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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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DOI (Published version): 10.1186/s12873-021-00562-9

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
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URI: https://cronfa.swan.ac.uk/Record/cronfa59244
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While patient experience in emergency departments (EDs) has been reported in research, there is limited evidence about patients&#x2019; 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.</abstract><type>Journal Article</type><journal>BMC Emergency Medicine</journal><volume>22</volume><journalNumber>1</journalNumber><paginationStart>12</paginationStart><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1471-227X</issnElectronic><keywords>Patient experience, Emergency department, Realist evaluation, Primary care services, Qualitative</keywords><publishedDay>22</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-01-22</publishedDate><doi>10.1186/s12873-021-00562-9</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This study is funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&amp;DR) Programme, project number 15/145/04.</funders><lastEdited>2022-02-04T12:08:50.1424656</lastEdited><Created>2022-01-25T12:49:35.7989923</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Delyth</firstname><surname>Price</surname><order>1</order></author><author><firstname>Michelle</firstname><surname>Edwards</surname><order>2</order></author><author><firstname>Freya</firstname><surname>Davies</surname><order>3</order></author><author><firstname>Alison</firstname><surname>Cooper</surname><order>4</order></author><author><firstname>Joy</firstname><surname>McFadzean</surname><order>5</order></author><author><firstname>Andrew</firstname><surname>Carson-Stevens</surname><order>6</order></author><author><firstname>Matthew</firstname><surname>Cooke</surname><order>7</order></author><author><firstname>Jeremy</firstname><surname>Dale</surname><order>8</order></author><author><firstname>Bridie</firstname><surname>Evans</surname><orcid>0000-0003-0293-0888</orcid><order>9</order></author><author><firstname>Barbara</firstname><surname>Harrington</surname><order>10</order></author><author><firstname>Julie</firstname><surname>Hepburn</surname><order>11</order></author><author><firstname>Aloysius Niroshan</firstname><surname>Siriwardena</surname><order>12</order></author><author><firstname>Helen</firstname><surname>Snooks</surname><orcid>0000-0003-0173-8843</orcid><order>13</order></author><author><firstname>Adrian</firstname><surname>Edwards</surname><order>14</order></author></authors><documents><document><filename>59244__22219__04cde071058442b69361f39f171fb62b.pdf</filename><originalFilename>12873_2021_Article_562.pdf</originalFilename><uploaded>2022-01-25T12:49:35.7989517</uploaded><type>Output</type><contentLength>1228920</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; The Author(s). 2022 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-02-04T12:08:50.1424656 v2 59244 2022-01-25 Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation 6098eddc58e31ac2f3e070cb839faa6a 0000-0003-0293-0888 Bridie Evans Bridie Evans true false ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 2022-01-25 HDAT 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. Journal Article BMC Emergency Medicine 22 1 12 Springer Science and Business Media LLC 1471-227X Patient experience, Emergency department, Realist evaluation, Primary care services, Qualitative 22 1 2022 2022-01-22 10.1186/s12873-021-00562-9 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 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. 2022-02-04T12:08:50.1424656 2022-01-25T12:49:35.7989923 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Delyth Price 1 Michelle Edwards 2 Freya Davies 3 Alison Cooper 4 Joy McFadzean 5 Andrew Carson-Stevens 6 Matthew Cooke 7 Jeremy Dale 8 Bridie Evans 0000-0003-0293-0888 9 Barbara Harrington 10 Julie Hepburn 11 Aloysius Niroshan Siriwardena 12 Helen Snooks 0000-0003-0173-8843 13 Adrian Edwards 14 59244__22219__04cde071058442b69361f39f171fb62b.pdf 12873_2021_Article_562.pdf 2022-01-25T12:49:35.7989517 Output 1228920 application/pdf Version of Record true © The Author(s). 2022 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
spellingShingle Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
Bridie Evans
Helen Snooks
title_short Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
title_full Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
title_fullStr Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
title_full_unstemmed Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
title_sort Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
author_id_str_mv 6098eddc58e31ac2f3e070cb839faa6a
ab23c5e0111b88427a155a1f495861d9
author_id_fullname_str_mv 6098eddc58e31ac2f3e070cb839faa6a_***_Bridie Evans
ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
author Bridie Evans
Helen Snooks
author2 Delyth Price
Michelle Edwards
Freya Davies
Alison Cooper
Joy McFadzean
Andrew Carson-Stevens
Matthew Cooke
Jeremy Dale
Bridie Evans
Barbara Harrington
Julie Hepburn
Aloysius Niroshan Siriwardena
Helen Snooks
Adrian Edwards
format Journal article
container_title BMC Emergency Medicine
container_volume 22
container_issue 1
container_start_page 12
publishDate 2022
institution Swansea University
issn 1471-227X
doi_str_mv 10.1186/s12873-021-00562-9
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description 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.
published_date 2022-01-22T04:16:24Z
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