AURA Protocol (Atenció Universal Respectuosa de l'Autisme): Adapted Hospital Access Methodology for Patients with Autism Spectrum Disorder

Background. Conventional hospital environments generate systematic sensory overload, communication barriers, and procedural difficulties for patients with Autism Spectrum Disorder (ASD). Despite established international guidelines (NICE CG142, NHS England 2025) and existing regional initiatives in Spain (M'adapTU at Vall d'Hebron Hospital; Autismo Andalucía Healthcare Protocol), structured reasonable adjustments remain largely absent in most Catalan hospital settings outside major tertiary centres. Objective. To document the clinical needs of an ASD community in a territory with no formalised hospital access protocol; to present a replicable operational framework applicable to heterogeneous hospital settings; and to propose a standardised research instrument for territory-specific ASD needs assessment, applicable across different territorial contexts to identify locally specific critical areas. Methods. Mixed observational descriptive study. Structured 23-item questionnaire (9 Likert scales 1-5, open-ended questions, multiple-choice items) administered digitally to ASD families in the territory (N=15). Descriptive statistical analysis for quantitative scales; deductive thematic analysis for open-ended responses. Results. Four domains exceeded mean severity of 4/5: overstimulating environments (4.27), procedural difficulties (4.20), waiting times (4.00), lack of anticipatory preparation (4.00). Intervention consensus: staff training (100%), companion access during procedures (93.3%), structured initial assessment (86.7%). Operational proposal. Three sequential interventions implementable at under 300 euros total cost. Clinical, process, and satisfaction indicators defined for pilot cycle evaluation. The AURA Protocol demonstrates that international reasonable adjustment standards are implementable in non-tertiary hospital settings at minimal cost, without specialist infrastructure.