Abstract
Background: Media attention has highlighted poor quality care experiences in emergency departments. Overcrowding, prolonged delays in treatment of pain and suffering, lengthy waiting times, and patient and staff dissatisfaction have all been reported. Person-centred approaches have been shown to transform the care experience in a range of healthcare settings, however this concept is largely unexplored within the emergency department context.Aim and objectives: This study was designed to explore person-centredness in emergency departments. Three objectives were established: (i) exploring the relationship between attributes of nurses and doctors, their engagement in care processes and the care environment from a staff perspective, (ii) investigating how the relationships identified from objective one were experienced by staff and service users and (iii) psychometric testing of the measurement tool.
Methodology: A two-stage sequential mixed methods study was adopted. For the stage 1 survey, the Person-centred Practice Inventory-Staff was distributed to qualified nurses and doctors in all emergency departments in one region in the United Kingdom. In qualitative stage two, semi-structured interviews were conducted with 44 emergency department staff and service users. The datasets from both stages were integrated at the interpretive stage.
Results: Statistical analysis of the 308 completed questionnaires revealed that staff felt they were person-centred and delivered person-centred care. Thematic analysis of the qualitative data, using Braun and Clarke’s framework, revealed an environment xi in which person-centredness was not being realised, and identified poor care experiences for staff and service users.
Integration of the datasets showed that while emergency department staff supported a philosophy of person-centeredness, service users do not experience person centred care. There was an interplay between the macro-context and the care environment, which had a powerful compromising influence on care delivery. In addition, staffs’ own value and belief systems, which valued the priority of medical technical care, were a barrier to person-centred practice.
| Date of Award | Jan 2018 |
|---|---|
| Original language | English |
| Sponsors | Ulster University |
| Supervisor | Tanya Mc Cance (Supervisor), Vidar Melby (Supervisor) & Paul Slater (Supervisor) |
Keywords
- Person-centredness
- Emergency Department
- Culture
- Macro-context
- Values and beliefs