In our everyday lives, we come across circumstances that require immediate medical attention. Patients get varying experiences in different systems that they seek care from and opt to maintain it or seek help from a different system the next time they experience an emergency. In their article, Patients experiences and views of an emergency and urgent care system , Knowles, OCathain and Nicholl carries out a survey to examine the observation of patients regarding the care systems they have sought assistance from. The authors acknowledge that it has necessitated the England policymakers to modify the available regulations in regard to urgent and emergency care as it is observed that people who seek urgent and emergency care have a tendency of consulting several service providers. The various services are found to work well independently but difficult to work together as a system that allows smooth movement of patients in the care corridors. Due to the changes that are frequently made on the individual services and systems, it is difficult to have them work together as changes in one system affect others. The authors point out that this calls for measurement of the system as well as individual service performance, and this is achieved through analyzing the experiences of the patients about each service or system.
The authors conducted the study in central England with the aid of an Urgent Care Network Board. The area covered in the survey consists of one of the big cities, several large towns, and vast rural places. It also consists of a small number of minority communities and many home owners. The urgent and emergency care systems that were taken into consideration include two hospitals that have both emergency and minor injuries sections, and ambulance trust. The data used in the study were collected by carrying out a survey of the whole population in the selected areas. This approach was occasioned by the challenges involved in taking a system survey such as identification of urgent and emergency care users since there is no particular way of capturing them. Furthermore, it is cumbersome to use records in an attempt to identify the users of such systems since there are myriads of services involved and the high chances of multi-counting users who get services on several occasions from the same system. The study overcame these challenges by simply selecting recent users of urgent and emergency care system and this was able to ensure that all the system parts were utilized.
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The study engaged a research company which conducted random phone calls to 1000 respondents. Adults and children were selected to ensure that the sample is representative, and comparing it with random sampling postal survey showed that the sample consisted of all the required variables, was able to differentiate the various system services, cost friendly, and had less missing data. In order to obtain the required information from the respondents, the study utilized a questionnaire developed by utilizing qualitative research where all the respondents answered both socio-demographic and urgent and emergency use related questions. Those who were found to have consulted the care services were asked to provide details of the services they received and their perception on the effectiveness of the system.
The sample size of 1000 respondents was expected to give at least 100 individuals who had received services in the past few months and this would be a good number to analyze the respondents’ views and perceptions on the systems they used. The analysis was done using SPSS and the ANOVA results gave a comparison of chi-squared test and means. The results obtained from the study showed that 15% of the sample had recently used the urgent and emergency care with 145 of them providing their experiences of the systems. Due to the small number of respondents who were able to complete the survey, the authors found it difficult to come up with accurate comparisons on the various systems since the variations were found to be statistically insignificant. Some respondents reported that they contacted the system for an urgent illness but had to wait for longer while others had to receive the services outside the normal working hours. Some also pointed out that they had contacted a number of pathways before receiving the urgent care. Those who used a pathway were as a result of being referred by one service or a change in the health problem. Others were not happy with the services they received while others wanted to seek a second opinion. However, majority of the respondents were satisfied with the system as their needs were met in time although those who had long pathways showed low satisfaction.
Generally, this survey provides insights required to improve care for patients in urgent and emergency systems although it cannot give clear experience of patients who move from one service to another.
Codes used on the study
In health related researches, Research Activity Codes are used to categorize the various research activity types. Generally, coding involves identifying related information in the research and giving them similar labels that can be easily identified. Codes groups can either be based on initial research or created by the researcher and include all facets of research activities. In this research, the most appropriate code is based on grounded theory. Some of the codes that clearly describe the study by Knowles, OCathain and Nicholl include;
Survey on patients’ perception regarding urgent and emergency care
Sampling of the correspondents and the response on emergency care in the last there months
Patients tend to seek care from a number of services in the system and their next step depends on the satisfaction level
Some services provided immediate help for emergency while others took more than expected.
Some services were offered outside the normal working hours depending on the urgency level.
The longer the pathway taken by a patient in urgent and emergency care, the level of satisfaction decreases.
The need to have a second opinion led to a long pathway in seeking services.
The emergency of the ailment as observed by the patient is sometimes taken lightly by the contacted services and makes the patients seek other options.
In every research, researchers take into account various aspects to ensure a professional flow of information. The linkage from the beginning to the end of the research is exhibited by themes, aspects, or issues. In the study under consideration, themes that clearly come out include;
number of pathways in seeking emergency and urgent care
satisfaction in service delivery
services sought in the system
urgent and emergency care
Form the study, the dominant observation is the tendency of individuals to have a long pathway in emergency and urgent care as a result of unsatisfaction and change of ailments. The longer the pathways, the less satisfied the patient is.
Urgent and emergency care may not be as urgent as the patient thinks. Although one may contact a service in a situation that looks urgent, the response might take longer than expected as the care provider finds it as a normal medical case. Patients tend to contact various services in an emergency case before making a decision on which to choose. Although some may opt to get help from one service, they at some point change depending on the kind of ailment or the quality of service they received.
Although most patients get satisfied from the services they obtain, some find that referrals or the need to seek a second opinion has increases their pathways and subsequently decreased their level of satisfaction. This is brought out by the fact that patients are able to compare the services they receive, how long they took to be served, and how effective the help was.
This research provides good information regarding the various available services and what patients think about them. Health services research can be able to use this research is cementing their research basis as they already understand what patients look for in a service. It can also use this research to provide recommendations to the various urgent and emergency care systems which will incorporate any adjustments required to improve their service delivery and boost patients’ confidence in them