The physical space where patient care delivery is conducted, known as the health care work environment is the setting where clinicians deliver health care services to patients requiring care across the spectrum of health states [1], [2], [3]. The work environment is a context for human activities and interactions such as work, wherein humans and the activities they do co-create the physical space. Physical space is developed around the activities humans do and what they value [3]. The physical space of work environments is commonly modified to improve the quality and/or efficiency of patient care services through renovation or expansion projects [3]. In this manuscript, the term work environment is used to describe the atmosphere created by the healthcare staff within the physical workspace.

Emergency departments (EDs) represent a unique health care setting because they serve as a primary entrance into hospitals, [4] they operate 24/7 to accommodate acute to chronic illnesses, and they represent a safety net for patients without financial resources to receive outpatient care [5]. Due to the steady influx of patients presenting to hospitals and the additional surge seen with the COVID-19 outbreak [6], hospitals worldwide adapted to patient crowding in part by expanding their EDs. The physical space and design of an ED significantly impacts the workflow [7] and efficiency [8], [9] of the department; therefore, in order to improve the quality of patient care delivery, the structure of the ED must be optimal.

Findings from existing literature on ED physical spaces have identified two significant ED work environment configurations, centralized and decentralized [10], and associated impacts to patient care delivery [11]. Centralized EDs are those that have work stations placed within a central part of a unit. Decentralized ED spaces are those that have workspaces distributed throughout the unit (e.g., in pods) [10]. Centralized work stations are cited to have staff readily available for team collaboration in patient care delivery [12]. A study by Zamani [13] assessing ED efficiency and physical space design found that central nursing work stations resulted in restricted visibility of patient rooms among RNs, which in turn reduced staff satisfaction. Participants perceived that decentralized work stations increased work efficiency due to increased visibility and access to patient rooms and team support [13].

Physical space renovation in this study pertains to the expansion or move of a health care work environment (i.e., moves from an old to new space) [14], [15], [16]. In this study, the terms ‘reconfiguration’ and ‘renovation’ are used interchangeably. Despite existing research on ED physical space design, staff satisfaction, and work efficiency, there is scant research describing how physical space renovations impact interprofessional collaboration (i.e., RNs, patient care technicians [PCTs], and physicians [MDs]), patient care delivery, and clinician job satisfaction in EDs specifically. Each of these aspects informs the quality of an ED to function properly under high-stakes patient care experiences. Clinicians witness firsthand the problems that arise from a poorly designed workstation and should have their input utilized to guide the construction. Understanding how space impacts job satisfaction is critical as well given worldwide increases in clinician burnout, moral distress, and associated/costly turnover [17], [18], [19]. Health care organizations seeking to expand or update their physical workspaces must use their financial resources efficiently, and thus have minimal room to accommodate additional financial burdens associated with clinician burnout and turnover.

The purpose of this study was to describe how physical space reconfiguration in an emergency department (ED) impacts perceived interprofessional collaboration, patient care delivery, and clinician job satisfaction. In this study interprofessional collaboration was considered the communication and participation of clinicians from different professional groups (i.e., RN, PCT, MD) in health care delivery. Patient care delivery was considered clinicians’ perceived ability to deliver safe, efficient, and effective care to patients [20], [21]. Job satisfaction in this study pertained to the perceived fulfillment of desired needs within the work environment from a job values or gratification perspective [22], [23]. Job satisfaction can encompass aspects of perceived safety, control over work infrastructure, relationship with coworkers and/or relationships with patients. Job satisfaction attributes, as discussed by Liu and colleagues [23] can pertain to emotional, demographic, or environmental variables at work.

Space reconfiguration in this study was considered a move from an old ED to new ED space. Examining the aspects of space configuration in the ED is important to inform health care organization space expansion projects. Such projects are common in health care organizations as the demand to accommodate rising patient volume increases in the United States (U.S.) and in other countries [10], [11].