The experiences of patients, their families, and carers during care from alternative ambulance response units: A scoping review

Purpose of the research In response to increasing demand and the changing nature of patient presentations and to maintain emergency response capability, ambulance health services are adapting their approaches to health service delivery. Initiatives include dispatch of alternative response units (ARUs) that deliver tailored care for patients with non-time-critical needs. As advocated by both the World Health Organisation and the Australian Commission on Safety and Quality in Health Care, routinely capturing patients’ experiences of care is imperative to evaluate and strengthen such innovations in healthcare models. To inform the development of a valid and reliable patient-reported experience measure, this scoping review aims to identify currently known key constructs of experience as described by patients and their families or carers when receiving unscheduled care from ARUs. This scoping review was informed by mixed-methods guidance, searched databases MEDLINE Complete, CINAHL Complete, APA PsycInfo, Scopus and Web of Science Core Collection, and grey literature. Major findings Three studies conducted in diverse settings and applying heterogeneous methodologies were identified. Concepts reported by patients, their families, and carers about their experience highlighted the convenience of receiving care within their home while avoiding unnecessary attendance at hospital, receiving professionally competent care supported by interpersonal communication, person-centred care, and feelings of reassurance and psychological safety. A notable finding was perceived longer-term beneficial impacts associated with linkage to referral pathways and continuity of care beyond the immediate episode. Conclusion The identified sources indicate that patients, families, and carers value several aspects of ARU healthcare delivery, including care provided in the home that avoids unnecessary hospital attendance, provision of reassurance through high-quality, person-centred care and longer-term impacts resulting from linkage to appropriate care services. The limited evidence base highlights the need for further research to develop a conceptual framework describing patient experience of emerging models of ambulance healthcare delivery, to explore the fit-for-purpose of these models. These findings provide a foundation for the development of a context-specific patient-reported experience measure to support evaluation and continuous quality improvement of ARUs.