ArticleBMC health services research2021
Factors to improve quality for older patients in the emergency department: a qualitative study of patient trajectory.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Inclusion of Informal Carers in the Care of Older Adults in the Emergency Department: An Integrative Review.Journal of clinical nursing · 2025Pooled it
- Involving patients and caregivers to develop items for a new patient-reported experience measure for older adults attending the emergency department. Findings from a nominal group technique study.Health expectations : an international journal of public participation in health care and health policy · 2023Pooled it
- A Physiotherapy-Led Transition to Home Intervention for Older Adults Following Emergency Department Discharge: A Pilot Feasibility Randomised Controlled Trial (ED PLUS).Clinical interventions in aging · 2023Trial
- A simple quality-of-care intervention targeting nurses for improving care of older patients in the emergency department: a Western European multicenter study.European geriatric medicine · 2026Article
- Demographics, clinical features and outcomes of older patients presenting to an Irish emergency department.Irish journal of medical science · 2026Article
- Balancing care needs - a qualitative study on prehospital emergency nurses' experiences of providing self-care advice and home referrals for frail older patients.BMC emergency medicine · 2025Article
- The PRO-AGE Tool and Its Association With Post Discharge Outcomes in Older Adults Admitted From the Emergency Department.Journal of the American Geriatrics Society · 2025Observational
- Optimizing older patient care in emergency departments: a comprehensive survey of current practices and challenges in Northern Italy.BMC emergency medicine · 2024Article
- Evaluating a new emergency department avoidance service for older people: patient and relative experiences.Emergency medicine journal : EMJ · 2023Article
- Initial Development of a Patient-Reported Experience Measure for Older Adults Attending the Emergency Department: Part II-Focus Groups with Professional Caregivers.Healthcare (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManaging older people in the emergency department remains a challenge. We aimed to identify the factors influencing the care quality of older patients in the emergency department, to fine-tune future interventions for older people, considering the naturalistic context of the ED.
methodsThis is a qualitative study of some 450 h of observations performed in three emergency departments selected for their diverse contexts. We performed seventy observations of older patient trajectories admitted to the emergency department. Themes were extracted from the material using an inductive reasoning approach, to highlight factors positively or negatively influencing management of patient's trajectories, in particular those presenting with typically geriatric syndromes.
resultsFour themes were developed: no geriatric flow routine; risk of discontinuity of care; unmet basic needs and patient-centered care; complex older patients are unwelcome in EDs.
conclusionsThe overall process of care was based on an organ- and flow-centered paradigm, which ignored older people's specific needs and exposed them to discontinuity of care. Their basic needs were neglected and, when their management slowed the emergency department flow, older people were perceived as unwelcome. Findings of our study can inform the development of interventions about the influence of context and organizational factors.
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