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Research Article: Experience-based codesign approach to improve care in Australian emergency departments for complex consumer cohorts: the MyED project protocol, Stages 1.1–1.3

Date Published: 2023-07-05

Abstract:
Introduction Emergency department (ED) care must adapt to meet current and future demands. In Australia, ED quality measures (eg, prolonged length of stay, re-presentations or patient experience) are worse for older adults with multiple comorbidities, people who have a disability, those who present with a mental health condition, Indigenous Australians, and those with a culturally and linguistically diverse (CALD) background. Strengthened ED performance relies on understanding the social and systemic barriers and preferences for care of these different cohorts, and identifying viable solutions that may result in sustained improvement by service providers. A collaborative 5-year project (MyED) aims to codesign, with ED users and providers, new or adapted models of care that improve ED performance, improve patient outcomes and improve patient experience for these five cohorts. Methods and analysis Experience-based codesign using mixed methods, set in three hospitals in one health district in Australia. This protocol introduces the staged and incremental approach to the whole project, and details the first research elements: ethnographic observations at the ED care interface, interviews with providers and interviews with two patient cohorts—older adults and adults with a CALD background. We aim to sample a diverse range of participants, carefully tailoring recruitment and support. Ethics and dissemination Ethics approval has been obtained from the Western Sydney Local Health District Human Research Ethics Committee (2022/PID02749-2022/ETH02447). Prior informed written consent will be obtained from all research participants. Findings from each stage of the project will be submitted for peer-reviewed publication. Project outputs will be disseminated for implementation more widely across New South Wales, Australia.

Introduction:
The demand for urgent hospital care is increasing in Australia 1 and internationally, 2 placing prolonged strain on emergency departments (ED). Overcrowding and access block arising from increased ED demand and inadequate hospital patient flow is associated with increased adverse events 3 4 and poor patient outcomes, 5 6 including increased mortality. 7 Integrated system-level approaches that incorporate evidence-based human factors and codesign are needed to adapt ED care to meet current and future demand. 8 9…

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