Navigating the unknown: A qualitative analysis exploring patient experience in the Emergency Department

Background: Patient experience within healthcare is an increasingly pivotal area of exploration. The objective of this study was to use qualitative methods to elucidate the primary drivers shaping patients' ED experience and to discern how these factors diverge between the UAC and RCH environments. Methods: Qualitative, semi-structured individual interviews with ED patients were conducted across two EDs, an urban academic center (UAC) and a rural community hospital (RCH). An inductive thematic analysis approach was used. Results: Fifty-six participants were interviewed. Four major themes (attitudes of staff, showing concern, patient-centered communication, and frequent updates) emerged across six subthemes: what mattered most, wait time, rushed, end of visit, discrimination, and intent to return ; with an overarching theme which encompasses all four major themes – empathy. Overall, positive experiences were associated with positive and empathetic attitudes of all staff, frequent updates along the spectrum of their ED visit, patient-centered communication particularly during the discharge process, and having the ability to ask questions without feeling rushed. A primary distinguishing feature between the UAC vs the RCH included confidence in care received and differences in the ED environment. Regardless of the patient’s experience, showing empathy, even in unfavorable situations, was identified as the most impactful part of their visit. Conclusion: Patients’ perceptions of healthcare staff empathy is a critical driver in influencing overall ED patient experience. Future studies should include further characterization of patients’ perceptions of healthcare provider empathy and its impact on ED patient experience.