Privacy Matters: Experiences of Rural and Remote Emergency Department Patients - A Mixed-Methods Research Conducted in Newfoundland and Labrador, Canada.

Objectives: This study aims to investigate patients' privacy experience when receiving care in emergency departments (EDs) in Newfoundland and Labrador, Canada. We aim to assess the level of satisfaction with privacy and to assess for factors that improve or worsen the privacy experience, not limited to patient demographics, length of stay, and hospital location. Methods: This study used a mixed-methods design, gathering quantitative and qualitative data using a telephone survey and semi-structured interviews. Our primary outcome measure was patients' privacy experience in the ED. The independent variables in our study were age, gender, ED location, patient-reported wait times, reason for ED visit, and healthcare provider involved in care. Results: Among the 821 patients who participated in the interviews, 1 in 4 patients (24%) did not have satisfactory ED privacy experiences. Multinominal logistic regression showed patients who waited 4+ hours before being examined by a provider [aOR = 0.34, 95% CI: 0.17-0.69] and those who visited the urban EDs [aOR = 0.17, 95% CI: 0.09-0.35] reported low levels of privacy. Furthermore, those whose overall length of stay was 4 to 8 hours [aOR = 0.44, 95% CI: 0.23-0.84] and 8+ hours [aOR = 0.36, 95% CI: 0.17-0.78] also reported dissatisfaction with ED privacy experience. Our qualitative analysis found privacy concerns in waiting rooms, triage areas, and curtain rooms, with females voicing more concerns than males. Conclusion: Patients with longer wait times and who have been seen in urban EDs experience less privacy. Our qualitative data shows that women also raised more privacy concerns than men and that waiting rooms and triage areas are the locations with the most reported privacy concerns. Patient experience and outcomes would benefit from improving patient privacy when receiving care in EDs.