Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T14:49:40.495Z Has data issue: false hasContentIssue false

Patient Expectations of Emergency Department Care: Phase II – A Cross-Sectional Survey

Published online by Cambridge University Press:  21 May 2015

Timothy Cooke
Affiliation:
Health Quality Council of Alberta, Calgary, Alta.
Denise Watt*
Affiliation:
Department of Emergency Medicine, University of Calgary, Calgary, Alta.
William Wertzler
Affiliation:
Department of Emergency Medicine, University of Calgary, Calgary, Alta.
Hude Quan
Affiliation:
Department of Community Health Sciences, and The Center for Health and Policy Studies, University of Calgary, Calgary, Alta.
*
Department of Emergency Medicine, Calgary Health Region, 1403 29th St. NW, Calgary AB T2N 2T9

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

To explore emergency department (ED) patient expectations regarding staff communication with patients, wait times, the triage process and information management.

Methods:

We conducted a cross-sectional English-language telephone survey among patients aged 18 years or older who visited the EDs in the Calgary Health Region in 2002. Survey items were based on a preceding qualitative study.

Results:

Of the 941 surveys, 837 were analyzed. Patients placed the highest importance on the explanation of test results (96.5%), a description of circumstances that would require the patient to return to the ED (94.4%), the use of plain language (92.1%) and the reason for the tests (90.8%). Seventy-six percent of patients felt that ED staff should update patients every 30 minutes or less, 51.3% expected patients with non-life threatening problems should wait <1 hour, and 58.3% expected that the tests should be done within 1 hour. Almost two-thirds of the patients (64.4%) believed that the most serious patients should be seen first; 59.3% felt that the seriousness of medical concern should be determined by a triage nurse, and 63.9% thought that their personal health records should be immediately available to the emergency physician without their consent. The actual length of stay was significantly longer than expected length of stay for all patient groups, with Canadian Emergency Department Triage and Acuity Scale Levels IV and V patients expecting a shorter wait than patients in more urgent triage groups. Triage level effects on other expectations were not observed.

Conclusions:

ED patient expectations appear to be similar across all triage levels. Patients value effective communication and short wait times over many other aspects of care. They have expectations for short wait times that are met infrequently and are currently unattainable in many Canadian EDs. Although it may be neither feasible nor desirable to meet all patient expectations, increased focus on wait times and staff communication may increase both ED efficiency and patient satisfaction.

Type
Original Research • Recherche originale
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

