Barriers, Challenges, and Facilitators Experienced by Healthcare Professionals in Providing Immediate and Efficient Care in the Emergency Department: A Mixed-Methods Study.

backgroundEmergency departments (EDs) are frontline units serving 24×7 services to patients. Healthcare professionals often face several barriers and challenges that hinder them from delivering immediate and efficient care. Overcrowding, inadequate staffing, lack of triage skills, communication gaps, and workplace aggression from relatives of patients are the major factors that impact ED performance. Identifying these barriers, challenges, and facilitators is important for quality emergency care services. MATERIALS AND

methodsA sequential explanatory mixed-method design was employed in the ED of Uttar Pradesh University of Medical Sciences, Saifai, India. The study was divided into two phases. Phase I used a quantitative descriptive approach with a reliable Likert-scale questionnaire to estimate barriers and facilitators among 53 participants (22 doctors and 31 nurses). Phase II used a qualitative approach through semi-structured interviews with 13 purposively selected participants until data saturation was achieved. Qualitative data were analysed through thematic analysis.

resultsQuantitative findings showed that 26 (49.1%) participants marked inadequate staffing, 32 (60.4%) identified delayed information transfer, and 42 (79.2%) showed inefficient triage as primary barriers. Facilitators reported included team support (n=31, 58.5%), clear protocols (n=32, 60.4%), and continuous professional development (n=31, 58.5%). Qualitative analysis revealed six themes: overcrowding, challenges with triage, safety concerns due to aggressive relatives, shortage of staff, communication barriers, and time-consuming duplication of paperwork. These challenges lead to staff burnout, delayed patient care, and medical errors.

conclusionThe study critically analysed the barriers, challenges, and facilitators affecting the ED's performance. It highlights that supportive teamwork, training, and clear communication are key factors in facilitators. Urgent interventions such as improving staff numbers, enhancing triage training, and streamlining administrative processes are important. These issues should be assessed to improve patient outcomes, healthcare staff wellbeing, and the efficiency of emergency services.