Abstract
INTRODUCTION: Emergency departments (ED) worldwide are under pressure. Older people are disproportionally represented in ED, and many of these presentations are for nonlife-threatening ailments that could be attended to elsewhere. Urgent care services have been established to relieve ED pressures and may be a better alternative for older people with urgent but nonlife-threatening health issues. The purpose of this study was to understand the needs and preferences of older people when accessing urgent care, and what an ideal journey through an urgent care service would look like. METHODS: This qualitative study consisted of three consumer workshops with engagement activities designed and facilitated by an organisation designed to advocate for the rights and interests of older people in Adelaide, South Australia. Primary analysis was completed using a framework analysis approach, which consisted of identifying key themes and meanings in the audio-recorded data and workshop outputs (including maps, notes and lists). Regular team meetings were held to discuss findings to enhance study rigour. RESULTS: A total of 39 participants aged 65 and above took part in the workshops. Most participants were female (n = 24, 62%), born in Australia (n = 26, 67%) and only spoke English at home (n = 36, 92%). Most participants (n = 33, 85%) had recent experience with ED. Four themes emerged regarding the needs and preferences for urgent care services: (1) accessible and responsive, (2) age appropriate with expert care, (3) listen to me, my story and (4) safe and well-planned discharge. Participants felt that there needs to be more information available to the public about urgent care services for older people. CONCLUSIONS: This study has identified needs and preferences of older people when accessing urgent care services. Services should consider these preferences when implementing or refining urgent care services to maximise acceptability. PATIENT AND PUBLIC INVOLVEMENT: Our workshops engaged service users to explore and articulate their needs and preferences for service development in an urgent care setting for individuals aged 65 and older. These workshops involved public participation to evaluate the currently available services and reflect on their ideal future design. Service user experiences and priorities were the primary data sources. This study underscored the significance of lived experience, aiming to listen, learn and collaboratively reflect to understand and propose ideas for enhancing urgent care through a co-design process.