Initial Development of a Patient Reported Experience Measure for Older Adults Attending the Emergency Department: Part I—Interviews with Service Users

Abstract

Older adults are a major Emergency Department (ED) user group who may be especially vulnerable to the consequences of crowding and sub-optimal care. Patient experience is a critical component of high-quality ED care and has previously been conceptualised using a framework focusing on patients’ needs. This study aimed to explore the experiences of older adults attending the ED in relation to the existing needs-based framework. Semi-structured interviews were conducted during an emergency care episode with 24 participants aged over 65 years in a United Kingdom ED with an annual census ~100,000. Questions exploring patient experiences of care confirmed that meeting the communication, care, waiting, physical, and environmental needs were prominent determinants of experience for older adults. A further analytical theme emerged which did not align to the existing framework, focused on ‘team attitudes and values’. This study builds on existing knowledge relating to the experience of older adults in the ED. In addition, data will also contribute to the generation of candidate items for the development of a patient reported experience measure for older adults attending the ED.

Involving patients and caregivers to develop items for a new patient‐reported experience measure for older adults attending the emergency department. Findings from a nominal group technique study

“…An initial list of candidate items was developed by two researchers (B. G. and J. M. L.) following methodological triangulation of findings from prior studies conducted by the research team. These consisted of a qualitative metasynthesis of 22 studies of patient experience in the ED 17 ; interviews conducted with 24 patients aged over 65 attending the ED 18 ; and interprofessional focus groups with 37 ED staff 19 . Methodological triangulation describes the use of multiple data sources to study a phenomenon, and is useful to confirm findings, enrich data and increase overall validity 20 .…”

“…Confirmation of conceptual validity and expansion of the framework was then achieved by undertaking semi-structured interviews with older adults during an emergency care episode, and focus groups with staff responsible for the provision of emergency care to older adults across three EDs. 18,19 This study aims to describe the process of generating and prioritising a list of suggested items for PREM-ED 65 by involving multiple stakeholders including patient and public representatives, healthcare professionals and advocates for older adults.…”

“…This framework highlighted the importance of meeting patients' communication, emotional, care, physical/environmental and waiting needs. Confirmation of conceptual validity and expansion of the framework was then achieved by undertaking semi‐structured interviews with older adults during an emergency care episode, and focus groups with staff responsible for the provision of emergency care to older adults across three EDs 18,19 …”