THE COLLABORATIVE ROLE OF HEALTHCARE PROVIDERS IN EMERGENCY PATIENT CARE: INTEGRATION OF MEDICAL RECORDS STAFF, NURSING, PHYSICIANS, RADIOLOGY, AND PHARMACY SERVICES
Main Article Content
Keywords
Emergency department, interprofessional collaboration, healthcare integration, Saudi Arabia, communication, workflow coordination, electronic medical records, pharmacy services, mixed-methods, patient safety.
Abstract
Effective interprofessional collaboration is essential to ensuring timely, coordinated, and high-quality emergency care. This study investigates the collaborative dynamics among physicians, nurses, pharmacists, radiology staff, and medical records personnel in the emergency department (ED) of a tertiary care hospital in Saudi Arabia. Utilizing a convergent mixed-methods design, quantitative data were collected via a validated 30-item survey (n = 160), while qualitative insights were gathered through semi-structured interviews with 20 healthcare professionals. Results showed high overall collaboration levels (Mean = 4.01), with interprofessional communication receiving the highest domain score (Mean = 4.12), followed by workflow coordination and role clarity. However, access to electronic medical records emerged as a notable barrier, with the lowest average rating (Mean = 3.77). Correlation analysis revealed strong relationships between communication and workflow efficiency. Thematic analysis identified four key challenges: communication breakdowns, delayed record access, role overlap, and misalignment between clinical and pharmacy workflows. Joint interpretation highlighted that strong interpersonal coordination is often undermined by infrastructural and process-level constraints. The study underscores the importance of integrating clinical and support services through both team-based and system-level interventions. Recommendations include optimizing EMR systems, embedding pharmacy support in the ED, and standardizing handover protocols. These findings align with global frameworks on people-centered and integrated emergency care and offer actionable strategies for enhancing collaboration and care delivery in high-pressure environments. The insights are relevant to hospital administrators, policymakers, and emergency managers aiming to improve system responsiveness and patient outcomes.
Downloads
References
Agency for Healthcare Research and Quality. (2023). TeamSTEPPS® 3.0 curriculum materials. U.S. Department of Health and Human Services. Retrieved July 31, 2025, from https://www.ahrq.gov/teamstepps-program/index.html ahrq.gov Gittell, J. H., Logan, C., Cronenwett, J., Foster, T. C., Freeman, R., Godfrey, M., & Collins Vidal, D. (2020). Impact of relational coordination on staff and patient outcomes in outpatient surgical clinics. Health Care Management Review, 45(1), 12–20. https://doi.org/10.1097/HMR.0000000000000192 PubMed House, S., Wilmoth, M., & Kitzmiller, R. (2022). Relational coordination and staff outcomes among healthcare professionals: A scoping review. Journal of Interprofessional Care, 36(6), 891–899. https://doi.org/10.1080/13561820.2021.1965101 PubMed Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: A systematic review. BMJ Open, 8(8), e022202. https://doi.org/10.1136/bmjopen-2018-022202 PubMed Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 2017(6), CD000072. https://doi.org/10.1002/14651858.CD000072.pub3 PubMed Skains, R. M., Hayes, J. M., Selman, K., Zhang, Y., Thatphet, P., Toda, K., … Liu, S. W. (2025). Emergency department programs to support medication safety in older adults: A systematic review and meta-analysis. JAMA Network Open, 8(3), e250814. https://doi.org/10.1001/jamanetworkopen.2025.0814 PubMed World Health Organization. (2010). Framework for action on interprofessional education & collaborative practice. Author. https://apps.who.int/iris/bitstream/handle/10665/70185/WHO_HRH_HPN_10.3_eng.pdf apps.who.int World Health Organization. (2016). Framework on integrated, people-centred health services: Report by the Secretariat (A69/39). Author. https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_39-en.pdf apps.who.int • Joseph, A. G., Saji, S., Kumbhar, A. N., Shivakumar, G., Bhandari, R., & Ganachari, M. S. (2024). Pharmacists’ medication reconciliation interventions during admission and transfer from an emergency department at a tertiary care hospital: A randomized pilot study and evaluation of physician and patient perceptions. Current Drug Safety, 19(3), 368–376. https://doi.org/10.2174/1574886318666230911144912 PubMed • Freitas, P. S. d., de Mendonça, G. S., & Resende, E. S. (2023). Implementation of the Lean Healthcare system in the emergency room of the Clinical Hospital of the Federal University of Uberlândia: A case study. International Journal of Environmental Research and Public Health, 20(24), 7184.* https://doi.org/10.3390/ijerph20247184* MDPI • Gupta, A., Kumari, R., & Alqahtani, A. (2025). Barriers, challenges, and facilitators experienced by healthcare professionals in providing immediate and efficient care in the emergency department: A mixed-methods study. Cureus, 17(6), e86089.