Interventions to improve older adults' Emergency Department patient experience: A systematic review

2020 ◽  
Vol 38 (6) ◽  
pp. 1257-1269 ◽  
Author(s):  
Michelle J. Berning ◽  
Lucas Oliveira J. e Silva ◽  
Nataly Espinoza Suarez ◽  
Laura E. Walker ◽  
Patricia Erwin ◽  
...  
2017 ◽  
Vol 5 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Jonathan D Sonis ◽  
Emily L Aaronson ◽  
Rebecca Y Lee ◽  
Lisa L Philpotts ◽  
Benjamin A White

Introduction: Patient experience with emergency department (ED) care is an expanding area of focus, and recent literature has demonstrated strong correlation between patient experience and meeting several ED and hospital goals. The objective of this study was to perform a systematic review of existing literature to identify specific factors most commonly identified as influencing ED patient experience. Methods: A literature search was performed, and articles were included if published in peer-reviewed journals, primarily focused on ED patient experience, employed observational or interventional methodology, and were available in English. After a structured screening process, 107 publications were included for data extraction. Result: Of the 107 included publications, 51 were published before 2011, 57% were conducted by American investigators, and 12% were published in nursing journals. The most commonly identified themes included staff-patient communication, ED wait times, and staff empathy and compassion. Conclusion: The most commonly identified drivers of ED patient experience include communication, wait times, and staff empathy; however, existing literature is limited. Additional investigation is necessary to further characterize ED patient experience themes and identify interventions that effectively improve these domains.


2016 ◽  
Vol 68 (4) ◽  
pp. S79-S80
Author(s):  
M. Saidinejad ◽  
S.N. Morrison ◽  
K. Breslin ◽  
S.V. Patel ◽  
S.F. Iqbal ◽  
...  

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gijs Hesselink ◽  
Özcan Sir ◽  
Yvonne Schoon

Abstract Background The growing demand for elderly care often exceeds the ability of emergency department (ED) services to provide quality of care within reasonable time. The purpose of this systematic review is to assess the effectiveness of interventions on reducing ED crowding by older patients, and to identify core characteristics shared by successful interventions. Methods Six major biomedical databases were searched for (quasi)experimental studies published between January 1990 and March 2017 and assessing the effect of interventions for older patients on ED crowding related outcomes. Two independent reviewers screened and selected studies, assessed risk of bias and extracted data into a standardized form. Data were synthesized around the study setting, design, quality, intervention content, type of outcome and observed effects. Results Of the 16 included studies, eight (50%) were randomized controlled trials (RCTs), two (13%) were non-RCTs and six (34%) were controlled before-after (CBA) studies. Thirteen studies (81%) evaluated effects on ED revisits and four studies (25%) evaluated effects on ED throughput time. Thirteen studies (81%) described multicomponent interventions. The rapid assessment and streaming of care for older adults based on time-efficiency goals by dedicated staff in a specific ED unit lead to a statistically significant decrease of ED length of stay (LOS). An ED-based consultant geriatrician showed significant time reduction between patient admission and geriatric review compared to an in-reaching geriatrician. Conclusion Inter-study heterogeneity and poor methodological quality hinder drawing firm conclusions on the intervention’s effectiveness in reducing ED crowding by older adults. More evidence-based research is needed using uniform and valid effect measures. Trial registration The protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017075575).


2019 ◽  
Vol 36 (6) ◽  
pp. 355-363 ◽  
Author(s):  
Blair Graham ◽  
Ruth Endacott ◽  
Jason E Smith ◽  
Jos M Latour

