Sydney, Australia.
HERD. 2021 Jan;14(1):190-209. doi: 10.1177/1937586720939665. Epub 2020 Jul 24.
Quality patient care in primary care settings, especially for patients with complex long-term health needs, is improved by interprofessional collaborative practice. Effective collaboration is achieved in large part by frequent informal face-to-face "on-the-fly" communication between team members. Research undertaken in hospitals shows that interior architecture influences informal communication and collaboration between staff. However, little is known about how the interior architecture of primary care practices might facilitate or hinder informal communication and collaboration among primary care staff.
This research explores the influence of primary care practice interior architecture on face-to-face on-the-fly communication for collaborative care.
An observational study was undertaken to compare face-to-face informal interactions between staff in three primary care practices of differing interior architecture. Data collected from practices included: direct observations floor plans, photographs, interviews, and surveys.
Most primary care staff engaged in frequent, brief face-to-face interactions, which appeared to be key to the delivery of effective collaboration. Features of primary care practice designs that were associated with increased frequency of staff interaction included shared spaces, staff proximity/visibility, and the presence of convenient circulatory and transitional spaces where staff were able to easily engage in timely on-the-fly communication with colleagues.
The interior architecture of primary care practices has an important impact on staff collaboration. Although more research is needed to investigate further details in more practices, close attention should nevertheless be paid to maximizing opportunities for brief face-to-face communication in well-designed shared spaces in primary care practices.
在基层医疗环境中，跨专业协作实践可提升优质的患者护理，尤其是对于有复杂长期健康需求的患者。有效的协作很大程度上通过团队成员之间频繁的非正式面对面“即时”沟通来实现。在医院进行的研究表明，内部建筑设计会影响员工之间的非正式沟通与协作。然而，对于基层医疗实践的内部建筑设计如何促进或阻碍基层医疗人员之间的非正式沟通与协作，我们知之甚少。
本研究探讨基层医疗实践的内部建筑设计对协作护理中面对面即时沟通的影响。
进行了一项观察性研究，以比较三种内部建筑设计不同的基层医疗实践中员工之间的面对面非正式互动。从这些实践中收集的数据包括：直接观察、楼层平面图、照片、访谈和调查。
大多数基层医疗人员进行频繁、简短的面对面互动，这似乎是实现有效协作的关键。与员工互动频率增加相关的基层医疗实践设计特征包括共享空间、员工的接近度/可见度，以及存在方便的流通和过渡空间，员工能够在这些空间轻松地与同事进行及时的即时沟通。
基层医疗实践的内部建筑设计对员工协作有重要影响。尽管需要更多研究来进一步调查更多实践中的细节，但仍应密切关注在设计良好的基层医疗共享空间中最大化简短面对面沟通机会。
