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Navigating and making sense of urgent and emergency care processes and provision

Navigating and making sense of urgent and emergency care processes and provision
Navigating and making sense of urgent and emergency care processes and provision
Background: whilst many health systems offer a range of urgent and emergency care services to deal with the need for unscheduled care, these can be problematic to navigate.

Objective: to explore how lay people make sense of urgent care provision and processes.

Design: qualitative study, incorporating citizen panels and longitudinal semi‐structured qualitative interviews.

Setting and Participants: two citizens’ panels, comprising purposively selected public populations—a group of regular users and a group of potentially marginalized users of urgent and emergency care. Semi‐structured interviews were conducted with 100 people, purposively sampled to include those over 75, aged 18‐26 years, and from East/Central Europe. A sub‐sample of 41 people received a second interview at +6‐12 months. Framework analysis was thematic and comparative, moving through coding to narrative and interpretive summaries.

Findings and Discussion: participants narratives illuminated considerable uncertainty and confusion regarding urgent and emergency care provision which in part could be traced to the contingent nature of urgent and emergency care need. Accounts of emergency care provision were underpinned by strong moral positioning of appropriate help‐seeking, demarcating legitimate service use that echoed policy rhetoric, but did not necessarily translate into individual behaviour. People struggled to make sense of urgent care provision making navigating “appropriate” use problematic.
Conclusions

The focus on help‐seeking behaviour, rather than sense‐making, makes it difficult to move beyond the polarization of “appropriate” and “inappropriate” service use. A deeper analysis of sense‐making might shift the focus of attention and allow us to intervene to reshape understandings before this point.
1369-6513
435-443
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Mckenna, Gemma
8ae50c08-6ff0-44de-aa7b-cbf26a60e98d
Turnbull, Joanne
cd1f8462-d698-4a90-af82-46c39536694b
Prichard, Jane
64ba5e39-0b0f-4529-877f-aa6ecc7e7e2e
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Pope, Catherine
21ae1290-0838-4245-adcf-6f901a0d4607
Mckenna, Gemma
8ae50c08-6ff0-44de-aa7b-cbf26a60e98d
Turnbull, Joanne
cd1f8462-d698-4a90-af82-46c39536694b
Prichard, Jane
64ba5e39-0b0f-4529-877f-aa6ecc7e7e2e
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7

Pope, Catherine, Mckenna, Gemma, Turnbull, Joanne, Prichard, Jane and Rogers, Anne (2019) Navigating and making sense of urgent and emergency care processes and provision. Health Expectations, 22 (3), 435-443. (doi:10.1111/hex.12866).

Record type: Article

Abstract

Background: whilst many health systems offer a range of urgent and emergency care services to deal with the need for unscheduled care, these can be problematic to navigate.

Objective: to explore how lay people make sense of urgent care provision and processes.

Design: qualitative study, incorporating citizen panels and longitudinal semi‐structured qualitative interviews.

Setting and Participants: two citizens’ panels, comprising purposively selected public populations—a group of regular users and a group of potentially marginalized users of urgent and emergency care. Semi‐structured interviews were conducted with 100 people, purposively sampled to include those over 75, aged 18‐26 years, and from East/Central Europe. A sub‐sample of 41 people received a second interview at +6‐12 months. Framework analysis was thematic and comparative, moving through coding to narrative and interpretive summaries.

Findings and Discussion: participants narratives illuminated considerable uncertainty and confusion regarding urgent and emergency care provision which in part could be traced to the contingent nature of urgent and emergency care need. Accounts of emergency care provision were underpinned by strong moral positioning of appropriate help‐seeking, demarcating legitimate service use that echoed policy rhetoric, but did not necessarily translate into individual behaviour. People struggled to make sense of urgent care provision making navigating “appropriate” use problematic.
Conclusions

The focus on help‐seeking behaviour, rather than sense‐making, makes it difficult to move beyond the polarization of “appropriate” and “inappropriate” service use. A deeper analysis of sense‐making might shift the focus of attention and allow us to intervene to reshape understandings before this point.

Text
Pope et al 2019 Health Expectations - Version of Record
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More information

Accepted/In Press date: 15 December 2018
e-pub ahead of print date: 10 January 2019
Published date: June 2019

Identifiers

Local EPrints ID: 428123
URI: https://eprints.soton.ac.uk/id/eprint/428123
ISSN: 1369-6513
PURE UUID: 6de307db-74ba-43af-843a-1ce73f08e13a
ORCID for Catherine Pope: ORCID iD orcid.org/0000-0002-8935-6702
ORCID for Joanne Turnbull: ORCID iD orcid.org/0000-0002-5006-4438
ORCID for Jane Prichard: ORCID iD orcid.org/0000-0001-7455-2244

Catalogue record

Date deposited: 12 Feb 2019 17:30
Last modified: 17 Sep 2019 01:06

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