Waiting and hoping: a phenomenographic study of the experiences of boarded patients in the emergency department.
OBJECTIVE
To understand the experiences and concerns of patients in the emergency department during inpatient boarding.


BACKGROUND
Boarding in the emergency department is an increasingly common phenomenon worldwide. Emergency department staff, patients and their families become more stressed as the duration of boarding in the emergency department increases. Yet, there is limited knowledge of the experiences and concerns of boarded patients.


METHODS
The qualitative approach of phenomenography was used in the study.


METHODS
The phenomenographic study was conducted in one emergency department that treats approximately 15,000 patients each month. Twenty emergency department boarding patients were recruited between July-September 2014. Semi-structured interviews were used for data collection. The seven steps of qualitative data analysis for a phenomenographic study - familiarisation, articulation, condensation, grouping, comparison, labelling and contrasting - were employed to develop an understanding of participants' experiences and concerns during their inpatient boarding in the emergency department.


RESULTS
The perceptions that emerged from the data were collected into four categories of description of the phenomenon of emergency department boarding patients: a helpless choice; loyalty to specific hospitals and doctors; an inevitable challenge of life; and distrust of the healthcare system. The outcome space for the emergency department boarding patients was waiting and hoping for a cure.


CONCLUSIONS
The experiences and concerns of emergency department boarding patients include physical, psychological, spiritual and health system dimensions. It is necessary to develop an integrated model of care for these patients.


CONCLUSIONS
Understanding the experiences and concerns of patients who are placed on boarding status in the ED will help emergency healthcare professionals to improve the quality of emergency care. There is a need to develop a care model and associated intervention measures for emergency department patients during the boarding process. The results of this study will help health regulatory authorities to develop an appropriate emergency department boarding system so that patients receive better emergency care.
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.|Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.
Chin-Yen
CY
Han
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.|Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.
Chun-Chih
CC
Lin
Faculty of Nursing, University of Calgary, Calgary, Canada.
Suzanne
S
Goopy
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.|Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.
Ya-Chu
YC
Hsiao
Queensland University of Technology, Brisbane, Queensland, Australia.
Alan
A
Barnard
Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.
Li-Hsiang
LH
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D065026:Hope; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010343:Patient Admission; D013315:Stress, Psychological; D013624:Taiwan; D055815:Young Adult
boarding; emergency care; hope; phenomenography; qualitative research