title: Tumultuous atmosphere (physical, mental), the main barrier to emergency department inter-professional communication.
abstract: BACKGROUND
  A highly important factor in enhancing quality of patient care and job satisfaction of health care staff is inter-professional communication. Due to the critical nature of the work environment, the large number of staff and units, and complexity of professional tasks and interventions, inter-professional communication in an emergency department is particularly and exceptionally important. Despite its importance, inter-professional communication in emergency department seems unfavorable. Thus, this study was designed to explain barriers to inter-professional communication in an emergency department.
  
  
  METHODS
  This was a qualitative study with content analysis approach, based on interviews conducted with 26 participants selected purposively, with diversity of occupation, position, age, gender, history, and place of work. Interviews were in-depth and semi-structured, and data were analyzed using the inductive content analysis approach.
  
  
  RESULTS
  In total, 251 initial codes were extracted from 30 interviews (some of the participants re-interviewed) and in the reducing trend of final results, 5 categories were extracted including overcrowded emergency, stressful emergency environment, not discerning emergency conditions, ineffective management, and inefficient communication channels. Tumultuous atmosphere (physical, mental) was the common theme between categories, and was decided to be the main barrier to effective inter-professional communication.
  
  
  CONCLUSIONS
  Tumultuous atmosphere (physical-mental) was found to be the most important barrier to inter-professional communication. This study provided a better understanding of these barriers in emergency department, often neglected in most studies. It is held that by reducing environmental turmoil (physical-mental), inter-professional communication can be improved, thereby improving patient care outcomes and personnel job satisfaction.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Jafari Varjoshani
authors.affiliation: Postdoctoral Fellow of Knowledge Transfer in Cardiac Rehabilitation from UTS, Sydney, Australia BSN, RN, MSN, MS in Medical Education, PhD in Higher Education Administration Head of Rehabilitation Management Group University of Social Welfare and Rehabilitation Sciences[Associate professor]. mahmaimy2020@gmail.com.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Hosseini
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Khankeh
authors.forename: Fazlollah
authors.initials: F
authors.lastname: Ahmadi
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008297:Male; D036301:Qualitative Research; D012931:Social Environment