title: Review article: Staff perception of the emergency department working environment: Integrative review of the literature.
abstract: Employees in EDs report increasing role overload because of critical staff shortages, budgetary cuts and increased patient numbers and acuity. Such overload could compromise staff satisfaction with their working environment. This integrative review identifies, synthesises and evaluates current research around staff perceptions of the working conditions in EDs. A systematic search of relevant databases, using MeSH descriptors ED/EDs, Emergency room/s, ER/s, or A&E coupled with (and) working environment, working condition/s, staff perception/s, as well as reference chaining was conducted. We identified 31 key studies that were evaluated using the mixed methods assessment tool (MMAT). These comprised 24 quantitative-descriptive studies, four mixed descriptive/comparative (non-randomised controlled trial) studies and three qualitative studies. Studies included varied widely in quality with MMAT scores ranging from 0% to 100%. A key finding was that perceptions of working environment varied across clinical staff and study location, but that high levels of autonomy and teamwork offset stress around high pressure and high volume workloads. The large range of tools used to assess staff perception of working environment limits the comparability of the studies. A dearth of intervention studies around enhancing working environments in EDs limits the capacity to recommend evidence-based interventions to improve staff morale.
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.|Emergency Department, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Johnston
authors.affiliation: Department of Emergency Medicine, Nambour Hospital, Nambour, Queensland, Australia.|Department of Emergency Medicine, Caloundra Hospital, Caloundra, Queensland, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Abraham
authors.affiliation: Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Jaimi
authors.initials: J
authors.lastname: Greenslade
authors.affiliation: Department of Emergency Medicine, Nambour Hospital, Nambour, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Ogilvie
authors.initials: O
authors.lastname: Thom
authors.affiliation: Sahlgrenska, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Eric
authors.initials: E
authors.lastname: Carlstrom
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.|School of Nursing and Midwifery, University of the Sunshine Coast, Maroochydore, Queensland, Australia.
authors.forename: Marianne
authors.initials: M
authors.lastname: Wallis
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.|Emergency Department, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Crilly
mesh_terms: D001291:Attitude of Health Personnel; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D013315:Stress, Psychological / Q000453:epidemiology; D000078329:Workforce; D017132:Workplace / Q000523:psychology
keywords: ED; integrative review; staff perception; working condition; working environment