ObjectiveThere is an increase in patients being discharged after short stays in the emergency department, but there is limited knowledge of their perspectives on treatment and care. This study aims to explore and understand the needs and preferences of emergency care from the perspective of patients and family members discharged from the emergency department within 24 hours of admission.DesignThe study reports from the first phase in an overall participatory design project. Systematic text condensation was used to identify key themes from field observations and interviews with patients and family members.SettingThis study was conducted in two emergency departments in the Region of Southern Denmark.ParticipantsAll adults aged ≥18 years who had been discharged from the emergency department within 24 hours were eligible to take part. Purposeful sampling was used to recruit patients and family members with different sociodemographic features.ResultsField observational studies (n=50 hours), individual interviews with patients (N=19) and family members (N=3), and joint interviews with patients and family members (N=4) were carried out. Four themes were derived from the material: (1) being in a vulnerable place—having emotional concerns; (2) having a need for person-centred information; (3) the atmosphere in the emergency department and (4) implications of family presence.ConclusionThis study demonstrates a gap between patients’ and family members’ needs and preferences and what current emergency departments deliver. The findings highlight the importance of family and person-centred care. Tailored communication and information with genuine involvement of family members is found to be essential needs during acute illness.

Background In cancer settings, relatives are often seen as a resource as they are able to support the patient and remember information during hospitalization. However, geographic distance to hospitals, work, and family obligations are reasons that may cause difficulties for relatives’ physical participation during hospitalization. This provided inspiration to uncover the possibility of telehealth care in connection with enabling participation by relatives during patient rounds. Telehealth is used advantageously in health care systems but is also at risk of failing during the implementation process because of, for instance, health care professionals’ resistance to change. Research on the implications for health care professionals in involving relatives’ participation through virtual presence during patient rounds is limited. Objective This study aimed to investigate health care professionals’ experiences in using and implementing technology to involve relatives during video-consulted patient rounds. Methods The design was a qualitative approach. Methods used were focus group interviews, short open interviews, and field observations of health care professionals working at a cancer department. The text material was analyzed using interpretative phenomenological analysis. Results Field observational studies were conducted for 15 days, yielding 75 hours of observation. A total of 14 sessions of video-consulted patient rounds were observed and 15 pages of field notes written, along with 8 short open interviews with physicians, nurses, and staff from management. Moreover, 2 focus group interviews with 9 health care professionals were conducted. Health care professionals experienced the use of technology as a way to facilitate involvement of the patient’s relatives, without them being physically present. Moreover, it raised questions about whether this way of conducting patient rounds could address the needs of both the patients and the relatives. Time, culture, and change of work routines were found to be the major barriers when implementing new technology involving relatives. Conclusions This study identified a double change by introducing both new technology and virtual participation by relatives at the same time. The change had consequences on health care professionals’ work routines with regard to work load, culture, and organization because of the complexity in health care systems.

ObjectiveDevelopment of initiatives to reduce hospitalisations is a major focus of healthcare planning. Strengthening the community with municipal acute care teams or units is a newly implemented Danish initiative aimed at preventing hospitalisations and supporting more flexible services. This study aims to describe patients treated by a municipal acute care team and to explore patients’ and caregivers’ experiences with at-home treatment.DesignA mixed-method study consisting of descriptive statistics of patients treated by an acute care team, and quantitative and qualitative data from follow-up telephone questionnaires with patients and caregivers.SettingThe acute care team, ‘Acute Team Odense’ (ATO), in the Odense Municipality, Denmark.ParticipantsPatients treated by ATO and their caregivers. ATO treated 3231 patients (5676 contacts) in the period of 2018–2019.ResultsAverage number of new contacts per day was 7.8, and the median treatment-length was 1 day. Patients were referred by various healthcare providers and most often by general practitioners, municipal staff and hospital staff. The median age of the patients was 80 years, and 20% were independent before the treatment. In total, 787/5676 contacts received at-home intravenous therapy, which corresponded to 3.6 hospital beds saved per day. The questionnaires were completed by 307/478 patients and 168/254 caregivers. Most respondents stated they would prefer at-home treatment in future similar situations as it enabled them to maintain their lives. Several respondents also experienced that ATO avoided hospitalisations or reduced hospital stays, which was described as a relief.ConclusionATO was frequently used, indicating the demand for community-based acute healthcare. The patients and caregivers experienced that this solution avoided hospitalisations and allowed them to maintain their lives, and this was described as less burdensome. As a result of these findings, this initiative has been continued with an ongoing focus on searching for possibilities aimed to prevent hospitalisations.