Improving A&E experiences
Patients suffering from mental ill health have reported poor care experiences at hospital emergency departments, with staff saying they don’t always have the resources to provide the right to care to everyone. To help combat these issues, researchers have now taken a human factors approach to understanding experiences in emergency rooms.
The findings of the work domain analysis study – the first of its kind – suggest targeted interventions can improve system functions, processes and environmental factors, ultimately enhancing patient care.
Two hospitals were used in the study, including a principal referral hospital with more than 800 beds and an emergency department that saw about 20,000 presentations in the first quarter of 2025. The second facility was a major hospital with 433 beds and an emergency room that had about 17,000 presentations during the same period. Both provide public healthcare to a diverse population, including ethnic minorities, socially disadvantaged people and the elderly.
Twenty-nine adults who had presented to both emergency departments (EDs) in the previous 12 months took part in the study, along with 16 specialist staff, including psychiatric experts. Patients reported feeling “dissatisfied” with the level of communication in emergency rooms, while “invasive” questions “increase patient distress and lead to disengagement”.
Hospital staff highlighted how the delivery of care in emergency departments is affected by limitations in community care, such as delaying follow-up care.
The researchers said: “Changes must occur at the community level, including improved resourcing for community care teams and ensuring appropriate ED referrals. Mental health epistemic experts reported inefficiencies of the broader health care system, which hinder the delivery of quality and timely emergency department care. Our findings have practical implications for emergency care delivery, indicating specific system processes and environmental features that could be leveraged to enhance care delivery for mental health patients.”
