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Association Between Patient and Emergency Department Operational Characteristics and Patient Satisfaction Scores in a
Jonathan Robert Nichol1, Rongwei Fu, Keith French
1From the *Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ; †Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, ‡Department of Public Health and Preventive Medicine, Oregon Health and Science University; §Oregon Health & Science University Healthcare, Portland, OR; and ∥Division of Emergency Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC.
Insights
Emergency department patient satisfaction scores are linked to operational factors. Reducing door-to-room time significantly improves overall experience and likelihood to recommend for pediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Quality Improvement
- Patient Experience Research
Background:
- Patient satisfaction scores are increasingly vital in emergency departments (EDs).
- Limited understanding exists regarding factors influencing these scores in pediatric EDs.
Purpose of the Study:
- To identify patient and operational characteristics associated with patient satisfaction scores in a pediatric ED.
- To inform strategies for enhancing patient experience in emergency care settings.
Main Methods:
- Retrospective analysis of 810 pediatric patient satisfaction surveys from a single academic ED (2009-2013).
- Linear mixed-effects regression model used to analyze associations between operational/patient factors and satisfaction outcomes.
- Key outcomes: overall experience, wait time to provider, likelihood to recommend.
Main Results:
- Increased door-to-room time significantly decreased all three satisfaction scores.
- A discrepancy of over 2 hours between perceived and actual length of stay (LOS) lowered overall experience and likelihood to recommend.
- Online surveys correlated with higher scores for waiting time compared to mailed surveys.
Conclusions:
- Emergency departments aiming to boost patient satisfaction should prioritize reducing door-to-room times.
- Addressing discrepancies in perceived versus actual length of stay is crucial for improving pediatric patient experience.
Background:
Emergency departments (EDs) are seeing an increase in the importance of patient satisfaction scores, yet little is known about their association with patient and operational characteristics.
Objectives:
This study aimed to identify patient and operational characteristics associated with patient satisfaction scores.
Methods:
This was a retrospective analysis of data from Press Ganey patient satisfaction surveys of pediatric patients (<18 years) and their families, discharged from the ED of a single, academic, pediatric ED from December 2009 to May 2013. A linear mixed-effects regression model was used to identify significant associations while taking the clustering within patients and physicians into account. Outcome variables included scores for overall experience (0-10), wait time to be seen by a provider (0-100), and likelihood to recommend (0-100). The ED characteristics considered included daily census, proportion of left without being seen, average length of stay (LOS), and total boarding hours, as well as time of day by shift, door-to-room time, and discharge LOS. Patient characteristics included patient age, sex, race, person completing survey, survey language, survey method (mailed or online), payer type, mode of arrival, distance to hospital, weekend or weekday visit, and difference of patient-reported LOS to actual LOS. Only statistically significant variables were included in the final model.
Results:
A total of 810 pediatric surveys were included for analysis. The overall mean (SD) was 8.7 (2.0) for overall experience, 84.0 (23.5) for waiting time to be seen by a provider, and 90.1 (22.2) for likelihood to recommend. The score for overall experience was highly correlated with likelihood to recommend (r = 0.90) and less strongly correlated with score for waiting time (r = 0.58). In the final models, increased door-to-room time was associated with a significant decrease in scores for all 3 outcome variables. In addition, a difference between perceived and actual LOS (>2 hours) was significantly associated with lower scores in overall experience and likelihood to recommend, whereas surveys completed online had higher scores for waiting time to see a provider compared with mailed.
Conclusions:
Emergency departments looking to increase satisfaction scores should focus efforts on decreasing door-to-room times.
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