Admission Decision-Making in Hospital Emergency Departments: the Role of the Accompanying Person

Article


Rance, S., Westlake, D., Brant, H., Holme, I., Endacott, R., Pinkney, J. and Byng, R. 2020. Admission Decision-Making in Hospital Emergency Departments: the Role of the Accompanying Person. Global Qualitative Nursing Research. 7. https://doi.org/10.1177/2333393620930024
AuthorsRance, S., Westlake, D., Brant, H., Holme, I., Endacott, R., Pinkney, J. and Byng, R.
Abstract

In resource-stretched emergency departments, people accompanying patients play key roles in patients' care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 healthcare professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient-carer relationship contrasted with accompanying persons' varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relations with patients. Taking a relationship-centered approach could improve attention to accompanying persons as co-producers of healthcare and participants in decision-making.

JournalGlobal Qualitative Nursing Research
Journal citation7
ISSN2333-3936
Year2020
PublisherSAGE Publications
Accepted author manuscript
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Digital Object Identifier (DOI)https://doi.org/10.1177/2333393620930024
Web address (URL)https://doi.org/10.1177/2333393620930024
Publication dates
Online18 Jun 2020
Publication process dates
Accepted21 Apr 2020
FunderNational Institute for Health Research
Copyright holder© The Authors
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