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. 2025 Jun 15;17(6):e86089.
doi: 10.7759/cureus.86089. eCollection 2025 Jun.

Barriers, Challenges, and Facilitators Experienced by Healthcare Professionals in Providing Immediate and Efficient Care in the Emergency Department: A Mixed-Methods Study

Anchal Gupta  1 , Sandeep Arya  2 , Pooja Yadav  3 , Anjali Gupta  4 , Ankit Raj  5 , Tarangini Maurya  6 , Pawanpreet Kaur  5
Affiliations

Barriers, Challenges, and Facilitators Experienced by Healthcare Professionals in Providing Immediate and Efficient Care in the Emergency Department: A Mixed-Methods Study

Anchal Gupta et al. Cureus. .

Abstract

Background: Emergency departments (EDs) are frontline units serving 24×7 services to patients. Healthcare professionals often face several barriers and challenges that hinder them from delivering immediate and efficient care. Overcrowding, inadequate staffing, lack of triage skills, communication gaps, and workplace aggression from relatives of patients are the major factors that impact ED performance. Identifying these barriers, challenges, and facilitators is important for quality emergency care services.

Materials and methods: A sequential explanatory mixed-method design was employed in the ED of Uttar Pradesh University of Medical Sciences, Saifai, India. The study was divided into two phases. Phase I used a quantitative descriptive approach with a reliable Likert-scale questionnaire to estimate barriers and facilitators among 53 participants (22 doctors and 31 nurses). Phase II used a qualitative approach through semi-structured interviews with 13 purposively selected participants until data saturation was achieved. Qualitative data were analysed through thematic analysis.

Results: Quantitative findings showed that 26 (49.1%) participants marked inadequate staffing, 32 (60.4%) identified delayed information transfer, and 42 (79.2%) showed inefficient triage as primary barriers. Facilitators reported included team support (n=31, 58.5%), clear protocols (n=32, 60.4%), and continuous professional development (n=31, 58.5%). Qualitative analysis revealed six themes: overcrowding, challenges with triage, safety concerns due to aggressive relatives, shortage of staff, communication barriers, and time-consuming duplication of paperwork. These challenges lead to staff burnout, delayed patient care, and medical errors.

Conclusion: The study critically analysed the barriers, challenges, and facilitators affecting the ED's performance. It highlights that supportive teamwork, training, and clear communication are key factors in facilitators. Urgent interventions such as improving staff numbers, enhancing triage training, and streamlining administrative processes are important. These issues should be assessed to improve patient outcomes, healthcare staff wellbeing, and the efficiency of emergency services.

Keywords: challenges faced; communication barriers; emergency department (ed); healthcare delivery; healthcare professionals (hcp); nursing; safety concerns; staffing shortages; triage protocols; barriers.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Research Cell, Uttar Pradesh University of Medical Sciences, Saifai issued approval 230/RC/UPUMS/2023-24. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Barriers to immediate and efficient care as reported by the study participants
SOP: standard operating procedure; CME: continuing medical education
Figure 2
Figure 2. Facilitators for immediate and efficient care as reported by study participants (N=53)
Figure 3
Figure 3. Tool 1: Demographic Profile
See this image and copyright information in PMC

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