A Mixed Methods SEIPS-based Evaluation of a Patient-centered ED Discharge Process Redesign for Older Adults

Area of Science:

• Gerontology
• Health Services Research
• Patient Safety

Background:

• Transitions from the emergency department (ED) to home for older adults present risks of preventable harm.
• Effective communication and coordination are crucial for safe patient discharges.
• Existing ED discharge processes often lack patient-centered elements.

Purpose of the Study:

• To develop and evaluate a patient-centered intervention for older adult ED discharges.
• To improve communication and coordination between ED staff and patients.
• To assess the intervention's impact from patient and provider perspectives.

Main Methods:

• Human-centered design process and SEIPS 3.0 model utilized for evaluation.
• Intervention included EHR template, redesigned after-visit summary (AVS), enhanced nurse training, and EHR-embedded tips.
• Mixed methods (quantitative and qualitative) data collected from patients, ED physicians, and nurses.

Main Results:

• The redesigned ED discharge process received positive feedback from patients, physicians, and nurses.
• Usability of the redesigned after-visit summary (AVS) was identified as a key facilitator.
• Areas for improvement include prepopulating information within the AVS.

Conclusions:

• A human-centered design approach successfully improved the ED discharge process for older adults.
• The SEIPS-based evaluation provides valuable input for learning health systems and patient safety initiatives.
• This study highlights the importance of a patient-centered approach in healthcare transitions.