Strengths and weaknesses in team communication processes in a UK emergency department setting: findings using the Communication Assessment Tool-Team

Introduction: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: The CAT-T survey may be used within a UK setting to identify discrete strengths and weaknesses in ED team communication.

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