Factors to Improve Quality for Older Patients in the Emergency Department: A Qualitative Study of Patient Trajectory
| Autor: | Franck Verschuren, William D'Hoore, Pascale Cornette, Vincent Lorant, Isabelle Aujoulat, Isabelle De Brauwer, Frédéric Thys |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
genetic structures Psychological intervention Context (language use) Health informatics behavioral disciplines and activities Health administration Elderly Medicine Humans Qualitative Research Aged Quality of Health Care business.industry Emergency department Health Policy Nursing research Research Hospitalization Family medicine Process of care Qualitative observations Public aspects of medicine RA1-1270 Basic needs business Emergency Service Hospital psychological phenomena and processes Qualitative research |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 21, Iss 1, Pp 1-10 (2021) |
| DOI: | 10.21203/rs.3.rs-155870/v1 |
| Popis: | BackgroundManaging older people in the emergency department remains a challenge. We aimed to identify the factors influencing the care quality of older patients in the emergency department, to fine-tune future interventions for older people, considering the naturalistic context of the ED.MethodsThis is a qualitative study of some 450 h of observations performed in three emergency departments selected for their diverse contexts. We performed seventy observations of older patient trajectories admitted to the emergency department. Themes were extracted from the material using an inductive reasoning approach, to highlight factors positively or negatively influencing management of patient’s trajectories, in particular those presenting with typically geriatric syndromes.ResultsFour themes were developed: no geriatric flow routine; risk of discontinuity of care; unmet basic needs and patient-centered care; complex older patients are unwelcome in EDs.ConclusionsThe overall process of care was based on an organ- and flow-centered paradigm, which ignored older people’s specific needs and exposed them to discontinuity of care. Their basic needs were neglected and, when their management slowed the emergency department flow, older people were perceived as unwelcome. Findings of our study can inform the development of interventions about the influence of context and organizational factors. |
| Databáze: | OpenAIRE |
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