Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Patrick Bodenmann MD; Miriam Kasztura MS; Madison Graells MS; Elodie Schmutz MS; Oriane Chastonay MS; Marina Canepa-Allen MS; Joanna Moullin PhD; Michael von Allmen MS; Melissa Lemoine PhD; Olivier Hugli MD; Jean-Bernard Daeppen MD; Véronique S. Grazioli PhD

doi:10.1177/00469580211028173

Inquiry: The Journal of Health Care Organization, Provision, and Financing (Jul 2021)

Healthcare Providers’ Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study

Patrick Bodenmann MD,
Miriam Kasztura MS,
Madison Graells MS,
Elodie Schmutz MS,
Oriane Chastonay MS,
Marina Canepa-Allen MS,
Joanna Moullin PhD,
Michael von Allmen MS,
Melissa Lemoine PhD,
Olivier Hugli MD,
Jean-Bernard Daeppen MD,
Véronique S. Grazioli PhD

Affiliations

Patrick Bodenmann MD: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Miriam Kasztura MS: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Madison Graells MS: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Elodie Schmutz MS: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Oriane Chastonay MS: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Marina Canepa-Allen MS: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Joanna Moullin PhD: Faculty Health Sciences, School of Pharmacy and Biomedical Sciences, Curtin University, Western Australia
Michael von Allmen MS: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Melissa Lemoine PhD: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Olivier Hugli MD: Emergency Department, Lausanne University Hospital, University of Lausanne, Switzerland
Jean-Bernard Daeppen MD: Addiction Medicine, Department of Psychiatry, University of Lausanne, Switzerland
Véronique S. Grazioli PhD: Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland

DOI: https://doi.org/10.1177/00469580211028173
Journal volume & issue: Vol. 58

Abstract

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Frequent users of emergency departments (FUED; ≥ 5 ED visits/year) commonly cumulate medical, social, and substance use problems requiring complex and sustained care coordination often unavailable in ED. This study aimed to explore ED healthcare providers’ challenges related to FUED care to gain insight into the support and resources required to address FUED complex needs. An online survey was sent to all general adult emergency services within Switzerland (N = 106). Participants were asked to indicate the extent to which they perceived that FUED represented a problem and to describe the main challenges encountered. In total, 208 physicians and nurses from 75 EDs (70.7%) completed the survey. Among the 208 participants, 134 (64%) reported that FUED represented a challenge and 133 described 1 to 5 challenges encountered. A conventional content analysis yielded 4 main categories of perceived challenges. Negative consequences in the ED secondary to FUED’s presence (eg, ED overcrowding, staff helplessness, and fatigue) was the most frequently reported challenge, followed by challenges related to FUEDs’ characteristics (eg, mental health and social problems) leading to healthcare complexity. The third most frequently encountered challenge was related to the ED inappropriateness and inefficiency to address FUEDs’ needs. Finally, challenges related to the lack of FUED healthcare network were the least often mentioned. ED healthcare providers experience a wide range of challenges related to FUED care. These findings suggest that currently EDs nor their staff are equipped to address FUEDs’ complex needs.

Published in Inquiry: The Journal of Health Care Organization, Provision, and Financing

ISSN: 0046-9580 (Print); 1945-7243 (Online)
Publisher: SAGE Publishing
Country of publisher: United States
LCC subjects: Medicine: Public aspects of medicine
Website: https://journals.sagepub.com/home/inq

About the journal