The Impact of the Healthcare Environment on Patient Experience in the Emergency Department: A Systematic Review to Understand the Implications for Patient-Centered Design

Abstract

Background: The emergency department (ED) is a complex, volatile, and limited-resource healthcare setting. Many environmental factors, including high patient volumes, overburdened staff, long waits, and a tense atmosphere, converge in the ED. The objective of this study was to perform a systematic review of extant literature to understand how the ED environment drives patient experience and identify methodological or empirical insights for patient-centered ED design. Methods: We searched eight academic databases (Web of Science, PubMed, Scopus, Medline [Ovid], CINAHL, PyscInfo, Compendex, and IEEE Explore) to identify studies that employed observational (descriptive) or interventional (evaluative) methodology. We performed a co-citation analysis of potentially eligible articles and a qualitative synthesis of findings from studies included in our final sample. Results: Our search yielded 117 records. Of the 35 potentially relevant articles, 18 were published in the last 5 years, and 50% were authored by investigators in the United States. We used 33 articles for a co-citation analysis, revealing three interdisciplinary clusters and promising potential for collaboration across fields. Thirty articles were subjected to a full-text analysis, resulting in the identification of three overarching dimensions linking the ED environment to patient experience. Conclusion: The most commonly identified factors influencing patient experience in the ED included overcrowding and wait times, privacy, and communication; however, existing literature is limited. More research is needed to understand how ED environments configure patient experience and can be improved through design. Particularly, there is little research on participatory interventional strategies in the ED, despite strong evidence suggesting a need for stakeholder participation.

Orthopaedic trauma patients’ experiences with emergency department care and follow-up through Virtual Fracture Care review: a qualitative study

“…It is important to note that information needs in the ED may differ from those at home, after patients have had time to reflect and become aware of their situation. Furthermore, an ED visit can be stressful and patients’ capacity to process and retain information may be impaired 28 29. The VFC workflow addresses these challenges, as patients receive only the necessary information in the ED and are provided with (digital) leaflets containing information on the VFC review workflow, immobilisation material (brace or cast) and general information about their injury.…”

Explore the practice and barriers of collaborative health policy and system research-priority setting exercise in Ethiopia

“…Such commitment is seen as a key way to ensure that research projects ask the 'right' questions those that are responsive to demanding stakeholder identified needs and create 'better' knowledge that draws on and reflects a diversity of knowledge systems and is more widely shared beyond peer-reviewed journals and academic conference [ 6 , 7 ]. HPSR looks for how different organizations and actors collaborate for the achievement of collective goals in the implementation of policy [ 8 – 11 ].…”