title: A multiple case study of patient journeys in Wales from A&E to a hospital ward or home.
abstract: The health service is having to plan for an increasingly older population putting extra demand on services, with a greater emphasis on providing care at home. A health board in Wales brought in an Early Response Service, which assessed whether patients attending accident and emergency needed to be admitted to hospital or could receive care at home. This qualitative study looked at the experiences of both patients and staff members in both settings. A multiple case study was undertaken using semi-structured interviews. The theoretical framework was derived from Kolcaba's comfort theory and the bio-psycho-social model. Staff were identifying the most suitable patients for care at home and all hospital admissions were necessary, as the patients required greater medical/surgical intervention than those cared for at home.
authors.affiliation: Clinical Skills Tutor, School of Healthcare Sciences, Cardiff University.
authors.forename: Sera Nia
authors.initials: SN
authors.lastname: Manning
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D019982:Organizational Case Studies; D010343:Patient Admission / Q000706:statistics & numerical data*; D036301:Qualitative Research; D013222:State Medicine; D000069341:Transitional Care / Q000458:organization & administration*; D014852:Wales
keywords: comfort needs; holistic care; intermediate care; prevention of inappropriate hospital admissions; unintended consequences