A qualitative study on the perspectives of patients and providers on the integration of geriatric personal support workers for improving quality of care in the emergency department.

Introduction: Canada's emergency departments (EDs) face extreme overcrowding, with older adults (65 +) comprising up to 25% of visits and often presenting with cognitive disorders, multiple comorbidities, and complex care needs. Personal support workers assist people needing help with daily activities, typically in homes or long-term care, but not EDs. The objective of this study was to describe patients, family members, and providers' perspectives on the implementation and impact of a novel Geriatric Personal Support Worker program in an ED setting in Toronto, Ontario.

Methods: This qualitative descriptive study used semi-structured interviews and focus groups with older adult patients, caregivers, and healthcare providers (n = 30). The guiding framework for the study was the Consolidated Framework for Implementation Research. Data were analyzed using an inductive thematic analysis.

Results: Both patients and providers valued personal support worker support in the ED, noting improvements in care efficiency and patient-centered service. Participants noted that personal support workers reduced nurses' workload by supporting patients' activities of daily living, which enabled nurses to prioritize clinical tasks, thereby improving the ED care experience for both patients and providers. The key factors identified to influence the program's implementation were organizational cohesiveness (personal support workers as unionized employees), the need for sustainable funding, and clearer role description.

Conclusions: Integrating Geriatric Personal Support Workers in the ED improved patient-centered care as well as nursing care efficiency. While well received, there are organizational, logistical and funding issues that require further exploration to sustain a Geriatric Personal Support Worker program in EDs.