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Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation

Delyth Price, Michelle Edwards, Freya Davies, Alison Cooper, Joy McFadzean, Andrew Carson-Stevens, Matthew Cooke, Jeremy Dale, Bridie Evans Orcid Logo, Barbara Harrington, Julie Hepburn, Aloysius Niroshan Siriwardena, Helen Snooks Orcid Logo, Adrian Edwards

BMC Emergency Medicine, Volume: 22, Issue: 1, Start page: 12

Swansea University Authors: Bridie Evans Orcid Logo, Helen Snooks Orcid Logo

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Abstract

Background: Patient experience is an important outcome and indicator of healthcare quality, and patient reported experiences are key to improving quality of care. While patient experience in emergency departments (EDs) has been reported in research, there is limited evidence about patients’ specific...

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Published in: BMC Emergency Medicine
ISSN: 1471-227X
Published: Springer Science and Business Media LLC 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa59244
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Abstract: Background: Patient experience is an important outcome and indicator of healthcare quality, and patient reported experiences are key to improving quality of care. While patient experience in emergency departments (EDs) has been reported in research, there is limited evidence about patients’ specific experiences with primary care services located in or alongside EDs. We aim to identify theories about patient experience and acceptability of being streamed to a primary care clinician in an ED. Methods: Using theories from a rapid realist review as a basis, we interviewed 24 patients and 106 staff members to generate updated theories about patient experience and acceptability of streaming to primary care services in EDs. Feedback from 56 stakeholders, including clinicians, policymakers and patient and public members, as well as observations at 13 EDs, also contributed to the development of these theories, which we present as a programme theory. Results: We found that patients had no expectations or preferences for which type of clinician they were seen by, and generally found being streamed to a primary care clinician in the ED acceptable. Clinicians and patients reported that patients generally found primary care streaming acceptable if they felt their complaint was dealt with suitably, in a timely manner, and when clinicians clearly communicated the need for investigations, and how these contributed to decision-making and treatment plans. Conclusions: From our findings, we have developed a programme theory to demonstrate that service providers can expect that patients will be generally satisfied with their experience of being streamed to, and seen by, primary care clinicians working in these services. Service providers should consider the potential advantages and disadvantages of implementing primary care services at their ED. If primary care services are implemented, clear communication is needed between staff and patients, and patient feedback should be sought.
Keywords: Patient experience, Emergency department, Realist evaluation, Primary care services, Qualitative
College: Swansea University Medical School
Funders: This study is funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) Programme, project number 15/145/04.
Issue: 1
Start Page: 12