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Communicating information effectively is a vital means for reducing uncertainty during crises, but how leaders should inform organizational members amid chaos is far from straightforward. Using a sequential qualitative to quantitative mixed-methods study design, we explored frontline clinician experience with information dissemination strategies during the COVID-19 pandemic, and investigated the qualities that make communicated information more desirable to those tasked with navigating the fog of uncertainty. We conducted semi-structured interviews with 55 emergency department personnel, and found that uncertainty, lack of safety, and poor teamwork experience were major challenges for ED staff during the COVID-19 crisis. Participants described feeling overwhelmed by the great deal of information sent to them, confused about conflicting messages, and frustrated that they were unable to find the information they needed. These challenges were ameliorated by the emergence of contextual experts who focused on simultaneously democratizing and centralizing information. Qualitative findings helped generate survey measures, which were distributed to a broader sample. Exploratory factor analysis revealed three factors of theoretical value (information flow, consistency, and accessibility), which helped triangulate qualitative findings. Our study indicates that while uncertainty and fear during crises lead to an increased desire for information among staff, the manner in which that information is delivered is vital. [ABSTRACT FROM AUTHOR]

Newly intensified and widespread use of personal protective equipment (PPE) as a result of the COVID-10 pandemic in emergency departments presents teamwork challenges affecting the quality and safety of care at the frontlines. We conducted a qualitative study to categorize and describe barriers to teamwork posed by PPE in the emergency setting. We conducted semi-structured interviews with 55 personnel from two emergency departments serving in a variety of roles. We then performed a thematic analysis to identify and construct patterns of teamwork challenges into themes. We discovered two types of challenges to teamwork: material barriers related to wearing masks, gowns, and powered air purifying respirators, and spatial barriers implemented to conserve PPE and limit coronavirus exposure. Both material and spatial barriers resulted in disrupted communication, roles, and interpersonal relationships, but did so in unique ways. Material barriers muffled information flow, impeded team member recognition and role/task division, and reduced belonging and cohesion while increasing interpersonal strain. Spatial barriers resulted in mediated communication, and added physical and emotional distance between teammates and patients. Our findings identify specific aspects of how intensified PPE use disrupts teamwork, and can inform efforts to ensure care quality and safety in emergency settings as PPE use continues during and, potentially beyond, the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]