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Who are SDEC patients?:
In April 2025, we gathered our stakeholder group to ask them who same day emergency care (SDEC) patients are. The question is easy to ask but difficult to answer. We'd already asked members of the public, but could the stakeholder group of clinicians and policy makers shed any more light on the matter?
Firm foundations?
Firm foundations?
Our stakeholder group is made up of policy makers, and clinicians in acute medicine, emergency medicine, same day emergency care, and social care. This group of experts bring a new range of perspectives to the questions we are asking in this project.
We brought the stakeholder group together to get their take on what kind of patient is suitable for SDEC. We wanted to know this because it would help us account for factors that might mislead our evaluations of SDEC. For example, older patients might need more time in SDEC so we shouldn't mark an SDEC as "too slow" just because it happens to handle more elderly patients than another SDEC.
The group's responses made us realise that we had made a crucial assumptions that we weren't aware of:
We assumed that there was such thing as a *well-defined SDEC patient.
*By "well-defined", we mean that the notion of an SDEC patient is unambiguous,
consistent, persistent, and possible to define in the first place!
But the group told us that there's no such thing as the SDEC patient...or at least, it depends.
Instead of providing us with a neat description of the kind of patient we should be looking for in our studies, the group gave us the greater gift of insight. They made us realise that the foundations of our questions were flawed. Better still, they gave us what we needed to build firmer foundations on which to base our investigations.
A different way of thinking about suitability for SDEC
A different way of thinking about suitability for SDEC
The stakeholder group couldn't give a straight answer to the question of what kind of patient is most suitable for SDEC. Their explanation was that the suitability of a patient for SDEC is not merely a question of the patient, but a question about the interaction between several factors.
In other words, we needed to change our outlook from looking for SDEC patients in SDEC services to seeing SDEC systems. These SDEC systems might be described as having four main components:
the aim of SDEC service;
the environmental context;
resource constraints; and
the needs arising from the patient presenting at the service.
As you can see, the kind of patient is only one of the factors, and even then, the stakeholder group felt that the important aspect was what the patient needed. The aspect of "what the patient needs" is not something that can be reduced to a diagnosis or an age. For example, some 60-year-olds are fitter than some 20-year-olds, and whether or not you have asthma probably won't affect how doctors treat your broken finger.
What's next?
What's next?
This single interaction with our stakeholder group is a great illustration of the importance of involving what some people term "experts by experience". Too often, academics can get caught up in their own expertise of answering question. Humbly involving stakeholders helps to ensure that we are asking the right questions and taking the right perspectives.
We've taken the advice of our professional, patient, and public stakeholders and used it to orient ourselves when undertaking our invesitgations. You can stay informed by signing up to our quarterly bulletin to receive our updates.
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