What are the clinical outcomes and patient experiences of adults accessing medical Same Day Emergency Care services? A multi-phase design mixed methods study. (The SDEC study).

Title What are the clinical outcomes and patient experiences of adults accessing medical same day emergency care services? A multi-phase design mixed methods study. Background Same Day Emergency Care (SDEC) is a new model of care provision within the NHS.

There is a need for evidence to demonstrate the safety, effectiveness, and quality of this model, which is currently lacking. Aims: The overall aims of this research are to evaluate the safety, effectiveness, and quality of acute medical SDEC.

Objectives: To conduct a retrospective, observational, cohort study to establish SDEC clinical outcomes across two hospitals, and compare these against clinical outcomes of local short stay medical patients.

To conduct a mixed methods study, utilising an explanatory sequential design, within two SDEC services: a survey of SDEC patients to gather quantitative data on patient experience followed by semi-structured qualitative interviews with a sub-group of surveyed patients.

Design and Methods This study is a multi-phase mixed methods explanatory sequential design with two core components: Component A: To meet objective 1: Work Package 1 - A retrospective, observational, twin-centre, cohort study of SDEC patients to determine readmission and mortality rates, related to the primary diagnosis.

Short-stay medical inpatients will provide the comparator group.

Component B: To meet objective 2: Work Package 2a: A cross-sectional validated survey to assess patient experiences of process and the quality of care received from SDEC. Data from the survey will be used to inform the next phase.

Work Package 2b: Semi-structured interviews to develop an in depth understanding of patients experience of SDEC services and ACP or medical-led care.

Component C: To meet overall aims and answer the research question: Work Package 3: Integration and interpretation of quantitative and qualitative findings, synthesised with the literature, enabling meta-inferences to be drawn, new insights and interpretations to be created. Recommendations for future development of SDEC and further research will be made.

Work Package 4: Dissemination: Ensuring results translate into policy impact.

Patient and Public Involvement The subject area, methods and dissemination plan have developed following consultation with members of the national NHS England SDEC Patient and Public Involvement and Engagement (PPIE) Group, United Lincolnshire Hospitals NHS Trust PPIE Group and SDEC patients.

A small group of PPIE representatives have reviewed my research proposal and will continue to support and advise as follows: Development of patient information sheets, and consent form for interviews. Assist in developing questions for semi-structured interviews. Discussion of themes emerging from the surveys and interviews to provide different viewpoints.

Ongoing review of study findings and papers for publication. Dissemination.

Dissemination and Outputs This study will be written up in a doctoral thesis along with the following outputs and dissemination: Presentation and discussion with national and local PPIE groups. Presentation and discussion with professional networks, locally and nationally. Use of social media to disseminate to all stakeholders.

Publications in peer reviewed journals, and presentations at national and international conferences. Presentation and discussion with policy makers and ministers in the Department of Health and Social Care.