BackgroundPatient experience is positively associated with both clinical effectiveness and patient safety and should be a priority for emergency care providers. While both quantitative and qualitative approaches can be used to evaluate patient experience in the emergency department (ED), the latter is well aligned to develop a detailed understanding of features influencing the lived experience of ED patients. This study aimed to systematically review the literature of qualitative studies to identify determinants of adult patient experience in the ED.MethodsA Preferred Reporting Items for Systematic review and Meta-Analysis compliant systematic review was conducted using PubMed, CINAHL, EMBASE, BNI and bibliography searches to identify qualitative studies exploring patient experiences in ED published in English between 1997 and 2018. Quality assessment was conducted using the Critical Appraisal Skills Programme checklist. Descriptive text and quotations relating to patient experience were extracted from included studies and a meta-synthesis conducted using thematic analysis.ResultsA total of 625 records were screened from which 40 studies underwent full review and 22 were included. Results were coded by two researchers (BG and JML). Meta-synthesis identified 198 discrete units of analysis which were clustered around five analytical themes. These were based on the perceived ‘needs’ of patients visiting the ED and were defined as communication, emotional, competent care, physical/environmental and waiting needs. Findings were translated into a conceptual model for optimising patient experience in the ED.ConclusionThis meta-synthesis provides a framework for understanding the determinants of patient experience in the ED. The resulting conceptual model and recommendations may have the potential to directly inform practice and improve the patient experience.


2019 ◽  
Vol 22 (1) ◽  
pp. 23-29
Author(s):  
Sharon Marr ◽  
Loretta Hillier ◽  
Diane Simpson ◽  
Sigrid Vinson ◽  
Sarah Goodwill ◽  
...  

2015 ◽  
Vol 18 (6) ◽  
pp. 500-505 ◽  
Author(s):  
Jeremy Oulton ◽  
Suzanne Michelle Rhodes ◽  
Carol Howe ◽  
Mindy J. Fain ◽  
Martha Jane Mohler

10.7249/rr761 ◽  
2014 ◽  
Author(s):  
Robin Weinick ◽  
Kirsten Becker ◽  
Layla Parast ◽  
Brian Stucky ◽  
Marc Elliott ◽  
...  

2019 ◽  
Vol 67 (7) ◽  
pp. 1516-1525 ◽  
Author(s):  
Jaime M. Hughes ◽  
Caroline E. Freiermuth ◽  
Megan Shepherd‐Banigan ◽  
Luna Ragsdale ◽  
Stephanie A. Eucker ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e039175
Author(s):  
Lucas Oliveira J e Silva ◽  
Michelle J Berning ◽  
Jessica A Stanich ◽  
Danielle J Gerberi ◽  
Jin Han ◽  
...  

IntroductionDelirium is commonly missed in older adults presenting to the emergency department (ED). Although current recommendations for active screening of delirium in the ED, this might not be feasible or practical. Identifying patients at high risk for prevalent and incident delirium in the ED will help to improve the screening process and to build interventions. There is currently scattered synthesis of evidence on risk factors associated with delirium in the ED. To address this gap, we are conducting a systematic review to describe the risk factors (patient vulnerability factors and precipitating factors) for delirium in the ED.Methods and analysisA literature search was performed from inception to March 2020 in Ovid EBM Reviews, Ovid EMBASE, Ovid MEDLINE, Scopus and Web of Science. We will include original research studies that report a quantitative relationship between at least one risk factor and delirium in the ED setting. Two investigators will use eligibility criteria from this protocol to independently screen titles and abstracts, and select studies based on full-text review of potentially eligible studies. After arriving at a final set of included studies, two investigators will extract data using a standardised data collection form. If appropriate, data regarding each risk factor will be pooled through a random-effect meta-analysis. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to evaluate the overall quality of evidence.Ethics and disseminationTo our knowledge, this will be the first systematic review evaluating risk factors for prevalent and incident delirium specifically related to the ED setting. Results of this study will aid in the identification of older adults at risk for delirium in the ED. We aim to publish the results of this systematic review in a peer-reviewed journal with good visibility for the fields of emergency medicine and geriatrics.PROSPERO registration numberCDR42020175261


2018 ◽  
Vol 36 (3) ◽  
pp. 510-511
Author(s):  
Yuan-Han Huang ◽  
Luke A. Sabljak ◽  
Zachary A. Puhala

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