Abstract / Summary
Abstract Background Emergency medical services are increasingly using non-conveyance models to expand capacity and provide patient-centred care. In Denmark, Prehospital Assessment Units were introduced to strengthen acute care pathways, with sustainable implementation dependent upon cross-sector cooperation. The aim of this study was to examine healthcare professionals’ experiences with the Prehospital Assessment Unit model across emergency medical service, emergency departments, general practice, and municipal acute care, with a focus on acceptability, appropriateness, and feasibility, and identify positive and negative implementation determinants. Methods A convergent parallel mixed-methods design combined quantitative questionnaire data collected using previously published and validated outcome measures with qualitative focus groups across emergency medical services, emergency departments, municipal care, and general practice. Data were collected April–August 2024 in the Region of Southern Denmark. Quantitative results were analysed descriptively, while qualitative data were examined using Reflexive Thematic Analysis. Integration used a joint display to align ratings with positive and negative implementation determinants. Results 231 healthcare professionals responded to the questionnaire (51.7%), with 166 included after prespecified exclusions. Three focus groups ( n = 18) captured cross-sector experiences. Quantitative ratings were positive with median scores on a 1–5 scale: Acceptability of Intervention Measure: 5.00 (IQR:4.00–5.00), Intervention Appropriateness Measure: 4.13 (IQR: 4.00–5.00), and Feasibility of Intervention Measure: 4.25 (IQR: 3.75-5.00). The qualitative analysis generated three themes: (1) The contested work of patient selection (2), Integration in acute care , and (3) Building understanding through shared narratives . Qualitative narratives reinforced the quantitative analysis, legitimising Prehospital Assessment Units and highlighting the contribution across sectors and positive implementation determinants. In contrast, variability in feasibility scores and accounts of patient selection, role negotiation, and integration revealed some negative implementation determinants. Conclusions Healthcare professionals reported predominantly positive experiences of the acceptability, appropriateness, and feasibility of the PAU model. The integrated analysis revealed positive implementation determinants, including the contribution of PAUs across sectors and the role of shared experiences in building understanding of the service. At the same time, challenges related to patient selection and the integration of PAUs within acute care services revealed important negative implementation determinants, reflecting contextual factors and unclear boundaries that may hinder consistent implementation.