Co-Design of a Framework for Person-Centred Care at Emergency Department Triage and Waiting Room

IF 3.2 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-09-22 DOI:10.1111/hex.70442

Carrie Janerka, Gavin D. Leslie, Fenella J. Gill, PCC ED Triage Group

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引用次数: 0

Abstract

Introduction

Patients presenting to an emergency department (ED) are typically assessed by a triage nurse and often required to wait for further assessment and care. Ongoing issues of ED overcrowding and prolonged wait times can impact the processes and patients' experiences. A person-centred approach is recommended. This study aimed to develop a person-centred care framework for use in the ED triage and waiting room.

Methods

The multi-phase research involved a synergistic partnership-based fully integrated mixed-methods approach based on person-centred care principles. Framework development followed target population-centred and partnership-based processes of conception, planning and designing. A consumer group was actively involved throughout. Data collection involved two literature reviews, a patient survey and triage nurse survey. Findings were synthesised through focus group sessions and the framework was developed during a collaborative workshop.

Results

A total of 225 patients and 176 triage nurses responded to the respective surveys. Patients reported the need for better communication, efficiencies and comfort in the waiting room. Nurses identified barriers to person-centred care, such as workloads, poor environment and long wait times. Strategies for overcoming barriers included enhanced communication, addition of waiting room staff and family involvement. Focus groups recommendations were synthesised as support for staff, systems and processes, environment and facilities, communication and information, and individual care needs, forming the framework elements/components. Practical micro, meso and macro level interventions were also recommended.

Conclusions

The newly developed framework can now be applied to ED triage settings and inform person-centred interventions.

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急诊科分诊和候诊室以人为本护理框架的共同设计

病人来到急诊科（ED）通常由分诊护士进行评估，通常需要等待进一步的评估和护理。急诊科过度拥挤和等待时间延长的持续问题会影响治疗过程和患者的体验。建议采用以人为本的方法。本研究旨在开发一个以人为本的护理框架，用于急诊科分诊和候诊室。方法采用以人为本的护理原则，采用基于协同伙伴关系的全面综合混合方法进行多阶段研究。框架的制定遵循了以目标人口为中心和以伙伴关系为基础的构思、规划和设计过程。一个消费者团体全程积极参与。数据收集包括两篇文献综述，一篇患者调查和一篇分诊护士调查。通过焦点小组会议综合了调查结果，并在合作研讨会期间制定了框架。结果共有225名患者和176名分诊护士参与了问卷调查。患者报告说，候诊室需要更好的沟通、效率和舒适度。护士确定了妨碍以人为本的护理的障碍，如工作量大、环境差和等待时间长。克服障碍的策略包括加强沟通、增加等候室工作人员和家庭参与。重点小组的建议被综合为对工作人员、系统和程序、环境和设施、通讯和信息以及个人护理需要的支持，形成框架要素/组成部分。提出了切实可行的微观、中观和宏观干预措施。新开发的框架现在可以应用于急诊科分诊设置，并告知以人为本的干预措施。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.