title: Strengths and weaknesses in team communication processes in a UK emergency department setting: findings using the Communication Assessment Tool-Team.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  The CAT-T survey may be used within a UK setting to identify discrete strengths and weaknesses in ED team communication.
authors.affiliation: aEmergency Department, Derriford Hospital bPlymouth University Peninsula School of Medicine and Dentistry, Plymouth cAcademic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK.
authors.forename: Blair
authors.initials: B
authors.lastname: Graham
authors.forename: Jason E
authors.initials: JE
authors.lastname: Smith
authors.forename: Doyo
authors.initials: D
authors.lastname: Enki
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D011379:Prognosis; D058996:Quality Improvement; D018570:Risk Assessment; D016896:Treatment Outcome; D014218:Triage / Q000379:methods; D006113:United Kingdom; D014850:Waiting Lists