The physical environment and multi-professional teamwork in three newly built stroke units

Abstract

Purpose: To explore multi-professional teamwork in relation to the physical environment in three newly built or renovated stroke units. Materials and methods: An observational study was undertaken. The participants were all staff members of a multi-professional team working in the reviewed stroke units. The data were collected using behavioural mapping and semi-structured observations, and they were analysed by content analysis and descriptive statistics. Results: Out of all the observations in the behavioural mapping, very few were of two or more members from the team together with a patient. None of the included stroke units had a co-location for all the members of the multi-professional team. Three main categories emerged from the analysis of the interviews: (i) the hub of the unit; (ii) the division of places; and (iii) power imbalance. All the categories reflected the teamwork in relation to parts of the physical environment. Conclusion: The design of the physical environment is important for multi-professional teamwork. Emphasis must be placed on better understanding the impact of the physical environment and on incorporating the evidence related to multi-professional teamwork during the design of stroke units. ä IMPLICATIONS FOR REHABILITATION Understanding the link between the physical environment and effective teamwork can lead to more tailored and supportive design solutions. The design of the physical environment should be considered as a vital part of effective teamwork in stroke units. The physical environment should include shared workstations, allowing team members to meet and communicate face to face.

Built environments for inpatient stroke rehabilitation services and care: a systematic literature review

“…31 An observational study of multiprofessional teamwork in three stroke units found that the design of the included stroke units did not appear to foster multiprofessional teamwork: Centrally located staff workplaces, such as the nurses' stations, created visible hubs but were not appropriate for confidential discussions between staff; none of the stroke units had dedicated rooms for multiprofessional meetings; and each profession worked mainly in their own dedicated offices. 48 The qualitative meta-synthesis conducted by O'Halloran et al 46 addressed the question of patient/staff communication and concluded that high levels of background noise, visual distractions and a lack of single-bed rooms acted as environmental barriers to communication between patients and staff. In another qualitative study, occupational therapists reported adapting their treatment sessions according to the available space, indicating that the suitability of therapy spaces impacts treatment decision-making.…”

Why hospital design matters: A narrative review of built environments research relevant to stroke care

“…11 Shared staff spaces support team communication and collaboration, enabling better understanding of patient needs, and greater knowledge about other team roles. 58,59 Therapy spaces are often discrete locations (e.g. gym, occupational therapy rooms), rather than being holistic, context-based environments that reflect the connectivity and continuity necessary for rehabilitation and transition beyond discharge.…”