Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background: Emergency departments (ED) are imperfect environments for information exchange. Communication interventions at discharge can lower readmission rates and improve adherence to follow-up. However, these interventions are rarely designed in partnership with ED clinicians, youth and their parents. Objective: To describe a theory-based co-design methodology and corresponding process evaluation to improve discharge communication for two common ED presentations: asthma and minor head injury. Methods: Eligible participants were clinicians who worked in a pediatric ED and parents and youth (aged 12-17) with recent ED experience for either presentation. Co-design teams followed a structured meeting process guided by the Behaviour Change Wheel to facilitate priority setting and intervention design. Process data was captured through meeting recordings, surveys and exit interviews. Quantitative data was analyzed using descriptive statistics and qualitative data through thematic analysis. Results: = 16) participating across eight co-design meetings (mean length: 82 min). The asthma team developed a symptom screening checklist, while the head injury team designed a concussion symptom management tool. Participants reported feeling confident in the co-design process, which increased with active engagement and seeing their decisions incorporated into intervention prototypes. Lengthy meetings and overall time commitment were issues identified by some participants across surveys and interviews. Conclusions: A theory-based co-design approach provided a useful structure to partner with youth, parents and ED clinicians to develop discharge communication tools. Consideration is needed when scheduling the timing and length of the co-design meetings to account for the schedules of both service providers and users.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it