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Abstract
Background Emergency department (ED) crowding causes increased mortality. Professionals working in crowded departments feel unable to provide high-quality care and are predisposed to burnout. Awareness of the impact on patients, however, is limited to metrics and surveys rather than understanding perspectives. This project investigated patients’ experiences and identified mitigating interventions.
Methods A qualitative service evaluation was undertaken in a large UK ED. Adults were recruited during periods of high occupancy or delayed transfers. Semi-structured interviews explored experience during these attendances. Participants shared potential mitigating interventions. Analysis was based on the interpretative phenomenological approach. Verbatim transcripts were read, checked for accuracy, re-read and discussed during interviewer debriefing. Reflections about positionality informed the interpretative process.
Results Seven patients and three accompanying partners participated. They were aged 24–87 with characteristics representing the catchment population. Participants’ experiences were characterised by ‘loss of autonomy’, ‘unmet expectations’ and ‘vulnerability’. Potential mitigating interventions centred around information provision and better identification of existing ED facilities for personal needs.
Conclusion Participants attending a crowded ED experienced uncertainty, helplessness and discomfort. Recommendations included process and environmental orientation.
- crowding
- emergency care systems
Data availability statement
No data are available.
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Data availability statement
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Footnotes
Handling editor Liza Keating
X @damian_roland, @J_vanOppen
AIPC, HS-M and MTO contributed equally.
Contributors JDvO conceptualised the project. AIPC, HS-M, MTO and JDvO collected and analysed the data and wrote the first draft. RA, KK, NM and DR gave academic supervision and reviewed the first draft. All authors revised the draft manuscripts. JDvO accepts full responsibility as guarantor for the work and conduct of the study.
Funding This project was not specifically funded. JDvO was funded by the National Institute for Health and Care Research (NIHR): Doctoral Research Fellowship 300901 and Clinical Lectureship.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting, or dissemination of this service evaluation.
Provenance and peer review Not commissioned; externally peer reviewed.
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