Emergency department culture and the care of older patients with frailty: a focused ethnography

Culture shapes care delivery, professional communication, and the development of trust between patients and providers. Culture encompasses identifiable elements, shared values and beliefs, and underlying assumptions that shape behaviour. The Emergency Department (ED) subculture arises from its complex, highpressure focus on acute illness. ED professionals increasingly encounter older patients with frailty, whose complex but often non-urgent needs require more holistic, individualised care. However, the ED subculture may hinder the provision of appropriate geriatric emergency care. Despite its relevance, little is known of the influence of the ED subculture on the care for older patients. This study provides insight into the ED subculture in relation to the care of older patients with frailty by exploring its visible elements, shared values and beliefs, and underlying assumptions that shape behaviour.