Healthcare workers’ perspectives on a prescription phone program to meet the health equity needs of patients in the emergency department: a qualitative study

• Published in: Canadian journal of emergency medicine 2024-08, Vol.26 (8), p.570-581
• Main Authors: Hodwitz, Kathryn, Ginocchio, Galo F., Fedorovsky, Tali, Girdler, Hannah, Bossin, Brielle, Juando-Prats, Clara, Dell, Evelyn, Somers, Andrea, Hulme, Jennifer
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; Emergency medical care; Emergency Medicine; Emergency Service, Hospital; Female; Health disparities; Health Equity; Health Personnel - psychology; Health Services Accessibility; Humans; Ill-Housed Persons; Male; Medical personnel; Medicine; Medicine & Public Health; Middle Aged; Ontario; Original Research; Program Evaluation; Public Health; Qualitative Research; Social exclusion
• ISSN: 1481-8035; 1481-8043; 1481-8043
• DOI: 10.1007/s43678-024-00735-y

Objectives People experiencing homelessness and marginalization face considerable barriers to accessing healthcare services. Increased reliance on technology within healthcare has exacerbated these inequities. We evaluated a hospital-based prescription phone program aimed to reduce digital health inequities and improve access to services among marginalized patients in Emergency Departments. We examined the perceived outcomes of the program and the contextual barriers and facilitators affecting outcomes. Methods We conducted a constructivist qualitative program evaluation at two urban, academic hospitals in Toronto, Ontario. We interviewed 12 healthcare workers about their perspectives on program implementation and outcomes and analyzed the interview data using reflexive thematic analysis. Results Our analyses generated five interrelated program outcomes: building trust with patients, facilitating independence in healthcare, bridging sectors of care, enabling equitable care for marginalized populations, and mitigating moral distress among healthcare workers. Participants expressed that phone provision is critical for adequately serving patients who face barriers to accessing health and social services, and for supporting healthcare workers who often lack resources to adequately serve these patients. We identified key contextual enablers and challenges that may influence program outcomes and future implementation efforts. Conclusions Our findings suggest that providing phones to marginalized patient populations may address digital and social health inequities; however, building trusting relationships with patients, understanding the unique needs of these populations, and operating within a biopsychosocial model of health are key to program success.