The Social Logic of Nursing Communication and Team Processes in Centralized and Decentralized Work Spaces
Abstract
This pre-post multi-method study explored how nurses made sense of changes in nurse station design and how they characterized communication processes within a hospital unit before and after it moved from an existing hospital into a newly designed trauma-1 level hospital. Quantitative observations (116 h) of real-time communication were gathered in both hospitals. Additionally, 41 nursing staff (nurses, nursing care technicians, nurse managers) participated in a qualitative study. Three months before moving, four focus groups were conducted with 16 nursing professionals working in traditional centralized nurse station units. One year later, four additional focus groups were conducted with 25 nursing staff in new decentralized units. The observational data resulted in two key findings: first, nursing staff participated in about 70 percent of interactions with nurses, techs, doctors, and families. Second, nursing communication decreased in decentralized units. In-depth qualitative analysis revealed that nursing communication was more frequent, relational and supportive in centralized spaces while distinguished by fragmentation and information exchange in decentralized units. Drawing upon theories of supportive design and healthcare systems, these findings illustrate how nurses in centralized units characterized communication as proximity, teamwork and relationships. Nurses in decentralized units described communication in terms of distance, fragmentation, and information exchang…
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Workstation distance and layout impact communication and patient interaction.
“Studies on the workstation’s distance and layout have shown their impact on communication and patient interaction.”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [304]
Increased distance can foster more private conversations with patients and other staff members.
“On the other hand, the increased distance can foster more private conversations with patients and other staff members, but it may raise potential concerns regarding delayed response times and reduced peer support [303,304].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [304]
Increased distance may raise concerns regarding delayed response times and reduced peer support.
“On the other hand, the increased distance can foster more private conversations with patients and other staff members, but it may raise potential concerns regarding delayed response times and reduced peer support [303,304].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [304]
Cites
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Glaser, B. G., Strauss, A. L., & Strutzel, E. (1968) · Nursing Research · doi:10.1097/00006199-196807000-00014 · Cited by 39,449 · see citing works
A 36-hospital time and motion study: how do medical-surgical nurses spend their time?
Hendrich, A., Chow, M. P., Skierczynski, B. A., & Lu, Z. (2008) · The Permanente Journal · doi:10.7812/tpp/08-021 · Cited by 530 · cited 2× · see citing works
“patients, walking, and spending more time searching for others (Hendrich et al., 2008; Pati et al., 2015).”
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Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors
Yen, C., Epling, J. W., Rockwell, M., & Vaughn-Cooke, M. (2026) · Diagnostics · doi:10.3390/diagnostics16020347 · Cited by 6 · see citing works
- Authors
- Real, K., Santiago, J., Fay, L., Isaacs, K., & Carll-White, A.
- Affiliations
- University of Kentucky (US)
- University of Kentucky HealthCare (US)
- Department of Interiors, College of Design, University of Kentucky
- Corresponding author
- Real, Kevin
- Venue
- Health Communication
- Publisher
- Informa UK Limited
- Published
- 2018-10-25
- Volume
- 34
- Issue
- 14
- Pages
- 1751-1763
- ISSN
- 1041-0236 (ISSN-L)
- 1532-7027
- OpenAlex
- W2898195654
- Cited by
- 23
- References
- 2
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 8 · 2023: 1 · 2022: 5 · 2021: 1 · 2018: 1
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Communication (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Social Sciences › Psychology › Social Psychology › Facilities and Workplace Management
- Social Sciences › Urban Studies › Healthcare Facilities Design and Sustainability
- Keywords
- nursing communication, team processes, information fragmentation, nurses' perceptions
- MeSH terms
- Communication, Female, Health Personnel, Hospital Design and Construction, Humans, Male, Nursing Staff, Hospital, Politics, Focus Groups, Qualitative Research, Nursing Stations
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