Background: There is limited provision of inpatient detoxification relative to other treatments for alcohol and other drug (AOD) use. This means people often need to wait prior to detoxifying. However, waiting for healthcare is generally perceived as negative and stressful. This paper aims to understand patients' experiences of waiting for inpatient AOD detoxification to ascertain whether and how service-level policies and practices might be improved.
Methods: Semi-structured telephone interviews were conducted with 32 people (20 males, 12 females; aged 25-67 years) who were waiting for inpatient detoxification. Data collection was part of a wider evaluation of a policy initiative started in 2021 to increase detoxification service capacity in England, UK. Interviews were professionally transcribed and data on waiting experiences were coded using qualitative software. Analyses were informed by new materialist thinking and undertaken via Iterative Categorisation.
Results: We found that waiting was constituted through five dimensions: i. duration; ii. support; iii. information; iv. preparations; and v. emotions. These five dimensions were multi-faceted and operated in and through wider interacting social, material, and affective forces (e.g., professional judgements, formal and informal relationships, the availability of beds and funding, bureaucratic procedures, the utility and relevance of information, and participants' diverse feelings, including desperation for treatment). Not all accounts of waiting were negative. The experience was complex, non-uniform and variable over time. Moreover, it affected how people felt and how they behaved.
Conclusions: Changes to service-level policies and practices can potentially minimise the stress of waiting for inpatient AOD detoxification. The negative impact of waiting may be reduced if professionals more consistently engage patients in a wider range of constructive pre-treatment activities, offer regular 'check-ins' to mitigate any anxiety, explain changes in wait duration to help with planning and demonstrate fairness, and facilitate contact between those waiting to lessen feelings of isolation.
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http://dx.doi.org/10.1016/j.drugpo.2023.104291 | DOI Listing |
Am J Emerg Med
December 2024
Department of Internal Medicine (Section of General Internal Medicine, Program for Hospital Medicine), Yale University School of Medicine, New Haven, CT, USA; Department of Pediatrics (Section of Hospital Medicine), Yale University School of Medicine, New Haven, CT, USA.
Boarding of admitted patients in the Emergency Department (ED) changes both the setting and teams providing care during the initial phase of admissions. We measured the waiting time from ED door arrival to inpatient floor arrival for 17,944 admissions to internal medicine services over a 5-year period from 2018 to 2023 and propose this as a metric for the total delay in care associated with ED boarding, termed "Door to Floor" (DTF) time. We find a sustained increase as well as significant seasonal and day-of-the-week variation in DTF times.
View Article and Find Full Text PDFAn Sist Sanit Navar
December 2024
Universidad de Vigo. Facultad de Ciencias Empresariales y Turismo. Departamento de Organización de Empresas y Marketing. Vigo. España .
Background: This study aims to assess the impact of transitioning a hospital/foundation from indirect management to direct management on the efficiency of hospital resource management.
Methodology: Until 2010, the Virxe da Xunqueira hospital/foundation, located in the Galicia-North Portugal Euroregion, operated under indirect management. In 2010, it transitioned to direct management as a health centre within the Galician Health Service (Spain).
Med J Aust
December 2024
Western NSW Local Health District, Dubbo, NSW.
Objective: To evaluate the quantity and quality of medical care provided by the Western NSW Local Health District Virtual Rural Generalist Service (VRGS).
Design: Retrospective cohort study; analysis of emergency department and administrative hospital data.
Setting: Twenty-nine rural or remote hospitals in the Western NSW Local Health District at which the VRGS was providing medical care in the emergency department (ED) and/or inpatient setting.
BMJ Open Qual
December 2024
Parkwood Hospital, London, Ontario, Canada.
Br J Neurosurg
November 2024
Imperial College London NHS Trust, London, UK.
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