Co-designing a better fit: ED communication for adults with disability
Tracks
Room 2
| Wednesday, December 2, 2026 |
| 2:10 PM - 2:30 PM |
| Concurrent Room 1 |
Overview
Dr Emilie Francis-Auton
Speaker
Dr Emilie Francis-Auton
Australian Institute of Health Innovation, Macquarie University
Co-designing a better fit: ED communication for adults with disability
Abstract
Emergency departments (EDs) are high-pressure environments that utilise standardised protocols to streamline care, yet can adapt care when supported by timely information and enabling system conditions. For adults living with a disability (alwD), this adaptive capacity is constrained by communication and environmental barriers. This study aimed to co-design communication interventions to improve system-user fit in the ED. The study built on findings from Stage 1 of our EBCD approach that prioritised communication-focused interventions to support identification of patient needs, reasonable adjustments, and anticipatory care in the ED.
Expert consultations with ED clinicians (n=3), paediatric clinicians (n=2) involved in a similar intervention, and a codesign workshop involving clinicians (n=3), carers (n=3), and alwD (n=2). Codesign workshop participants undertook journey mapping, prototype development, and narrative co-development to adapt a ready reference card and educational package for adult ED workflows. An embedded nurse (n=1) provided iterative input to ensure feasibility and workflow alignment. Workshop outputs were analysed inductively, examining participant experiences and design principles for the intervention.
Co-design workshops adapted a ready reference card for clinicians and suggested patient/carer narratives to support staff education and implementation. Design features included prompts for identification of patient needs, communication and environmental preferences, basic care needs, and preparation for procedures and discharge. Participants emphasised that in time-pressured ED interactions, staff rely on incomplete information or carers to bridge communication gaps. The reference card was designed to be portable and accessible, functioning as a cognitive aid to support consistent communication and reduce cognitive load during shifts.
Findings highlight the need for practical strategies that better align ED systems and workflows with the needs of alwD, carers, and staff. Embedding communication prompts within workflow offers practical support for anticipatory, person-centred care while remaining responsive to operational demands. Communication is a critical system-level factor in ED performance and patient safety.
Expert consultations with ED clinicians (n=3), paediatric clinicians (n=2) involved in a similar intervention, and a codesign workshop involving clinicians (n=3), carers (n=3), and alwD (n=2). Codesign workshop participants undertook journey mapping, prototype development, and narrative co-development to adapt a ready reference card and educational package for adult ED workflows. An embedded nurse (n=1) provided iterative input to ensure feasibility and workflow alignment. Workshop outputs were analysed inductively, examining participant experiences and design principles for the intervention.
Co-design workshops adapted a ready reference card for clinicians and suggested patient/carer narratives to support staff education and implementation. Design features included prompts for identification of patient needs, communication and environmental preferences, basic care needs, and preparation for procedures and discharge. Participants emphasised that in time-pressured ED interactions, staff rely on incomplete information or carers to bridge communication gaps. The reference card was designed to be portable and accessible, functioning as a cognitive aid to support consistent communication and reduce cognitive load during shifts.
Findings highlight the need for practical strategies that better align ED systems and workflows with the needs of alwD, carers, and staff. Embedding communication prompts within workflow offers practical support for anticipatory, person-centred care while remaining responsive to operational demands. Communication is a critical system-level factor in ED performance and patient safety.
Biography
Emilie Francis-Auton is a Research Fellow at the Australian Institute of Health Innovation at Macquarie University. With a background in sociology and qualitative health research, her work focuses on improving healthcare systems through co-design, implementation science, and human-centred approaches to service improvement.
Emilie’s research explores patient and clinician experiences within complex healthcare environments, particularly emergency care and disability-inclusive healthcare. She has expertise in qualitative and mixed-methods research, including interviews, participatory co-design, and realist evaluation, with a strong focus on translating research findings into practical improvements for healthcare delivery, communication, and organisational change.
