University of Massachusetts, Chan Medical School, Worcester, Massachusetts.
University of Massachusetts, Chan Medical School, Department of Emergency Medicine, Worcester, Massachusetts.
West J Emerg Med. 2023 May 3;24(3):377-383. doi: 10.5811/westjem.58406.
The emergency department (ED) is a critical service area for patients living with disabilities in the United States. Despite this, there is limited research on best practices from the patient experience regarding accommodation and accessibility for those with disabilities. In this study we investigate the ED experience from the perspective of patients living with physical and cognitive disability, as well as visual impairment and blindness, to better understand the barriers to accessibility in the ED for these populations.
Twelve individuals with either physical or cognitive disabilities, visual impairments or blindness were interviewed regarding their ED experiences, particularly related to accessibility. Interviews were transcribed and coded for qualitative analysis with generation of significant themes relating to accessibility in the ED.
Major themes from coded analysis were as follows: 1) inadequate communication between staff and patients with visual impairments and physical disabilities; 2) the need for electronic delivery for after-visit summaries for individuals with cognitive and visual disabilities; 3) the importance of mindful listening and patience by healthcare staff; 4) the role of increased hospital support including greeters and volunteers; and 5) comprehensive training with both prehospital and hospital staff around assistive devices and services.
This study serves as an important first step toward improving the ED environment to ensure accessibility and inclusivity for patients presenting with various types of disabilities. Implementing specific training, policies, and infrastructure changes may improve the experiences and healthcare of this population.
在美国,急诊科(ED)是残疾患者的关键服务区域。尽管如此,关于为残疾患者提供住宿和无障碍设施的最佳实践,从患者体验的角度来看,相关研究仍然有限。在这项研究中,我们从身体和认知残疾、视力障碍和失明患者的角度调查了 ED 的体验,以更好地了解这些人群在 ED 中面临的无障碍障碍。
对 12 名身体或认知残疾、视力障碍或失明的患者进行了 ED 体验采访,特别是与无障碍设施相关的问题。对访谈进行了转录和编码,进行了定性分析,并生成了与 ED 无障碍相关的重要主题。
编码分析的主要主题如下:1)工作人员与视力障碍和身体残疾患者之间沟通不足;2)认知和视力障碍患者需要电子传递就诊后摘要;3)医护人员需要用心倾听和耐心;4)增加医院支持的重要性,包括迎接人员和志愿者;5)对包括院前和院内工作人员进行有关辅助设备和服务的全面培训。
这项研究是朝着改善 ED 环境以确保具有各种残疾类型的患者获得可及性和包容性迈出的重要第一步。实施特定的培训、政策和基础设施改变可能会改善这一人群的体验和医疗保健。