title: Perceived incivility during emergency department phone consultations.
abstract: OBJECTIVE
  Perceived incivility during ED medical phone consultations is poorly researched. We aimed to determine frequency and factors influencing perceived incivility during ED phone consultations.
  
  
  METHODS
  We conducted a prospective self-reported survey of 40 consecutive phone consultations for 21 ED volunteer doctors. Consultations were classified based on the aim of consultation and deemed as 'positive', 'neutral' or 'negative' based on the perceptions of the consulting doctor. Training levels, time bands and specialty data were collected for both consulting and consulted parties.
  
  
  RESULTS
  Fifty-seven of 714 included consultations (7.98%, 95% CI 6.2-10.2%) were reported as negative by ED medical staff. Factors associated with significant incidence of negative grading of consultation involved requests for investigations (19.3% vs 5.3%, P < 0.01), consultations with specialist trainees postgraduate year > 4 (9.1% vs 3.8%, P < 0.01) and those involving radiology specialty (18% vs 5.32%, P < 0.01). The risk was lower when the consulted professional was a specialist medical practitioner as compared to specialist trainee (4.1% vs 9.4%, P = 0.02). Multiple logistical modelling suggests that female (adjusted OR 2.4, 95% CI 1.1-5.2) medical staff are more likely to report perceived incivility during ED phone consultations.
  
  
  CONCLUSIONS
  Perceived incivility occurs infrequently during ED phone consultations. ED female medical staff are at an increased risk of perceived incivility during phone consultations with non-ED medical professionals. Health organisations should actively pursue programmes to investigate the occurrence of incivility during healthcare consultations and implement programmes to mitigate the risk of developing a negative workplace culture.
authors.affiliation: Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.|Westmead Emergency Medical Research Unit, Westmead Hospital, Sydney, New South Wales, Australia.|NHMRC Centre of Research Excellence, Westmead Millennium Institute, Sydney, New South Wales, Australia.|Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Amith L
authors.initials: AL
authors.lastname: Shetty
authors.affiliation: Westmead Emergency Medical Research Unit, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Milan
authors.identifier: http://orcid.org/0000-0003-0128-4757
authors.initials: M
authors.lastname: Vaghasiya
authors.affiliation: Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.|Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Boddy
authors.affiliation: NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Byth
authors.affiliation: Emergency Department, Westmead Hospital, Sydney, New South Wales, Australia.|Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Unwin
mesh_terms: D000328:Adult; D003142:Communication; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013689:Telephone; D017132:Workplace / Q000523:psychology
keywords: consultation and referral; emergency departments; incivility; interdisciplinary communication; personal satisfaction