Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation
Background: Emergency departments (ED) are imperfect environments for information exchange. Communication interventions at discharge can lower readmission rates and improve adherence to follow-up. However, these interventions are rarely designed in partnership with ED clinicians, youth and their par...
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Elsevier
2025-12-01
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| Series: | International Journal of Nursing Studies Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666142X25000694 |
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| author | Allyson J Gallant Janet A Curran Mari Somerville Lori Wozney Christine Cassidy Alannah Delahunty-Pike Rebecca Mackay Shannon MacPhee Emma Burns Helen Wong Melanie Doyle Amy Plint Roger Zemek |
| author_facet | Allyson J Gallant Janet A Curran Mari Somerville Lori Wozney Christine Cassidy Alannah Delahunty-Pike Rebecca Mackay Shannon MacPhee Emma Burns Helen Wong Melanie Doyle Amy Plint Roger Zemek |
| author_sort | Allyson J Gallant |
| collection | DOAJ |
| description | Background: Emergency departments (ED) are imperfect environments for information exchange. Communication interventions at discharge can lower readmission rates and improve adherence to follow-up. However, these interventions are rarely designed in partnership with ED clinicians, youth and their parents. Objective: To describe a theory-based co-design methodology and corresponding process evaluation to improve discharge communication for two common ED presentations: asthma and minor head injury. Methods: Eligible participants were clinicians who worked in a pediatric ED and parents and youth (aged 12–17) with recent ED experience for either presentation. Co-design teams followed a structured meeting process guided by the Behaviour Change Wheel to facilitate priority setting and intervention design. Process data was captured through meeting recordings, surveys and exit interviews. Quantitative data was analyzed using descriptive statistics and qualitative data through thematic analysis. Results: Each co-design team included eight members (n = 16) participating across eight co-design meetings (mean length: 82 min). The asthma team developed a symptom screening checklist, while the head injury team designed a concussion symptom management tool. Participants reported feeling confident in the co-design process, which increased with active engagement and seeing their decisions incorporated into intervention prototypes. Lengthy meetings and overall time commitment were issues identified by some participants across surveys and interviews. Conclusions: A theory-based co-design approach provided a useful structure to partner with youth, parents and ED clinicians to develop discharge communication tools. Consideration is needed when scheduling the timing and length of the co-design meetings to account for the schedules of both service providers and users. |
| format | Article |
| id | doaj-art-2ddd4ddda6e545fd869d9d6c93d7f511 |
| institution | DOAJ |
| issn | 2666-142X |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Nursing Studies Advances |
| spelling | doaj-art-2ddd4ddda6e545fd869d9d6c93d7f5112025-08-20T03:21:46ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-12-01910036210.1016/j.ijnsa.2025.100362Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluationAllyson J Gallant0Janet A Curran1Mari Somerville2Lori Wozney3Christine Cassidy4Alannah Delahunty-Pike5Rebecca Mackay6Shannon MacPhee7Emma Burns8Helen Wong9Melanie Doyle10Amy Plint11Roger Zemek12Faculty of Health, Dalhousie University, Room 316-5968 College Street, PO BOX 15000, Halifax, Nova Scotia, NS, B3H 4R2, CanadaIWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, Canada; School of Nursing, Dalhousie University, Halifax, NS, Canada; Corresponding author.IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, CanadaIWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, CanadaSchool of Nursing, Dalhousie University, Halifax, NS, CanadaIWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, CanadaIWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, CanadaIWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, CanadaIWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, CanadaFaculty of Health, Dalhousie University, Room 316-5968 College Street, PO BOX 15000, Halifax, Nova Scotia, NS, B3H 4R2, CanadaIWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia, NS, B3K 6R8, CanadaCHEO Research Institute, 401 Smyth Road- Research Building 2, 2nd floor, Room 2119, Ottawa, Ontario, ON, Canada, K1H 8L1CHEO Research Institute, 401 Smyth Road- Research Building 2, 2nd floor, Room 2119, Ottawa, Ontario, ON, Canada, K1H 8L1Background: Emergency departments (ED) are imperfect environments for information exchange. Communication interventions at discharge can lower readmission rates and improve adherence to follow-up. However, these interventions are rarely designed in partnership with ED clinicians, youth and their parents. Objective: To describe a theory-based co-design methodology and corresponding process evaluation to improve discharge communication for two common ED presentations: asthma and minor head injury. Methods: Eligible participants were clinicians who worked in a pediatric ED and parents and youth (aged 12–17) with recent ED experience for either presentation. Co-design teams followed a structured meeting process guided by the Behaviour Change Wheel to facilitate priority setting and intervention design. Process data was captured through meeting recordings, surveys and exit interviews. Quantitative data was analyzed using descriptive statistics and qualitative data through thematic analysis. Results: Each co-design team included eight members (n = 16) participating across eight co-design meetings (mean length: 82 min). The asthma team developed a symptom screening checklist, while the head injury team designed a concussion symptom management tool. Participants reported feeling confident in the co-design process, which increased with active engagement and seeing their decisions incorporated into intervention prototypes. Lengthy meetings and overall time commitment were issues identified by some participants across surveys and interviews. Conclusions: A theory-based co-design approach provided a useful structure to partner with youth, parents and ED clinicians to develop discharge communication tools. Consideration is needed when scheduling the timing and length of the co-design meetings to account for the schedules of both service providers and users.http://www.sciencedirect.com/science/article/pii/S2666142X25000694Co-designProcess evaluationEmergency careYouth engagementParent engagementNurse engagement |
| spellingShingle | Allyson J Gallant Janet A Curran Mari Somerville Lori Wozney Christine Cassidy Alannah Delahunty-Pike Rebecca Mackay Shannon MacPhee Emma Burns Helen Wong Melanie Doyle Amy Plint Roger Zemek Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation International Journal of Nursing Studies Advances Co-design Process evaluation Emergency care Youth engagement Parent engagement Nurse engagement |
| title | Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation |
| title_full | Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation |
| title_fullStr | Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation |
| title_full_unstemmed | Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation |
| title_short | Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation |
| title_sort | co designing interventions to improve emergency department discharge communication with youths parents and healthcare providers a process evaluation |
| topic | Co-design Process evaluation Emergency care Youth engagement Parent engagement Nurse engagement |
| url | http://www.sciencedirect.com/science/article/pii/S2666142X25000694 |
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