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Determinants of Parent Satisfaction with Emergency or Urgent Care When the Patient Has Autism
Sarah F Kirsch1, David L Meryash1,2, Bárbara González-Arévalo3
1Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Cohen Children's Medical Center of New York, New Hyde Park, NY.
Insights
Parent satisfaction with emergency care for children with autism spectrum disorder (ASD) hinges on staff interactions. Effective communication and interpersonal skills from healthcare providers significantly impact the patient and family experience.
Area of Science:
- Pediatric Healthcare
- Autism Spectrum Disorder Research
- Healthcare Quality Improvement
Background:
- Children with autism spectrum disorder (ASD) often require emergency department (ED) or urgent care (UC) services.
- Parent satisfaction is a key indicator of healthcare quality, particularly for vulnerable populations.
- Understanding factors influencing parent satisfaction is crucial for improving care delivery for children with ASD.
Purpose of the Study:
- To identify key predictors of parent satisfaction (PS) during hospital emergency department (ED) or urgent care (UC) visits for children with autism spectrum disorder (ASD).
- To analyze the impact of various factors, including staff interactions and patient characteristics, on parental experiences in acute care settings.
Main Methods:
- Anonymous online questionnaires were completed by 378 parents of children (3-21 years) with ASD who had visited an ED/UC center within the past three years.
- Data collected included parent demographics, patient characteristics, visit expectations, and observations of staff interpersonal and communication skills (ICSs).
- Multiple correspondence analysis (MCA) was employed to determine the influence of different variables on overall parent satisfaction.
Main Results:
- Nine assessed staff ICS behaviors were among the top 10 determinants of parent satisfaction.
- Shorter-than-expected waiting times and the patient not being disruptive (ND) also positively influenced PS.
- Parent satisfaction was not significantly associated with patient disability severity, sensory hyperreactivity, reason for visit, or parent's education level.
Conclusions:
- Parent satisfaction in ED/UC visits for children with ASD is primarily driven by the quality of staff interactions.
- Healthcare administrators must prioritize training staff in effective communication and interaction strategies for patients with ASD and their families.
- Improving staff-patient-family communication is essential for enhancing the healthcare experience for children with autism.
Objective:
The purpose of this study was to identify factors that predict parent satisfaction (PS) with their child with autism spectrum disorder (ASD)'s visit to a hospital emergency department (ED) or urgent care (UC) center.
Methods:
Parents recruited through a national database whose child (3-21 years; N = 378) with ASD had been treated in an ED/UC center within the previous 3 years completed an anonymous on-line questionnaire. They answered questions about whether they were satisfied overall with the visit and the care provided, their demographics, patient characteristics, their expectations and preparation for the visit, and the ED/UC center experience itself, including their observations of staff interpersonal and communication skills (ICSs) and behaviors, and whether the patient was disruptive (D). Multiple correspondence analysis (MCA) was used to demonstrate the relative effects of individual variables on PS.
Results:
Among the 10 most important determinants of PS with the visit were the 9 assessed staff ICS behaviors. These were followed by shorter than expected waiting time and the patient not being disruptive (ND) during the visit. PS was not associated with any of the 3 measures of patient disability severity (ASD subtype, communicative competence, or restrictiveness of educational placement), whether the patient is hyperreactive to sensory stimuli, reason for the visit, or parent's education.
Conclusion:
PS with an ED/UC center visit when the patient has autism depends mostly on the quality of staff interactions with the patient and family. It is important for ED/UC center administrators to ensure that staff understand how to interact and communicate effectively with patients with ASD and their families.
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