Beyond Urgency: Emergency Nurse and Physician Perspectives on Nonurgent Emergency Department Use and the Role of Underlying Conditions
Bibliographic record
Abstract
INTRODUCTION: Research on nonurgent emergency department use is predominately focused on patients' perceptions. There are few published qualitative analyses of health care providers' viewpoints on the subject. The aims of this study were to: (a) explore the perceptions of both nurses and physicians regarding the role that the emergency department plays within the larger health care system; (b) contextualize how nonurgent visits in the emergency department were described by nurse and physician participants; and finally, (c) describe perceived reasons for nonurgent use of the emergency department by patients. METHODS: Using a qualitative descriptive approach, 16 emergency nurses and 12 emergency department physicians employed at a single institution (2 emergency departments) in Ontario, Canada, engaged in semi-structured interviews. Conventional content analysis was used to analyze qualitative data. Data were coded, iteratively reviewed, compared, and then placed into categories based on phrases, patterns, themes, and notable features. RESULTS: The overall role of the emergency department was perceived to be multifaceted in that it provided a place for quality care and acted as a safety net. Patients attending the emergency department non-urgently were characterized and differentiated by staff according to their underlying medical versus psychosocial/mental health condition. Health care providers reported that they believed nonurgent patients were influenced to attend the emergency department because of personal health beliefs, stress, and coping ability, health literacy, and/or satisfaction with emergency department functionality. DISCUSSION: Nonurgent use of the emergency department for minor medical conditions was generally discouraged by nurses and physicians; however, patients with psychosocial crises or mental health conditions that were nonurgent in nature were deemed appropriate and justified due to perceived gaps in health and social care in the community.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".