* https://doi.org/10.7759/cureus.86089* PMC • Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of electronic health record implementation and barriers to adoption and use: A scoping review and qualitative analysis. Life, 10(12), 327.* https://doi.org/10.3390/life10120327* PMC • Borawski, S., Ralph, J., & Mulcaster, A. (2025). Barriers and facilitators to nurse-provider communication in the emergency department: A scoping review. Canadian Journal of Nursing Research. Advance online publication. https://doi.org/10.1177/08445621251320710 PubMed • Dhanaliwala, A. H., Deutsch, A. J., Moon, J., Lalevic, D., Chambers, C., & Cook, T. S. (2025). Development and deployment of an emergency department radiology dashboard to improve communication and transparency of radiologic imaging and report status. Journal of the American College of Radiology, 22(2), 191–199.* https://doi.org/10.1016/j.jacr.2024.11.024* PubMed • Jhala, K., McPeake, F., Uyeda, J. W., Pianykh, O. S., & Sodickson, A. D. (2025). Bridging the gap: Evaluation of a supplemental surge staffing model to maintain radiology turnaround times amid labor constraints. Journal of the American College of Radiology, 22(4), 495–504.* https://doi.org/10.1016/j.jacr.2024.11.004* PubMed • Choi, Y. J., & Kim, H. (2019). Effect of pharmacy-led medication reconciliation in emergency departments: A systematic review and meta-analysis. Journal of Clinical Pharmacy and Therapeutics, 44(6), 932–945.* https://doi.org/10.1111/jcpt.13019* PubMed • Iscoe, M. S., Holland, M. L., Paek, H., Flood, C., & Melnick, E. R. (2022). Emergency physicians’ EHR use across hospitals: A cross-sectional analysis. American Journal of Emergency Medicine, 61, 205–207.* https://doi.org/10.1016/j.ajem.2022.07.014* PubMed • James, T. G., Mangus, C. W., Parker, S. J., Cassady, C. M., & Mahajan, P. (2025). “Everything is electronic health record-driven”: The role of the electronic health record in the emergency department diagnostic process. JAMIA Open, 8(2), ooaf029.* https://doi.org/10.1093/jamiaopen/ooaf029* PubMed • Cahill, M., Cleary, B. J., & Cullinan, S. (2025). The influence of electronic health record design on usability and medication safety: Systematic review. BMC Health Services Research, 25, 31.* https://doi.org/10.1186/s12913-024-12060-2* BioMed Central • Pierce, R. P., Eskridge, B. R., Rehard, L., Ross, B., Day, M. A., & Belden, J. L. (2020). The effect of electronic health record usability redesign on annual screening rates in an ambulatory setting. Applied Clinical Informatics, 11(4), 580–588.* https://doi.org/10.1055/s-0040-1715828* PubMed • Boiko, O., Edwards, M., Zschaler, S., Miles, S., & Rafferty, A. M. (2021). Interprofessional barriers in patient flow management: An interview study of the views of emergency department staff involved in patient admissions. Journal of Interprofessional Care, 35(3), 334–342.* https://doi.org/10.1080/13561820.2020.1760223* PubMed • White, B. A., Bravard, M. A., Kobayashi, K. J., Ziperstein, J. C., Strauss, J. L., Hughes, M., & Raja, A. S. (2019). Improving handoff efficiency for admitted patients: A multidisciplinary, lean-based approach. American Journal of Emergency Medicine, 37(6), 1202–1203.* https://doi.org/10.1016/j.ajem.2018.11.003* PubMed • Vermeulen, M. J., Stukel, T. A., Guttmann, A., Rowe, B. H., Zwarenstein, M., Golden, B., … Schull, M. J. (2014). Evaluation of an emergency department lean process improvement program to reduce length of stay. Annals of Emergency Medicine, 64(5), 427–438.* https://doi.org/10.1016/j.annemergmed.2014.06.007* PubMed • White, B. A., Yun, B. J., Lev, M. H., & Raja, A. S. (2017). Applying systems engineering reduces radiology transport cycle times in the emergency department. Western Journal of Emergency Medicine, 18(3), 410–418.* https://doi.org/10.5811/westjem.2016.12.32457* PubMed • White, B. A., Chang, Y., Grabowski, B. G., & Brown, D. F. M. (2014). Using lean-based systems engineering to increase capacity in the emergency department. Western Journal of Emergency Medicine, 15(7), 770–776.* https://doi.org/10.5811/westjem.2014.8.21272* PubMed • Flug, J. A., Stellmaker, J. A., Tollefson, C. D., Comstock, E. M., Buelna, E., Truman, B., … Jokerst, C. E. (2022). Improving turnaround time in a hospital-based CT division with the Kaizen method. Radiographics, 42(4), E125–E131.* https://doi.org/10.1148/rg.210128* PubMed • Tyler, S., Davis, R., & Patel, N. (2024). Use of artificial intelligence in triage in hospital emergency departments: A scoping review. Cureus, 16(5), e59906.* https://doi.org/10.7759/cureus.59906* PubMed • Almulihi, Q. A., Alotaibi, S., Alzahrani, A., & Alshamrani, M. (2024). Applications of artificial intelligence and machine learning in emergency medicine triage: A systematic review. Medical Archives, 78(3), 198–206.* https://doi.org/10.5455/medarh.2024.78.198-206* PubMed
Article Sidebar
Article Details
Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.