Challenges of recruiting emergency department patients to a qualitative study: a thematic analysis of researchers’ experiences

Abstract

Background: At times of increasing pressure on emergency departments, and the need for research into different models of service delivery, little is known about how to recruit patients for qualitative research in emergency departments. We report from one study which aimed to collect evidence on patients' experiences of attending emergency departments with different models of using general practitioners, but faced challenges in recruiting patients. This paper aims to identify and reflect on the challenges faced at all stages of patient recruitment, from identifying and inviting eligible patients, consenting them for participation and finally to engaging them in interviews, and make recommendations based on our learning. Methods: A thematic analysis was carried out on field-notes taken during research visits and meeting minutes of discussions to review and improve patient recruitment throughout the study. Results: The following factors influenced the success of patient recruitment in the emergency department setting: complicated or time-consuming electronic health record systems for identifying patients; narrow participant eligibility criteria; limited research nurse support; and lack of face-to-face communication between researchers and eligible patients. Conclusions: This paper adds to the methodological evidence for improving patient recruitment in different settings, with a focus on qualitative research in emergency departments. Our findings have implications for future studies attempting to recruit patients in similar settings.

Implementing public involvement throughout the research process—Experience and learning from the GPs in EDs study

“… reviewing all participant information and data collection tools and processes that were submitted for Research Ethics Committee approval, planning and participating in activities within each study phase: the rapid review of evidence, a survey of hospitals, selection of case study sites, case study data collection and analysis and overall management and scrutiny, 42 , 43 , 44 , 45 , 46 planning and delivering the two stakeholder events, including developing materials for workshops during each day, facilitating some of the round‐table discussions and presenting the workshop sessions alongside researchers, 47 dissemination activities including reports to the study funders, producing a range of accessible written and oral outputs during the study, preparing lay summaries of all academic papers [see GPs in emergency department (ED)s (primecentre.wales)], co‐authoring publications 45 , 46 , 48 and planning for dissemination at study end and scrutiny through the Study Steering Committee. …”

An online survey to assess parents' preferences for learning about child health research

“…In our study, more purposeful recruitment strategies such as emails from a child's healthcare provider did not generate more support than passively using posters. Participants had mixed responses on whether they wanted to be informed of new studies for their child during an emergency department visit, highlighting the complexity of trial recruitment within this setting (Price et al., 2020 ; Wulf et al., 2012 ) and the need for more research in this area. Our findings suggest that parents are more interested in hearing about research studies in non‐urgent care settings (e.g.…”

“…Interpersonal interactions and relationships between potential trial participants and recruiters can be particularly important when people find their children in urgent, unfamiliar and potentially life‐threatening situations (Caldwell et al., 2010 ; Price et al., 2020 ). In a systematic review of methods to improve recruitment to clinical trials, promising strategies included telephone reminders to non‐responders, opt‐out strategies, and the use of open trial designs (Treweek et al., 2013 ).…”

Testing the Feasibility of Sensor-Based Home Health Monitoring (TEC4Home) to Support the Convalescence of Patients With Heart Failure: Pre–Post Study

“…One challenge experienced was attempting to recruit patients at the height of their exacerbation in the ED. Indeed, other studies have encountered similar challenges in recruiting from the ED with common difficulties, such as time-consuming health record searches, limited research nurse support, and lack of face-to-face communication between patient and researcher [17]. The results we provide in Table 1 helped us to understand some of the factors that led to eligible patients declining participation, such as not feeling well enough to participate and not feeling comfortable using HHM or having someone to help them use it.…”