Emergency health care professionals' experiences of factors that influence care quality and safety

Abstract

Introduction: More research is required on care quality and patient safety, especially from the care provider perspective. Aims and objectives: The study describes factors that affect the quality of emergency care as experienced by nurses, paramedics, hospital and ambulance attendants and practical nurses in out-of-hospital emergency medical services. Methods: Data were collected in October 2013 by semi-structured interviews (n = 15) in Finland and analysed using inductive content analysis. Results: High quality emergency care is patient-centred, equal, professional, individualized and holistic. It encompasses the following areas: prompt emergency care on site; prevention of patient deterioration; individualized holistic care; arranging safe follow-up care; supporting the coping of patients and families and; securing the safety of patients and staff on site and in ambulance. The care quality care is affected by professionals’ theoretical and practical competence and personal qualities, by the availability of equipment, co-operation, contextual factors, personnel policy and by the outcome of consultation with a doctor. Conclusions: Emergency care staff will be expected to provide increasingly extensive, holistic care on site. All stages of the care pathway should be evaluated and comparative international studies conducted to detect development needs. Relevance to clinical practice: Consistent practices and instructions are indicated. Management needs to promote staff coping and motivation by means of education, focusing on the care of older patients and clients affected by multiple diseases, and on psychosocial and social problems of people affected by alcoholism or social exclusion.