Physical Design of the Emergency Department: A Key Factor in Reducing Medical Errors and Staff Burnout – A Narrative Review

Introduction: The Emergency Department (ED), as the primary gateway of hospitals, is an inherently turbulent, complex, and high-pressure environment. Although human factors and clinical protocols have long been the focus of research, the physical design of the ED—despite being a decisive variable in patient safety and staff well-being—has often been overlooked. This narrative review aims to analyze the existing evidence regarding the influence of physical design elements on medical errors and occupational burnout. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar up to December 2023. Observational studies, qualitative research, and systematic reviews related to ED physical design, medical errors, and staff burnout were included. Results: Strong evidence indicates that poor physical design—such as crowding, excessive noise, improper lighting, and inefficient layouts—contributes to increased medication and diagnostic errors, as well as delays in care delivery. Moreover, the absence of standard rest areas for staff leads to heightened stress, emotional fatigue, and burnout. Recent studies also show that AI-based modeling and behavioral-environmental architectural principles (as demonstrated in Mobaseri Abed, 2025) can enhance layout optimization, reduce cognitive load, and improve staff performance. Conclusion: The physical design of the ED is a crucial non-pharmacological intervention for improving patient safety and preserving the human workforce. Transitioning toward evidence-based design—integrated with advanced technologies and human-behavior-centered architectural principles—is an essential requirement for modern emergency departments

Keywords:

Emergency department design , medical errors , occupational burnout , human factors , patient safety , evidence-based des