Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.

<h4>Study objectives</h4>Heightened immigration enforcement may induce fear in undocumented patients when coming to the Emergency Department (ED) for care. Limited literature examining health system policies to reduce immigrant fear exists. In this multi-site qualitative study, we sought...

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Autores principales:	Carolina Ornelas-Dorian, Jacqueline M Torres, Jennifer Sun, Alexis Aleman, Emmanuel Cordova, Aristides Orue, Breena R Taira, Erik Anderson, Robert M Rodriguez
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f5c1a40b3d694c5db428e1724aa31756
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spelling	oai:doaj.org-article:f5c1a40b3d694c5db428e1724aa317562021-12-02T20:08:22ZProvider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.1932-620310.1371/journal.pone.0256073https://doaj.org/article/f5c1a40b3d694c5db428e1724aa317562021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256073https://doaj.org/toc/1932-6203<h4>Study objectives</h4>Heightened immigration enforcement may induce fear in undocumented patients when coming to the Emergency Department (ED) for care. Limited literature examining health system policies to reduce immigrant fear exists. In this multi-site qualitative study, we sought to assess provider and system-level policies on caring for undocumented patients in three California EDs.<h4>Methods</h4>We recruited 41 ED providers and administrators from three California EDs (in San Francisco, Oakland, and Sylmar) with large immigrant populations. Participants were recruited using a trusted gatekeeper and snowball sampling. We conducted semi-structured interviews and analyzed the transcripts using constructivist grounded theory.<h4>Results</h4>We interviewed 10 physicians, 11 nurses, 9 social workers, and 11 administrators, and identified 7 themes. Providers described existing policies and recent policy changes that facilitate access to care for undocumented patients. Providers reported that current training and communication around policies is limited, there are variations between who asks about and documents status, and there remains uncertainty around policy details, laws, and jurisdiction of staff. Providers also stated they are taking an active role in building safety and trust and see their role as supporting undocumented patients.<h4>Conclusions</h4>This study introduces ED-level health system perspectives and recommendations for caring for undocumented patients. There is a need for active, multi-disciplinary ED policy training, clear policy details including the extent of providers' roles, protocols on the screening and documentation of status, and continual reassessment of our health systems to reduce fear and build safety and trust with our undocumented communities.Carolina Ornelas-DorianJacqueline M TorresJennifer SunAlexis AlemanEmmanuel CordovaAristides OrueBreena R TairaErik AndersonRobert M RodriguezPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256073 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Carolina Ornelas-Dorian Jacqueline M Torres Jennifer Sun Alexis Aleman Emmanuel Cordova Aristides Orue Breena R Taira Erik Anderson Robert M Rodriguez Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.
description	<h4>Study objectives</h4>Heightened immigration enforcement may induce fear in undocumented patients when coming to the Emergency Department (ED) for care. Limited literature examining health system policies to reduce immigrant fear exists. In this multi-site qualitative study, we sought to assess provider and system-level policies on caring for undocumented patients in three California EDs.<h4>Methods</h4>We recruited 41 ED providers and administrators from three California EDs (in San Francisco, Oakland, and Sylmar) with large immigrant populations. Participants were recruited using a trusted gatekeeper and snowball sampling. We conducted semi-structured interviews and analyzed the transcripts using constructivist grounded theory.<h4>Results</h4>We interviewed 10 physicians, 11 nurses, 9 social workers, and 11 administrators, and identified 7 themes. Providers described existing policies and recent policy changes that facilitate access to care for undocumented patients. Providers reported that current training and communication around policies is limited, there are variations between who asks about and documents status, and there remains uncertainty around policy details, laws, and jurisdiction of staff. Providers also stated they are taking an active role in building safety and trust and see their role as supporting undocumented patients.<h4>Conclusions</h4>This study introduces ED-level health system perspectives and recommendations for caring for undocumented patients. There is a need for active, multi-disciplinary ED policy training, clear policy details including the extent of providers' roles, protocols on the screening and documentation of status, and continual reassessment of our health systems to reduce fear and build safety and trust with our undocumented communities.
format	article
author	Carolina Ornelas-Dorian Jacqueline M Torres Jennifer Sun Alexis Aleman Emmanuel Cordova Aristides Orue Breena R Taira Erik Anderson Robert M Rodriguez
author_facet	Carolina Ornelas-Dorian Jacqueline M Torres Jennifer Sun Alexis Aleman Emmanuel Cordova Aristides Orue Breena R Taira Erik Anderson Robert M Rodriguez
author_sort	Carolina Ornelas-Dorian
title	Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.
title_short	Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.
title_full	Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.
title_fullStr	Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.
title_full_unstemmed	Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.
title_sort	provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f5c1a40b3d694c5db428e1724aa31756
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Provider and administrator-level perspectives on strategies to reduce fear and improve patient trust in the emergency department in times of heightened immigration enforcement.

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