Informing quality in emergency care: understanding patient experiences.

PURPOSE: Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as critical. Much patient experience research is quantitative and survey based. The purpose of this paper is to report a qualitative study gathering in-depth data in an emergency department (ED).

DESIGN/METHODOLOGY/APPROACH: The authors used empirical data from seven focus groups to understand patient experience as participants progressed through a major teaching hospital in an Ireland ED. A convenience sampling technique was used, and 42 participants were invited to share their perceptions and outline key factors affecting their journey. A role-playing exercise was used to develop improvement themes. Data were analysed using thematic analysis and data analysis software (NVivo 10).

FINDINGS: Capturing ED patient experience increases our understanding and process impact on the patient journey. Factors identified include information, access, assurance, responsiveness and empathy, reliability and tangibles such as surroundings, food and seating.

RESEARCH LIMITATIONS/IMPLICATIONS: Owing to the ED patient's emergency nature, participants were recruited if triaged at levels 3-5 (Manchester Triage System). The study explored patients' immediate rather than post hoc experiences where recollections may change over time.

ORIGINALITY/VALUE: To the authors' knowledge, no study has examined in-depth, ED patient experience in Ireland using qualitative interviewing, obtaining critical process insights as it occurs. The potential to inform patient process improvements in Irish EDs is significant.