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A qualitative study performed with a cross-sectional survey to report staff perceptions on emergency department (ED) communication while trialling a personal hands-free wireless communication device (WCD) between August and October 2008 in a busy inner city ED.A survey of all Royal London Hospital ED staff was conducted pre and post-implementation of a personal WCD. The survey included responses to occupation, experience, communication modes, communication wait times, perceived interruptions at the bedside and general perceptions of communication efficiency.No appreciable change in communication modes or perceived waiting times was reported No increase in bedside interruptions were reported. An overwhelming number of respondents considered the system had contributed significantly to improving the quality of the work environment, patient safety and care.This study correlated with others showing a very strong perception of improved communication and working environment: less noise, better handovers and improved staff resource use. The study adds to the limited number of published trials examining WCD in health care. Observational reports post-implementation were overwhelmingly positive. Quantitative studies measuring the impact on patient flow, safety and cost benefits should be considered.