Patients’ Perspectives on Outcomes of Care After Discharge From the Emergency Department: A Qualitative Study

Vaillancourt, Samuel; Seaton, M. Bianca; Schull, Michael J.; Cheng, Amy; Beaton, Dorcas; Laupacis, Andreas; Dainty, Katie N.

doi:10.1016/j.annemergmed.2017.05.034

Cited by 43 publications

(34 citation statements)

References 37 publications

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“…In addition, a positive experience is associated with superior outcomes including mortality, morbidity and length of stay 28. This shows the importance of including patient experiences as a fifth domain in evaluating the quality of care, which is new in comparison to the study of Vaillancourt et al 12…”

Section: Discussionmentioning

confidence: 99%

“…We also included questions about expectations of ED care, reason for presentation at the ED and experiences of the care delivered. At an early stage of our study, the study of Vaillancourt et al was published 12. In this study, relevant PROs for patients treated and directly discharged from the ED in Canada were determined.…”

Section: Methodsmentioning

confidence: 99%

“…In this study, relevant PROs for patients treated and directly discharged from the ED in Canada were determined. We compared our interview guide with the questionnaire of Vaillancourt et al and made some minor adjustments 12. Input of the first four interviews was assessed, making sure all themes were covered, to determine the final interview guide (appendix 1).…”

Section: Methodsmentioning

confidence: 99%

“…Patient reported outcome measures (PROMs) are developed on the basis of PROs and can be used for measurement of the quality of care 11. There is little experience in performing PROM-related research at the ED6 12; however, recent research shows that the measurement of PROMs in acute medical units is feasible 13…”

Section: Introductionmentioning

confidence: 99%

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Patient’s perspective on improving the quality of acute medical care: determining patient reported outcomes

Kremers¹,

Zaalberg

Ende

et al. 2019

BMJ Open Qual

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RationaleThere is an increasing societal demand for quality assurance and transparency of medical care. The American National Academy of Medicine has determined patient centredness as a quality domain for improvement of healthcare. While many of the current quality indicators are disease specific, most emergency department (ED) patients present with undifferentiated complaints. Therefore, there is a need for generic outcome measures. Our objective was to determine relevant patient reported outcomes (PROs) for quality measurement of acute care.MethodsWe conducted semistructured interviews in patients ≥18 years presenting at the ED for internal medicine. Patients with a cognitive impairment or language barrier were excluded. Interviews were analysed using qualitative content analysis.ResultsThirty patients were interviewed. Patients reported outcomes as relevant in five domains: relief of symptoms, understanding the diagnosis, presence and understanding of the diagnostic and/or therapeutic plan, reassurance and patient experiences. Experiences were often mentioned as relevant to the perceived quality of care and appeared to influence the domain reassurance.ConclusionWe determined five domains of relevant PROs in acute care. These domains will be used for developing generic patient reported measures for acute care. The patients’ perspective will be incorporated in these measures with the ultimate aim of organising truly patient-centred care at the ED.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patient’s perspective on improving the quality of acute medical care: determining patient reported outcomes

Kremers¹,

Zaalberg

Ende

et al. 2019

BMJ Open Qual

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show abstract

“…These were symptom relief, understanding of their health concern, reassurance and having a plan. 5 Based on this foundational work, we went through a comprehensive development and validation process, which resulted in the Patient-Reported Outcome Measure for Emergency Department Care (PROM-ED) questionnaire (Appendix 1, available at www.cmaj.ca/lookup/suppl/ doi:10.1503/cmaj.180353/-/DC1).…”

mentioning

confidence: 99%

Engaging patients to develop a patient-reported outcome measure for the emergency department

Vaillancourt

Beaton

Maybee

2018

CMAJ

Self Cite

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Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario

et al. 2022

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Introduction As part of the COVID-19 pandemic response, the Ontario Ministry of Health funded a virtual care pilot program intended to support emergency department (ED) diversion of patients with low acuity complaints and reduce the need for face-to-face contact. The objective was to describe the demographic characteristics, outcomes and experience of patients using the provincial pilot program. Methods This was a prospective cohort study of patients using virtual care services provided by 14 ED-led pilot sites from December 2020 to September 2021. Patients who completed a virtual visit were invited by email to complete a standardized, 25-item online survey, which included questions related to satisfaction and patient-reported outcome measures. Results There were 22,278 virtual visits. When patients were asked why they contacted virtual urgent care, of the 82.7% patients who had a primary care provider, 31.0% said they could not make a timely appointment with their family physician. Rash, fever, abdominal pain, and COVID-19 vaccine queries represented 30% of the presenting complaints. Of 19,613 patients with a known disposition, 12,910 (65.8%) were discharged home and 3,179 (16.2%) were referred to the ED. Of the 2,177 survey responses, 94% rated their overall experience as 8/10 or greater. More than 80% said they had answers to all the questions they had related to their health concern, believed they were able to manage the issue, had a plan they could follow, and knew what to do if the issue got worse or came back. Conclusions Many presenting complaints were low acuity, and most patients had a primary care provider, but timely access was not available. Future work should focus on health equity to ensure virtual care is accessible to underserved populations. We question if virtual urgent care can be safely and more economically provided by non-emergency physicians. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-022-00407-9.

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Patients’ Perspectives on Outcomes of Care After Discharge From the Emergency Department: A Qualitative Study

Cited by 43 publications

References 37 publications

Patient’s perspective on improving the quality of acute medical care: determining patient reported outcomes

Patient’s perspective on improving the quality of acute medical care: determining patient reported outcomes

Engaging patients to develop a patient-reported outcome measure for the emergency department

Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario

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