References

1.Committee on Quality Health Care in America; Institute of Medicine. Crossing the quality chiasm. Washington (DC): National Academy Press; 2001. Available: http://www.nap.edu/books/0309072808/Google Scholar
2.Peck, BM, Asch, DA, Goold, SD, et al. Measuring patient expectations: Does the instrument affect satisfaction or expectations? Med Care 2001;39:100–8.Google Scholar
3.Williams, B. Patient satisfaction: A valid concept? Soc Sci Med 1994;38:509–16.CrossRefGoogle ScholarPubMed
4.Aharony, L, Strasser, S. Patient satisfaction: what we know about and what we still need to explore. Med Care Rev 1993;1:4979.Google Scholar
5.Carr-Hill, RA. The measurement of patient satisfaction. J Public Health Med 1992;14:236–49.Google Scholar
6.Williams, B, Coyle, J, Healy, D. The meaning of patient satisfaction: an explanation of high reported levels. Soc Sci Med 1998;47:1351–9.CrossRefGoogle ScholarPubMed
7.Sitzia, J, Wood, N. Patient satisfaction: a review of issues and concepts. Soc Sci Med 1997;45:1829–43.CrossRefGoogle ScholarPubMed
8.Staniszewska, S, Ahmed, L. Patient expectations and satisfaction with health care. Nurs Stand 1998;12:34–8.Google Scholar
9.Linder-Pelz, S. Toward a theory of patient satisfaction. Soc Sci Med 1982;16:577–82.Google Scholar
10.O’Connor, SJ, Trinh, HQ, Shewchuck, RM. Perceptual gaps in understanding patient expectations for health care service quality. Health Care Manage Rev 2000;25:723.CrossRefGoogle ScholarPubMed
11.Taylor, C, Benger, JR. Patient satisfaction in emergency medicine. Emerg Med J 2004;21:528–52.Google Scholar
12.Boudreaux, ED, Ary, RD, Mandry, CV, et al. Determinants of patient satisfaction in a large municipal ED: the role of demographic variables, visit characteristics and patient perceptions. Am J Emerg Med 2000;18:394400.Google Scholar
13.Boudreaux, ED, O’Hea, EL. Patient satisfaction in the emergency department: a review of the literature and implications for practice. J Emerg Med 2004;26:1326.CrossRefGoogle ScholarPubMed
14.Mayer, TA, Cates, RJ, Mastorovich, MJ, et al. Emergency department patient satisfaction: customer service training improves patient satisfaction and ratings of physician and nurse skill / practitioner response. J Healthc Manag 1998;43:427–42.Google Scholar
15.Tran, TP, Schutte, WP, Muelleman, RL, et al. Provision of clinically based information improves patients’ perceived length of stay and satisfaction with EP. Am J Emerg Med 2002;20(6):506–9.Google Scholar
16.Sun Benjamin, C, Brinkley, M, Morrissey, J, et al. A patient education intervention does not improve satisfaction with emergency care. Ann Emerg Med 2004;44:378–83.Google Scholar
17.Sun, BC, Adams, J, Orav, EJ, et al. Determinants of patient satisfaction and willingness to return with emergency care. Ann Emerg Med 2000;35:426–34.CrossRefGoogle ScholarPubMed
18.Trout, A, Magnusson, AR, Hedges, JR. Patient satisfaction investigations and the emergency department: What does the literature say? Acad Emerg Med 2000;7:695709.CrossRefGoogle ScholarPubMed
19.Thompson, DA, Yarnold, PR, Williams, DR, et al. Effects of actual waiting time, perceived waiting time, information delivery, and expressive quality on patient satisfaction in the emergency department. Ann Emerg Med 1996;28:657–65.Google Scholar
20.Aragon, SJ, Gesell, SB. A patient satisfaction theory and its robustness across gender in emergency departments: a multi-group structural equation modeling investigation. Am J Med Qual 2003;18:229–41.Google Scholar
21.Spaite, DW, Bartholomeaux, F, Guisto, J, et al. Rapid process redesign in a university-based emergency department: decreasing waiting time intervals and improving patient satisfaction. Ann Emerg Med 2002;39:168–77.CrossRefGoogle Scholar
22.Nerney, MP, Chin, MH, Jin, L, et al. Factors associated with older Patients satisfaction with care in an inner-city emergency departaient. Ann Emerg Med 2001;38:140–5.CrossRefGoogle Scholar
23.Boudreaux, ED, Friedman, J, Chansky, ME, et al. Emergency department patient satisfaction: examining the role of acuity. Acad Emerg Med 2004;11:162–8.Google Scholar
24.Grol, R, Wensing, M, Mainz, J, et al. Patients’ priorities with respect to general practice care: an international comparison. Fam Pract 1999;16:411.Google Scholar
25.Greene, JY, Weinberger, M, Mamlin, JJ. Patient attitudes toward health care: expectations of primary care in a clinic setting. Soc Sci Med [Med Psychol Med Sociol] 1980;14A(2):133–8.Google Scholar
26.Beveridge, R, Clarke, B, Janes, L, Savage, N, Thompson, J, Dodd, G, et al. Canadian Emergency Department Triage and Acuity Scale: implementation guidelines. Can J Emerg Med 1999;1(3 suppl). Online version available at: http://www.caep.ca/002.policies/002-02.ctas.htm (accessed 3 Apr 2006).Google Scholar
27.Watt, D, Wertzler, W, Brannan, G. Patient expectations of emergency department care: phase I — a focus group study. Can J Emerg Med 2005;7(1):12–6.Google Scholar
28.Schull, MJ, Slaughter, PM, Redelmeier, DA. Urban emergency department overcrowding: defining the problem and eliminating the misconceptions. Can J Emerg Med 2002;4:7683.CrossRefGoogle ScholarPubMed
29.Goodacre, S, Webster, A. Who waits longest in the emergency department and who leaves without being seen. Emerg Med J 2005;22:93–6.Google Scholar
30.Moser, MS, Abu-Laban, RB, van Beek, CA. Attitude of emergency department patients with minor problems to being treated by a nurse practitioner. Can J Emerg Med 2004;6:246–52.Google Scholar