Codesigning discharge communication interventions with healthcare providers, youth and parents for emergency practice settings: EDUCATE study protocol

Abstract

IntroductionDischarge communication is an important aspect of patient care but frequently has shortcomings in emergency departments (EDs). In a paediatric context, youth or parents with young children often leave the ED with minimal opportunity to ask questions or to ensure comprehension of important information. Strategies for improving discharge communication have primarily targeted patients and/or parents, although neither group has been engaged in intervention design or implementation. Furthermore, ED healthcare providers (HCPs), important actors in discharge communication practice, are rarely consulted regarding intervention design decisions. We will generate evidence to enhance discharge communication by engaging youth, parents and HCPs in the codesign of ED discharge communication strategies (EDUCATE) for asthma and minor head injury.Methods and analysisThis mixed methods study will take place at two academic paediatric EDs in Canada. The study will occur in two phases: (A) codesign and refinement of the intervention prototypes; and (B) usability testing of the prototypes. During the first phase, two codesign teams (one for each condition) will follow a series of structured design meetings based on the Behavior Change Wheel to develop the EDUCATE interventions. Each codesign team (composed of youth, parents, HCPs and study researchers) will collaborate to identify priority target behaviours and acceptable components to include in the interventions. During the second phase, we will conduct usability testing in two EDs with a group of youth, parents and HCPs to refine the interventions. Two cycles of usability testing will be conducted with intervention refinement occurring at the end of each cycle.Ethics and disseminationInformed consent will be obtained from all participants. Ethics approval for this study has been obtained from the Research Ethics Board, IWK Health Centre. Results from this study will form the basis of a future effectiveness implementation trial. Key findings will be presented at national and international conferences and published within peer-reviewed journals.

Designing Implementation Strategies for a Digital Suicide Safety Planning Intervention in a Psychiatric Emergency Department: Protocol for a Multimethod Research Project

“…There may be concerns about placing service users, family members, and clinicians in the same group as service users may feel uncomfortable speaking up. However, previous research has shown that forming a heterogeneous co-design team with patients and clinicians can be done well [113][114][115][116]. Furthermore, the CAMH Lived Experience Advisory Group supported this as an effective approach for reaching a consensus.…”

Shortening and validation of the Patient Engagement In Research Scale (PEIRS) for measuring meaningful patient and family caregiver engagement

“…Shortly after Boivin et al’s 2018 systematic review was published, 14 the Patient Engagement In Research Scale (PEIRS) was published as the first tool designed to measure the degree of meaningful patient engagement in research on project teams 16 . The PEIRS is based on an empirical conceptual framework enhanced with a literature review, 5 recognized as a promising and important tool for the evaluation of patient and family caregiver engagement in research 13,17‐20 . The framework outlines the key components of and defines meaningful patient engagement in research as the planned, supported and valued involvement of patients in the research process, which facilitates their contributions and offers a rewarding experience 5 .…”

“…16 The PEIRS is based on an empirical conceptual framework enhanced with a literature review, 5 recognized as a promising and important tool for the evaluation of patient and family caregiver engagement in research. 13,[17][18][19][20] The framework outlines the key components of and defines meaningful patient engagement in research as the planned, supported and valued involvement of patients in the research process, which facilitates their contributions and offers a rewarding experience. 5 While the original 37-item PEIRS has undergone face and content validation, most of its measurement properties have not yet been assessed.…”

Discharge communication for mental health visits to the pediatric emergency department: A mixed-methods study

“…Parents/caregivers have also reported wanting information on how to help their child deal with the next crisis and how to support themselves [8]. Past research has indicated, however, that 32-48% of families do not receive any discharge instructions [4], and if instructions are provided, they are often brie y explained with crucial details missing [12], and may not be well understood by patients or parents/caregivers [8,11].…”

“…Despite the signi cant role that parents/caregivers, pediatric patients, and health care providers play in the discharge communication process, they have not been involved in developing discharge interventions [12]. The involvement of children/adolescents and parents/caregivers in the development of discharge inventions for mental health care could improve access to treatment and services after the ED visit and increase the quality and appropriateness of discharge interventions provided in the ED [13,14].…”