How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study

Abstract

IntroductionThe development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient’s and family’s ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.Methods and analysisThe study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.Ethics and disseminationThe study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000–111). Findings will be published in suitable international journals and disseminated through conferences.

Health professionals’ perspectives of patients’ and family members’ needs in emergency departments and patient pathway improvement: a qualitative study in Denmark

“…Three focus groups comprising 16 HCPs were conducted ( table 1 ). According to the protocol of the overall study, 21 we planned four focus groups for the 20 participants. Therefore, 20 HCPs were approached.…”

“…This research is part of the first phase of a three-phase participatory design study, with an overall aim to improve the experiences of patients and their family members discharged from the ED within 24 hours. 21 22 Participatory design is a research methodology where the involvement of representatives of future end-users of the research field is a core element. 22 Phase 1 focuses on uncovering and understanding needs and practices, 23 24 whereas phases 2 and 3 focus on developing and testing a solution to cover the needs identified in phase 1.…”

“…This research is part of the first phase of a three-phase participatory design study, with an overall aim to improve the experiences of patients and their family members discharged from the ED within 24 hours 21 22. Participatory design is a research methodology where the involvement of representatives of future end-users of the research field is a core element 22.…”

Development of a health information system to promote emergency care pathways: A participatory design study

“…The overall study was framed by PD and conducted in three phases 25 , 28 as illustrated in Figure 1 , with the overall objective being to identify the needs for ED care and develop a solution to improve the outcomes of patients discharged within 24 hours of admission. 28 This article reports on the second phase, Design and development (see Figure 1 ). All the phases were conducted in iterative cycles comprising the process steps of plan , act , observe , and reflect.…”

What are the needs and preferences of patients and family members discharged from the emergency department within 24 hours? A qualitative study towards a family-centred approach

“…This study reports from the first phase of a three-phased PD project. 21 Consolidated criteria for Reporting Qualitative research: a 32-item checklist for interviews and focus groups was used as guidelines. 22…”