# Voices from the emergency department: A theoretical framework analysis on patient experiences of care in emergency departments of Newfoundland and Labrador, Canada

## TL;DR

This study explores patient experiences in emergency departments in Newfoundland and Labrador, identifying key themes to improve care and patient-centered approaches.

## Contribution

The study introduces a novel application of symbolic interactionism to analyze patient experiences in EDs, revealing actionable themes for improvement.

## Key findings

- Six key themes were identified, including respect, communication, and continuity of care.
- Findings highlight the need for training programs and system modifications to enhance patient experience.
- Patient navigators and triage system changes are recommended for vulnerable populations.

## Abstract

Patient experience in the emergency department (ED) encompasses different aspects of care, such as respect, communication, timeliness, shared decision-making, and care transition. The inherently stressful ED environment presents additional challenges for providers in ensuring a positive patient experience. Studying patient experience allows health systems to recognize areas of care that need improvement and introduce strategies to improve patient-centred care.

To explore the patient experience of emergency department care in Newfoundland and Labrador (NL), Canada.

This qualitative study collected data from patients who visited two urban and two rural EDs in NL via telephone surveys and semi-structured interviews. Five researchers used a theoretical framework, symbolic interactionism, to analyze open-ended survey responses and semi-structured interviews. Patient research partners were consulted to ensure the themes reflected their lived experiences.

A total of 836 responses were analyzed (831 survey responses, five semi-structured interviews), leading to six key themes on patient experience. They are: (1) Mutual respect and trust in providers, (2) Timeliness of care, (3) Communication, (4) Comfort and accommodations, (5) Information sharing and decision-making, and (6) Continuity of care.

Our findings show an immediate need to improve the patient experience of ED care and highlight areas within these themes that could be targeted for improvement. We recommend regular training programs for healthcare providers to improve their interpersonal skills, the addition of patient navigators, and modifications to the triage system for vulnerable populations to improve patient experience and provide patient-centred care.