Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation
Open accessAbstract
Background: Patient experience is an important outcome and indicator of healthcare quality, and patient reported experiences are key to improving quality of care. While patient experience in emergency departments (EDs) has been reported in research, there is limited evidence about patients’ specific experiences with primary care services located in or alongside EDs. We aim to identify theories about patient experience and acceptability of being streamed to a primary care clinician in an ED. Methods: Using theories from a rapid realist review as a basis, we interviewed 24 patients and 106 staff members to generate updated theories about patient experience and acceptability of streaming to primary care services in EDs. Feedback from 56 stakeholders, including clinicians, policymakers and patient and public members, as well as observations at 13 EDs, also contributed to the development of these theories, which we present as a programme theory. Results: We found that patients had no expectations or preferences for which type of clinician they were seen by, and generally found being streamed to a primary care clinician in the ED acceptable. Clinicians and patients reported that patients generally found primary care streaming acceptable if they felt their complaint was dealt with suitably, in a timely manner, and when clinicians clearly communicated the need for investigations, and how these contributed to decision-making and treatment plans. Conclusions: From our findings, we have developed a programme theory to demonstrate that service providers can expect that patients will be generally satisfied with their experience of being streamed to, and seen by, primary care clinicians working in these services. Service providers should consider the potential advantages and disadvantages of implementing primary care services at their ED. If primary care services are implemented, clear communication is needed between staff and patients, and patient feedback should be sought.
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The degrees of agreement and calculations of sensitivity to change in one-item analogical scales are influenced both by the interventions and by events in the patient's life between evaluations.
“Although therapist-patient agreement is also assumed to be acceptable in this measure, the degrees of agreement and the calculations of sensitivity to change are influenced both by the interventions and by events in the patient's life between evaluations (Hobbs et al., 2021; Price et al., 2022; Robinson et al., 2017).”
From Patients´ and Therapists´ Reports of Psychotherapy Outcomes: Similarities and Differences (2023) · cites this paper as Price et al., 2022
The Background discusses patient experience and satisfaction, and the Methods describe interviews and stakeholder feedback; neither addresses one-item analogical scales. Searches for sensitivity to change, therapist–patient agreement, and events between evaluations found no passage in our copy supporting the attributed claim. No page numbers were provided for these passages. (LLM, conf=0.75)
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References 40 · Cited by 15
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- Authors
- Price, D., Edwards, M., Davies, F., Cooper, A., McFadzean, J., Carson-Stevens, A., Cooke, M., Dale, J., Evans, B. A., Harrington, B., Hepburn, J., Siriwardena, A. N., Snooks, H., & Edwards, A.
- Affiliations
- Cardiff University (GB)
- University of Warwick (GB)
- Swansea University (GB)
- University of Lincoln (GB)
- Corresponding author
- Price, Delyth
- ORCID
- Venue
- BMC Emergency Medicine
- Published
- 2022-01-22
- Volume
- 22
- Issue
- 1
- Pages
- 12-12
- ISSN
- 1471-227X (ISSN-L)
- PMC
- PMC8783419
- OpenAlex
- W4207067144
- Cited by
- 15
- References
- 40
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 2 · 2022: 3
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Emergency Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lincoln Repository (University of Lincoln) (acceptedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (15/145/04)
- Department of Health and Social Care
- Topics
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- patient experience, emergency department, primary care services, patient satisfaction, acceptability, program theory, clinician-patient communication, patient complaints, quality of care
- MeSH terms
- Communication, Emergency Service, Hospital, Humans, Primary Health Care, Quality of Health Care, Qualitative Research
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