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Early unplanned return visits to a pediatric emergency department in Israel
Or Reiser1, Raz Diamand2, Itai Shavit2
1Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
Insights
Parents reported high overall satisfaction with their child's first emergency department (ED) visit. However, satisfaction with physician communication and explanations was notably lower, indicating an area for improvement in pediatric ED care.
Area of Science:
- Pediatric Emergency Medicine
- Patient Satisfaction Studies
- Healthcare Quality Improvement
Background:
- Early unplanned return visits (EURV) to the emergency department (ED) cause stress for children and caregivers.
- Patient dissatisfaction with initial ED care may drive revisits.
- Comprehensive evaluation of parental satisfaction with the first ED visit is needed.
Purpose of the Study:
- To comprehensively evaluate parental satisfaction with the initial emergency department visit for children experiencing early unplanned return visits.
Main Methods:
- Prospective questionnaire-based study in a pediatric ED.
- Utilized a 27-item Parental Satisfaction Questionnaire (PSQ) assessing attitude, information, continuity, and waiting times.
- Convenience sampling of parents of EURV patients, rated on a five-point Likert scale.
Main Results:
- 88.7% of caregivers reported high overall satisfaction (8-10/10) with the first ED visit.
- Median satisfaction scores for most items were high (4/5).
- Lower median satisfaction scores were observed for physician attention (3/5) and clarity of explanations (2/5).
Conclusions:
- Parents expressed overall satisfaction with the initial emergency department care.
- Physician interaction, including attention and clarity of explanations, emerged as an area with lower parental satisfaction.
Background:
Early unplanned return visits (EURV) to the emergency department (ED) are stressful for children and caregivers. Dissatisfaction with the first ED visit could influence the decision to revisit the ED. The aim was to evaluate comprehensively parents' satisfaction with the first ED visit.
Methods:
A prospective questionnaire-based study of parents of EURV patients was conducted in a pediatric ED. Participants were enrolled based on convenience sampling. The study instrument was the parental satisfaction questionnaire (PSQ). The 27 PSQ items evaluate four themes related to satisfaction: attitude and respect, information provided, continuity of care, and waiting times. Items are rated on a five-point Likert scale.
Results:
During the 18-month study, 101 parents of EURV patients were surveyed and 98 agreed to participate. On the return visit, 63 EURV patients were discharged and 35 EURV patients were hospitalized. Eighty-seven (88.7%) caregivers scored an overall level of satisfaction with the first visit of 8-10 on a 10-point Likert scale. Median scores in 22 PSQ items were 4 (interquartile range [IQR] 4-5) or 4 (IQR 3-4). Median scores for "physicians attention and answering questions and concern" and "physicians clear and understood explanations" were 3 (IQR 3-4) and 2 (IQR 2-3), respectively. The PSQ scores were similar for patients who were discharged on the return visit and patients who were hospitalized.
Conclusions:
Parents were satisfied with the care provided at the first ED visit. There was a lower level of satisfaction with physician interaction.
