A Small-Scale Qualitative Study of Early Comprehensive Patient Engagement in Acute Clinical Settings: Is It Feasible?

Background: Patient-centered care (PCC) based on systematic and comprehensive patient engagement is important for patient satisfaction. However, ensuring PCC is difficult in emergency departments (ED) characterized by a high patient flow and a substantial proportion of older adults with multimorbidity and complex care needs. This small-scale qualitative study aimed to identify potentials and barriers for providing early PCC for older adults in Danish EDs using a novel user-engagement conversation tool.Methods: Participant observation, focus group interviews and individual semi-structured interviews with ED nurses and geriatric nurses were conducted between September and December 2019 in an ED at a hospital in the Capital Region of Denmark. Thematic network analysis with a focus on potentials and barriers for patient engagement was conducted.Results: Two key subthemes related to potentials emerged: 1) a positive attitude towards patient engagement in the context of PCC, and; 2) perceived benefits of PCC overall and the engagement tool in particular. Additionally, two key subthemes related to barriers emerged: 1) time constraints and; 2) concerns related to the importance of cross-sectoral care coordination.Conclusion: This study contributes to mounting evidence in support of policies and practices that encourage PCC as a driver of unpacking patients’ needs and values leading to targeted follow-up care. However, barriers such as time constraints, and lack of cross-sectoral care collaboration should be acknowledged if the potentials of PCC is to be fulfilled in ED settings.