Patient- and Family-Centered Care in the Emergency Department for Children With Autism
BACKGROUND: Emergency department (ED) care processes and environments impose unique abstract challenges for children with autism spectrum disorder (ASD). The implementation of patientand family-centered care (PFCC) emerges as a priority for optimizing ED care. In this article, as
part of a larger study, we explore PFCC in the context of ASD. Our aims were to examine how
elements of PFCC were experienced and applied relative to ED care for children with ASD.
METHODS: Qualitative interviews were conducted with parents and ED service providers,
drawing on a grounded theory approach. Interviews were audio recorded, transcribed
verbatim, and analyzed by using established constant comparison methods. Data were
reviewed to appraise the reported presence or absence of PFCC components.
RESULTS: Fifty-three stakeholders (31 parents of children with ASD and 22 ED service providers)
participated in interviews. Results revealed the value of PFCC in autism-based ED care.
Helpful attributes of care were a person-centered approach, staff knowledge about ASD,
consultation with parents, and a child-focused environment. Conversely, a lack of staff
knowledge and/or experience in ASD, inattention to parent expertise, insufficient
communication, insufficient family orientation to the ED, an inaccessible environment,
insufficient support, a lack of resources, and system rigidities were identified to impede
the experience of care.
CONCLUSIONS: Findings amplify PFCC as integral to effectively serving children with ASD and their families in the ED. Resources that specifically nurture PFCC emerge as practice and program
priorities