Craston Alex I P, Scott-Murfitt Harriet, Omar Mariam T, Abeyratne Ruw, Kirk Kate, Mackintosh Nicola, Roland Damian, van Oppen James David
Medical School, University of Leicester, Leicester, UK.
Emergency & Specialist Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
Emerg Med J. 2025 Feb 21;42(3):148-153. doi: 10.1136/emermed-2023-213751.
Emergency department (ED) crowding causes increased mortality. Professionals working in crowded departments feel unable to provide high-quality care and are predisposed to burnout. Awareness of the impact on patients, however, is limited to metrics and surveys rather than understanding perspectives. This project investigated patients' experiences and identified mitigating interventions.
A qualitative service evaluation was undertaken in a large UK ED. Adults were recruited during periods of high occupancy or delayed transfers. Semi-structured interviews explored experience during these attendances. Participants shared potential mitigating interventions. Analysis was based on the interpretative phenomenological approach. Verbatim transcripts were read, checked for accuracy, re-read and discussed during interviewer debriefing. Reflections about positionality informed the interpretative process.
Seven patients and three accompanying partners participated. They were aged 24-87 with characteristics representing the catchment population. Participants' experiences were characterised by 'loss of autonomy', 'unmet expectations' and 'vulnerability'. Potential mitigating interventions centred around information provision and better identification of existing ED facilities for personal needs.
Participants attending a crowded ED experienced uncertainty, helplessness and discomfort. Recommendations included process and environmental orientation.
急诊科拥挤导致死亡率上升。在拥挤科室工作的专业人员感到无法提供高质量护理，且易产生职业倦怠。然而，对患者影响的认知仅限于指标和调查，而非理解其观点。本项目调查了患者的经历并确定了缓解干预措施。
在英国一家大型急诊科进行了定性服务评估。在高占用率或转运延迟期间招募成年人。半结构化访谈探讨了这些就诊期间的经历。参与者分享了潜在的缓解干预措施。分析基于解释现象学方法。逐字记录被阅读、检查准确性、再次阅读并在访谈者汇报期间进行讨论。关于位置性的反思为解释过程提供了信息。
七名患者和三名陪同家属参与。他们年龄在24至87岁之间，特征代表了服务区域内的人群。参与者的经历以“自主性丧失”、“期望未满足”和“脆弱性”为特征。潜在的缓解干预措施集中在信息提供以及更好地识别现有的急诊科设施以满足个人需求。
在拥挤急诊科就诊的参与者经历了不确定性、无助感和不适。建议包括流程和环境引导。
