Satisfaction among non-conveyed patients and significant others when discharged at the scene by the ambulance service: an exploratory cross-sectional survey

Larsson, Glenn; Dagerhem, Alma; Wihlborg, Jonas; Rantala, Andreas

doi:10.1186/s12873-022-00659-9

Cited by 5 publications

(5 citation statements)

References 60 publications

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“…However, most of the non-conveyed patients in our study thought that the service they received helped them, and the overall evaluations were good. These results are in accordance with previous Swedish, Australian and Finnish studies [ 12 , 14 , 21 ].…”

Section: Discussionsupporting

confidence: 94%

“…In addition, providing self-care instructions or directing the patient to their own general practitioner made patients feel more confident about non-conveyance [ 11 ]. However, there is a difference in study results on whether the family members are less satisfied than the patients themselves [ 12 , 14 ]. Another recent study from Sweden revealed that patients’ experiences of non-conveyance are versatile and complex, as they felt, for example, insecurity and uncertainty [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Non-conveyance in EMS is still a relatively novel perspective in the study of patient experience and requires further investigation to improve the experience for all parties [ 21 ]. Previous evidence concerning non-conveyance from the perspective of patients or their significant others is mostly qualitative [ 11 , 13 , 14 , 22 ]. This survey study enhances the understanding of the level of patient experience by offering all non-conveyed patients an opportunity to provide feedback on their experience during the research period.…”

Section: Introductionmentioning

confidence: 99%

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Patient experience of non-conveyance in the EMS of Southwest Finland: a descriptive survey study

Skaffari,

Iirola,

Nordquist

2024

BMC Emerg Med

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Background Emergency Medical Services are dispatched more frequently than before. However, many non-urgent patients do not need ambulance transportation to a healthcare facility after evaluation and treatment on scene. This study explored the experiences of non-conveyed patients. Our research questions were: (1) How have non-conveyed patients experienced the service received from EMS? (2) Does a patient’s age, gender, or time of the emergency call impact the patient’s experience? Methods This descriptive survey study examined non-conveyed Emergency Medical Services patients in the Wellbeing Services County of Southwest Finland. The study period was from March 1, 2023, to March 31, 2023. The study population was 1017. They received a questionnaire that was sent by mail. The questionnaire was formed based on questions previously used in four different questionnaires. We received 247 answers (24.3% response rate). Percentages, medians with interquartile ranges, and non-parametric tests were used in the descriptive analyses. Results Non-conveyed patients were very satisfied with the paramedics’ expertise and behavior, their ability to meet their individual needs, the sense of safety provided by the paramedics, and the instructions given to the patients. Time to receive help (19% rated 3 or less on a scale from 1 to 5), how paramedics introduced themselves (16.5%), and satisfaction with non-conveyance decisions (14.6%) were more frequently rated lower than other areas. Further, pain management stood out in the less favorable evaluations. Still, patients’ experiences of the service were positive. The age group, gender, or time of the emergency call were not associated with patient experience. Conclusions Patients were very satisfied with the paramedics’ interpersonal skills. A more focused approach to pain management and developing EMS to ensure faster patient outreach and clearer explanations of non-conveyance decisions could further enhance the patient experience.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient experience of non-conveyance in the EMS of Southwest Finland: a descriptive survey study

Skaffari,

Iirola,

Nordquist

2024

BMC Emerg Med

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“…This study's findings supplement the limitations of prehospital emergency care in Africa that contribute to emergency center mortality. This result of users' satisfaction considerably contradicts the majority of studies conducted regarding ambulance service satisfaction that produced a ceiling effect stating a high ambulance service user satisfaction portfolio [3,4,8,10,11,[22][23][24][25][26]. This discrepancy in satisfaction level might be due to the difference in ambulance service quality that exists among developed and developing countries, given that almost all the literature referenced was conducted in well-developed countries and there is a literature gap regarding ambulance service satisfaction in developing countries to compare to.…”

Section: Discussionmentioning

confidence: 82%

Ambulance service satisfaction level and associated factors among service users in Addis Ababa, Ethiopia

