Experiences and perspectives of older patients with a return visit to the emergency department within 30 days: patient journey mapping
Open accessAbstract
Purpose: Up to 22% of older patients who visit the emergency department (ED) have a return visit within 30 days. To achieve patient-centered care for this group at the ED it is important to involve the patient perspective and strive to provide the best possible experience. The aim of this study was to gain insight into the experiences and perspectives of older patients from initial to return ED visit by mapping their patient journey. Methods: We performed a qualitative patient journey study with 13 patients of 70 years and older with a return ED visit within 30 days who presented at the Amsterdam UMC, a Dutch academic hospital. We used semi-structured interviews focusing on the patient experience during their journey and developed a conceptual framework for coding. Results: Our sample consisted of 13 older patients with an average age of 80 years, and 62% of them were males. The framework contained a timeline of the patient journey with five chronological main themes, complemented with an ‘experience’ theme, these were divided into 34 subthemes. Health status, social system, contact with the general practitioner, aftercare, discharge and expectations were the five main themes. The experiences regarding these themes differed greatly between patients. The two most prominent subthemes were waiting time and discharge communication, which were mostly related to a negative experience. Conclusions: This study provides insight into the experiences and perspectives of older patients from initial to return ED visit. The two major findings were that lack of clarity regarding waiting times and suboptimal discharge communication contributed to negative experiences. Recommendations regarding waiting time (i.e. a two-hour time out at the ED), and discharge communication (i.e. checklist for discharge) could contribute to a positive ED experience and thereby potentially improve patient-centered care.
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Patient journey mapping has been effectively used to understand patient experience, improve quality of care, and inform health service redesign/improvement.
“Of the existing literature, patient journey mapping has been effectively used to understand the patient experience [16–18], improve the quality of care [7, 19], and for informing health service redesign/improvement [13, 15, 20].”
From The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping (2023) · cites this paper as [16]
The Discussion says patient journey mapping allowed the authors to measure and visualize older patients’ experiences, and the Conclusion says it helped pinpoint potential solutions for more patient-centered ED care. The paper does not report that those solutions were implemented or that mapping improved care quality or led to a health service redesign. Page numbers were not provided in our copy. (LLM, conf=0.85)
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References 58 · Cited by 30
Research works printed but not linked: 1
- [20]Institute of Medicine Committee on Quality of Health Care in A (2001) Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US) Copyright 2001 by the National Academy of Sciences. All rights reserved
- Authors
- Schouten, B., Driesen, B. E. J. M., Merten, H., Burger, B. H. C. M., Hartjes, M. G., Nanayakkara, P. W. B., & Wagner, C.
- Affiliations
- Amsterdam Public Health (NL)
- Netherlands Institute for Health Services Research (NL)
- Corresponding author
- Schouten, Bo
- ORCID
- Venue
- European Geriatric Medicine
- Published
- 2021-11-10
- Volume
- 13
- Issue
- 2
- Pages
- 339-350
- ISSN
- 1878-7649 (ISSN-L)
- 1878-7657
- PMC
- PMC9018642
- OpenAlex
- W3213025554
- Cited by
- 30
- References
- 58
- Citations by year
- 2026: 10 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 2
- FWCI
- 3.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Geriatric Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Keywords
- elderly patients, emergency department visits, patient experience, patient journey mapping, waiting time, discharge communication, patient-centered care, follow-up care, general practitioner contact, patient expectations
- MeSH terms
- Aftercare, Aged, 80 and over, Emergency Service, Hospital, Female, Hospitals, Humans, Male, Patient Discharge, Qualitative Research
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