A need for further improvement and transparency was elucidated. The extended collaboration was built on trust, responsibility taken, shared and entrusted, and the common goal of adapted care for the unique patient. Through dialogue experience and knowledge were shared and certainty in decisions was increased. The extended collaboration means that decisions were supported through dialogue by bridging knowledge spaces between person, within-team and across-team levels. The transcribed interviews were analysed for meanings of the phenomenon.
Participants included in three specific situations with extended collaboration were interviewed: three older patients, one significant other, three ambulance personnel and four personnel at the PHC centre. The study used a phenomenological reflective lifeworld research (RLR) approach. This study aimed to describe extended collaboration in situations when an ambulance was called, as experienced by older patients, a significant other, and ambulance- and primary healthcare (PHC) centre personnel. The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ² = 232.56), and in the 08:00–11:59 interval (p < 0.001, χ² = 1224.08). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Age had a small but additive effect in relation to on-scene time (p < 0.001, R² = 0.01, F = 53.82). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio 0.63, 95% confidence interval 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns. One-sample χ² test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requiring emergency care at home in Sweden.Ī descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly.
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