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

Colleen Cheek; Nema Hayba; Lieke Richardson; Elizabeth E Austin; Emilie Francis Auton; Mariam Safi; Natália Ransolin; Matthew Vukasovic; Aaron De Los Santos; Margaret Murphy; Reema Harrison; Kate Churruca; Janet C Long; Peter D Hibbert; Ann Carrigan; Bronwyn Newman; Karen Hutchinson; Rebecca Mitchell; Henry Cutler; Leanne Holt; Jeffrey Braithwaite; Donna Gillies; Paul M Salmon; Ramesh Lahiru Walpola; Yvonne Zurynski; Louise A Ellis; Kylie Smith; Anthony Brown; Reza Ali; Kylie Gwynne; Robyn Clay-Williams

doi:10.1136/bmjopen-2023-072908

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

BMJ Open. 2023 Jul 5;13(7):e072908. doi: 10.1136/bmjopen-2023-072908.

Authors

Colleen Cheek¹, Nema Hayba¹, Lieke Richardson¹, Elizabeth E Austin¹, Emilie Francis Auton¹, Mariam Safi¹, Natália Ransolin¹, Matthew Vukasovic², Aaron De Los Santos³, Margaret Murphy^{2

4}, Reema Harrison¹, Kate Churruca¹, Janet C Long¹, Peter D Hibbert^{1

5}, Ann Carrigan¹, Bronwyn Newman¹, Karen Hutchinson¹, Rebecca Mitchell¹, Henry Cutler^{1

6}, Leanne Holt⁷, Jeffrey Braithwaite¹, Donna Gillies⁸, Paul M Salmon⁹, Ramesh Lahiru Walpola¹⁰, Yvonne Zurynski¹, Louise A Ellis¹, Kylie Smith¹¹, Anthony Brown¹², Reza Ali³, Kylie Gwynne⁷, Robyn Clay-Williams¹³

Affiliations

¹ Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
² Department of Emergency Medicine, Westmead Hospital, Westmead, New South Wales, Australia.
³ Department of Emergency Medicine, Blacktown and Mount Druitt Hospital, Blacktown, New South Wales, Australia.
⁴ University of Sydney, Sydney, New South Wales, Australia.
⁵ University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia.
⁶ Macquarie University Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia.
⁷ Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
⁸ NDIS Quality and Safeguards Commission, Penrith, New South Wales, Australia.
⁹ Centre for Human Factors and Sociotechnical Systems, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia.
¹⁰ School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
¹¹ Emergency Care Institute, NSW Agency for Clinical Innovation, St Leonards, New South Wales, Australia.
¹² Western Sydney University, Penrith, New South Wales, Australia.
¹³ Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia robyn.clay-williams@mq.edu.au.

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.

Keywords: health equity; patient participation; patient-centered care; quality in health care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Australia
Emergency Medical Services*
Emergency Service, Hospital*
Hospitals
Humans
New South Wales