Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception
Abstract Objective Frequent users of emergency departments (FUED) account for a disproportionate number of emergency department (ED) visits and contribute to a wide range of challenges for ED staff. While several research has documented that case management (CM) tailored to FUED leads to a reduction...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-021-00481-9 |
| _version_ | 1818728785207361536 |
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| author | Michael von Allmen Véronique S. Grazioli Miriam Kasztura Oriane Chastonay Joanna C. Moullin Olivier Hugli Jean-Bernard Daeppen Patrick Bodenmann |
| author_facet | Michael von Allmen Véronique S. Grazioli Miriam Kasztura Oriane Chastonay Joanna C. Moullin Olivier Hugli Jean-Bernard Daeppen Patrick Bodenmann |
| author_sort | Michael von Allmen |
| collection | DOAJ |
| description | Abstract Objective Frequent users of emergency departments (FUED) account for a disproportionate number of emergency department (ED) visits and contribute to a wide range of challenges for ED staff. While several research has documented that case management (CM) tailored to FUED leads to a reduction in ED visits and a better quality of life (QoL) among FUED, whether there is added value for ED staff remains to be explored. This study aimed to compare, among staff in two academic EDs in Switzerland (one with and one without CM), the FUED-related knowledge, perceptions of the extent of the FUED issue, FUED-related work challenges and FUEDs’ legitimacy to use ED. Method Mixed methods were employed. First, ED physicians and nurses (N = 253) of the two EDs completed an online survey assessing their knowledge and perceptions of FUEDs. Results between healthcare providers working in an ED with CM to those working in an ED without CM were compared using independent two-sided T-tests. Next, a sample of participants (n = 16) took part in a qualitative assessment via one-to-one interviews (n = 6) or focus groups (n = 10). Results Both quantitative and qualitative results documented that the FUED-related knowledge, the extent FUED were perceived as an issue and perceived FUEDs’ legitimacy to use ED were not different between groups. The level of perceived FUED-related challenges was also similar between groups. Quantitative results showed that nurses with CM experienced more challenges related to FUED. Qualitative exploration revealed that lack of psychiatric staff within the emergency team and lack of communication between ED staff and CM team were some of the explanations behind these counterintuitive findings. Conclusion Despite promising results on FUEDs’ QoL and frequency of ED visits, these preliminary findings suggest that CM may provide limited support to ED staff in its current form. Given the high burden of FUED-related challenges encountered by ED staff, improved communication and FUED-related knowledge transfer between ED staff and the CM team should be prioritized to increase the value of a FUED CM intervention for ED staff. |
| first_indexed | 2024-12-17T22:35:30Z |
| format | Article |
| id | doaj.art-b4dd3d73fdc04f4ab61f25beaea22b38 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-17T22:35:30Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-b4dd3d73fdc04f4ab61f25beaea22b382022-12-21T21:30:06ZengBMCBMC Emergency Medicine1471-227X2021-08-012111810.1186/s12873-021-00481-9Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff PerceptionMichael von Allmen0Véronique S. Grazioli1Miriam Kasztura2Oriane Chastonay3Joanna C. Moullin4Olivier Hugli5Jean-Bernard Daeppen6Patrick Bodenmann7Department of Vulnerabilities and Social Medicine, University Center for General Medicine and Public HealthDepartment of Vulnerabilities and Social Medicine, University Center for General Medicine and Public HealthDepartment of Vulnerabilities and Social Medicine, University Center for General Medicine and Public HealthDepartment of Vulnerabilities and Social Medicine, University Center for General Medicine and Public HealthFaculty of Health Sciences, Curtin UniversityEmergency Department, University HospitalAddiction Medicine, Department of Psychiatry, Lausanne University Hospital, University of LausanneDepartment of Vulnerabilities and Social Medicine, University Center for General Medicine and Public HealthAbstract Objective Frequent users of emergency departments (FUED) account for a disproportionate number of emergency department (ED) visits and contribute to a wide range of challenges for ED staff. While several research has documented that case management (CM) tailored to FUED leads to a reduction in ED visits and a better quality of life (QoL) among FUED, whether there is added value for ED staff remains to be explored. This study aimed to compare, among staff in two academic EDs in Switzerland (one with and one without CM), the FUED-related knowledge, perceptions of the extent of the FUED issue, FUED-related work challenges and FUEDs’ legitimacy to use ED. Method Mixed methods were employed. First, ED physicians and nurses (N = 253) of the two EDs completed an online survey assessing their knowledge and perceptions of FUEDs. Results between healthcare providers working in an ED with CM to those working in an ED without CM were compared using independent two-sided T-tests. Next, a sample of participants (n = 16) took part in a qualitative assessment via one-to-one interviews (n = 6) or focus groups (n = 10). Results Both quantitative and qualitative results documented that the FUED-related knowledge, the extent FUED were perceived as an issue and perceived FUEDs’ legitimacy to use ED were not different between groups. The level of perceived FUED-related challenges was also similar between groups. Quantitative results showed that nurses with CM experienced more challenges related to FUED. Qualitative exploration revealed that lack of psychiatric staff within the emergency team and lack of communication between ED staff and CM team were some of the explanations behind these counterintuitive findings. Conclusion Despite promising results on FUEDs’ QoL and frequency of ED visits, these preliminary findings suggest that CM may provide limited support to ED staff in its current form. Given the high burden of FUED-related challenges encountered by ED staff, improved communication and FUED-related knowledge transfer between ED staff and the CM team should be prioritized to increase the value of a FUED CM intervention for ED staff.https://doi.org/10.1186/s12873-021-00481-9Frequent users of emergency departmentsCase managementEmergency serviceStaff |
| spellingShingle | Michael von Allmen Véronique S. Grazioli Miriam Kasztura Oriane Chastonay Joanna C. Moullin Olivier Hugli Jean-Bernard Daeppen Patrick Bodenmann Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception BMC Emergency Medicine Frequent users of emergency departments Case management Emergency service Staff |
| title | Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception |
| title_full | Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception |
| title_fullStr | Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception |
| title_full_unstemmed | Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception |
| title_short | Does Case Management Provide Support for Staff Facing Frequent Users of Emergency Departments? A Comparative Mixed-Method Evaluation of ED Staff Perception |
| title_sort | does case management provide support for staff facing frequent users of emergency departments a comparative mixed method evaluation of ed staff perception |
| topic | Frequent users of emergency departments Case management Emergency service Staff |
| url | https://doi.org/10.1186/s12873-021-00481-9 |
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