A participatory case study on youth’s emergency department experience through youth engagement as a change agent

Abstract

My doctoral research involved a participatory case study (PCS) on youth’s emergency department (ED) experiences through youth engagement as a change agent. One of the vulnerable populations in our society, namely, street-involved (SI) youth, was the focus of the research. An innovative PCS approach allowed me to engage, learn from, and be guided by SI youth in order to gain insights into how the ED can become more accountable to respectfully meet SI youth’s unique, complex needs. The overarching research question was: How can SI youth contribute to improving their ED experience using a youth engagement approach? Fourteen youths (including 12 of Aboriginal descent) participated in art work, individual interviews, and a focus group to offer insights into SI youth’s lived experiences of treatment and care in EDs. Overarching themes supported through content and thematic analysis of the data included: gaps in health care, lack of food, commonality of substance use among SI youth, and perceived lack of communication. Implications from this research suggest a recommendation that Alberta Health Services (AHS) should put forth overarching mandates for youth in care, specifically, the need for more youth-centric actions of EDs to more respectfully reflect SI youth’s unique characteristics and day-to-day experiential challenges in order to facilitate positive outcomes for ED youth care. SI youth participants’ recommendations to transform the ED experience included: better, more respectful communication from ED staff about all aspects of care, wait times, and discharge instructions; strategies to allow food for SI youth without cost, as well as free prescriptions; and involving youth as facilitators to be change agents in EDs. Overall, not only do the findings highlight the importance of respect and non-judgmental attitude toward SI youth among ED health professionals and policy-makers, but these also remind those professionals/policy-makers of the need and willingness to learn from and engage with the SI youth in a respectful, youth-centred way in order to provide more effective communication, interaction, and care with and for the SI youth.