"I just needed help": a qualitative study of patients' experiences with a single responder ambulance

BACKGROUND: In response to the growing demand for prehospital care in the Central Denmark Region, a single responder ambulance, the Prehospital Visitation Unit (PVU), was introduced in early 2022. Staffed by a single paramedic, the PVU focuses on completing patient treatment on-site and/or facilitating access to appropriate healthcare services. Despite the increasing implementation of non-conveyance initiatives, little is known about patients' experiences of receiving emergency medical care in such settings. This qualitative study aimed to explore patients' expectations when calling for emergency help and their experiences with encountering the PVU in response to their need for help. METHODS: The study was conducted in two stages of fieldwork: preliminary and main. Participant observation and semi-structured interviews were utilized throughout. The preliminary fieldwork took place between 1 June and 31 August 2022, and the main fieldwork between 1 February and 30 March 2023. In total, the researchers observed 12 PVU shifts, documenting patient-paramedic encounters through fieldnotes. Additionally, 22 patients completed a follow-up telephone interview. Interview transcripts and fieldnotes were analyzed using a two-cycle coding approach. RESULTS: Overall, patients expressed satisfaction with the PVU and appreciated receiving treatment on-site rather than being transported to the hospital. When asked about their expectations after calling the Emergency Medical Services (EMS), patients consistently emphasized that they "just needed help". They were unconcerned about which type of EMS resource was dispatched or how many staff arrived. The PVU was perceived as less dramatic due to its smaller vehicle and single-paramedic operation. The paramedic's calm attitude, clear communication, and use of eye contact contributed to a reassuring atmosphere that put patients at ease. CONCLUSIONS: This study highlights patient satisfaction with the PVU as an EMS response, emphasizing their need for help and the benefits of on-site treatment. It contributes to the scarce literature on patient perspectives regarding non-conveyance, showing how the PVU meets patient expectations, creates a calm atmosphere, and fosters a sense of safety.