Asfaw,

Yalew,

Godie

et al. 2024

BMC Emerg Med

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Introduction Pre-hospital ambulance service is the most important part of healthcare service. Client satisfaction with the service indicates the degree of adaptation to the appropriate quality and quantity of services. Patients’ dissatisfaction with the service can affect their expectations of the overall services that they will receive later in the definitive care facility. However, it is not a well-addressed area in developing countries, including Ethiopia. Objective This study aimed to identify the ambulance service satisfaction level and associated factors among service users in Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted in five governmental hospitals in Addis Ababa city. A face-to-face exit interview technique was employed on a total of 410 consecutively selected participants using a pretested tool developed from similar sources. The cleaned data was entered into the Epi-Data Manager 4.6 version and then exported to SPSS version 26 for analysis. The dependent variable was dichotomized into satisfied and unsatisfied to compute bivariate logistic regression. In the multivariate logistic regression model, predictors with a p-value < 0.05 at the 95% CI were considered to have a significant association. Result A total of 410 respondents were included in the study. The mean of participants’ responses regarding ambulance personnel, call operator, treatment on the scene, and ambulance subscale was 3.64, 3.48, 3.40, and 3.43, respectively. The study found that only 21.5% of participants were satisfied by the ambulance service they received. There was a statistically significant association between ambulance service satisfaction and age (AOR = 3.52, 95% CI: 1.01–12.36), monthly income (AOR = 3.13, 95% CI: 1.41–6.94), ambulance response time (AOR = 10.33, 95% CI: 2.09–51.06), type of ambulance used (AOR = 4.55, 95% CI: 2.19–9.43), and previous ambulance usage (AOR = 2.33, 95% CI: 1.34–4.05). Conclusion The study found a low level of satisfaction among ambulance users. The findings suggest that ambulance personnel performance is a key determinant of user satisfaction, while treatment at the scene and in the ambulances, and call operator areas require improvement. Age, monthly income, ambulance response time, type of ambulance, and previous ambulance use also influenced satisfaction. Improving the quality of services, reducing response time, and ensuring call operators are trained are vital steps to enhance satisfaction.

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“…Their wishes were possibly affected by previous experiences and the sense of severity of an acute situation (63,104,152). Of the older patients who remained at home after assessment by ambulance personnel, most of them were satisfied with the decision (80), among patients of all ages have both satisfaction (153) and dissatisfaction (154) been identified. It is reasonable to assume that older patients also had experienced dissatisfaction.…”

Section: Older Patientsmentioning

confidence: 99%

Pathways for older patients in acute situations and involved actors' experiences of decision-making in ambulatory care

Forsgärde¹

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Aim: The overall aim was to describe and compare pathways for older patients and the involved actors’ experiences of decision-making in acute situations in ambulatory care. Methods: The overall three-fold design, comprising exploratory, descriptive as well as comparative ones, was conducted inductively, including a mixed method with a convergent integrated approach to empirical data. The four involved studies were analysed using either quantitative or qualitative analysis methods. Results: Most older patients’ pathways when being assessed by ambulance personnel involved receiving care at hospitals. However, an increasing trend of non-conveyance to hospitals was identified during a five-year period (2014–2018), which means receiving care, for example, at home or primary healthcare (PHC) centres. Decision-making about the level-of-care for older patients was more or less uncertain for all involved actors, i.e. older patients, significant others and healthcare professionals such as ambulance personnel, registered nurses, specialists in general practice at PHC centres and community health nurses. To increase the level of certainty in the decision-making process, all actors was supported by both an individual and external dialogue. Individual dialogue gave support by using own experience and knowledge. For ambulance personnel and community health nurses, support was also partially gained from decision support tools but was regarded as insufficient when older patients had non-specific symptoms. External dialogue provided support through mutuality, and via collaboration, a common goal, trust and responsibility. Mutuality gave support through experience and knowledge being shared with all involved actors, which provided a common comprehensive understanding that facilitated consensus in the decision-making. Conclusion: The increasing level of non-conveyance to hospitals and uncertainty during decision-making highlights the need to develop and extend the availability of dialogue-based collaborations as support in ambulatory care. Dialogue-based support involves all actors contributing to the decision-making. Healthcare professionals need to be aware of the prerequisites and the support that mutuality in external dialogues brings. Healthcare organisations need to develop and extend dialogue-based collaboration in ambulatory care by combining different expertise and providing conditions to increase support in decisions adapted to older patients' needs.

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Satisfaction among non-conveyed patients and significant others when discharged at the scene by the ambulance service: an exploratory cross-sectional survey

Cited by 5 publications

References 60 publications

Patient experience of non-conveyance in the EMS of Southwest Finland: a descriptive survey study

Patient experience of non-conveyance in the EMS of Southwest Finland: a descriptive survey study

Ambulance service satisfaction level and associated factors among service users in Addis Ababa, Ethiopia

Pathways for older patients in acute situations and involved actors' experiences of decision-making in ambulatory care

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