Emergency Department Expansion Versus Patient Flow Improvement: Impact on Patient Experience of Care

Sayah, Assaad; Lai-Becker, Melisa W.; Kingsley-Rocker, Lisa; Scott-Long, Tasha; O'Connor, Kelly; Lobón, Luis F

doi:10.1016/j.jemermed.2015.06.068

Cited by 22 publications

(21 citation statements)

References 24 publications

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“…[4][5][6] Medical student involvement in patient care in the ED has previously been shown not to detract from overall satisfaction scores. 7 However, the impact of emergency medicine (EM) residents on patient satisfaction is unknown.…”

Section: Importancementioning

confidence: 99%

Measuring the Correlation Between Emergency Medicine Resident and Attending Physician Patient Satisfaction Scores Using Press Ganey

Lang

Weygandt

Darling

et al. 2017

AEM Education and Training

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Objective: The purpose of this study was to assess the relationship between emergency medicine (EM) resident and attending physician patient satisfaction scores. Methods:We added four resident questions to the standard Press Ganey survey used at a large, urban, university hospital with a PGY-1 to -4 EM residency. The resident questions were identical to the traditional attending questions. Press Ganey distributed the modified survey to a random sample of 30% of discharged patients. We assessed the correlation between resident and attending top-box Press Ganey scores using Pearson's coefficients. Two-tailed two-sample comparisons of proportions were used to compare top-box responses between residents and attendings.Results: From September 1, 2012, to August 31, 2015, a total of 66,216 patients received surveys, and 7,968 responded, resulting in a 12.03% response rate, similar to Press Ganey survey response rate at comparable peer institutions. Patients were able to discriminate between residents and attendings; however, 751 surveys did not contain responses for residents, resulting in a total number of 6,957. All 64 of the EM residents had a minimum of 5 or more surveys returned. There was a high degree of correlation between resident and attending top-box scores with correlation coefficients ranging from 0.75 to 0.80. However, the proportion of top-box scores was consistently higher for residents (p < 0.05).Conclusions: There is a high degree of correlation between resident and attending top-box scores on Press Ganey surveys, with residents scoring slightly higher than attendings. The addition of resident questions to the standard Press Ganey survey does not appear to decrease overall attending scores.

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Section: Importancementioning

confidence: 99%

Measuring the Correlation Between Emergency Medicine Resident and Attending Physician Patient Satisfaction Scores Using Press Ganey

Lang

Weygandt

Darling

et al. 2017

AEM Education and Training

View full text Add to dashboard Cite

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“…Diverting non-urgent patients has shown little difference in terms of flow, and is a patient safety issue as many “non-urgent” patients will eventually require hospital admission [39,40]. Expanding ED capacity does little to reduce time to admission but rather increases the capacity for boarded patients, further straining an already overwhelmed staff [41-43]. While additional staff from the inpatient unit can help relieve the strain on the ED nursing staff, boarded patients still create space constraints limiting the capacity of the ED to see new patients [44].…”

Section: Inneffective Interventionsmentioning

confidence: 99%

Emergency department and hospital crowding: causes, consequences, and cures

et al. 2019

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Overcrowding with associated delays in patient care is a problem faced by emergency departments (EDs) worldwide. ED overcrowding can be the result of poor ED department design and prolonged throughput due to staffing, ancillary service performance, and flow processes. As such, the problem may be addressed by process improvements within the ED. A broad body of literature demonstrates that ED overcrowding can be a function of hospital capacity rather than an ED specific issue. Lack of institutional capacity leads to boarding in the ED with resultant ED crowding. This is a problem not solvable by the ED and must be addressed as an institution-wide problem. This paper discusses the causes of ED overcrowding, provides a brief overview of the drastic consequences, and discusses possible cures that have been successfully implemented.

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“…Studies show that process improvement positively impacts patient satisfaction scores and ED performance in the CMS benchmarks. [2,3] While we observe many benefits, we also witness the negative impacts on physicians' work ethic and team morale as a result of the HCAHPS reports. ED physicians reported that survey results moderately or severely affected job satisfaction to where some considered leaving the medical field.…”

Section: Introductionmentioning

confidence: 89%

Emergency department patient experience: Same location, same provider, different scores by different survey methods

Hoonpongsimanont¹,

Sahota²,

Chen³

et al. 2019

World Journal of Emergency Medicine

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BACKGROUND: Recent findings on emergency department (ED) patient experience surveys and concerns for the low response rates challenge the quality and reliability of the survey reports. We assessed the consistency of an ED patient experience survey report and identifi ed the effects of patient demographics on ED patient experiences. METHODS: We conducted a prospective, cross-sectional study at a university-based ED from July to December 2017. We obtained ED patient experience scores from an institutional version (IS) survey and the Press Ganey Associates-distributed survey (PGA). We compared top box scores from the two reports using frequency analysis and performed multivariable logistic regressions to identify associations between IS patient demographics and scores. RESULTS: We obtained 289 PGA and 234 IS responses. The IS reported signifi cant, higher top box scores in doctor-specifi c patient questions compared to PGA (all four P-values < 0.01). Female, Christian and White patients were more likely to give top box scores (OR 3.07, OR 2.22 and OR 2.41, P-value < 0.05, respectively). CONCLUSION: We found significant differences in ED patient experience scores between the IS and PGA surveys. We recommend that healthcare providers consider patient demographic variables when interpreting ED experience score reports. Multiple survey techniques and distribution methods may be adopted to best capture ED patient experiences.

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Emergency Department Expansion Versus Patient Flow Improvement: Impact on Patient Experience of Care

Cited by 22 publications

References 24 publications

Measuring the Correlation Between Emergency Medicine Resident and Attending Physician Patient Satisfaction Scores Using Press Ganey

Measuring the Correlation Between Emergency Medicine Resident and Attending Physician Patient Satisfaction Scores Using Press Ganey

Emergency department and hospital crowding: causes, consequences, and cures

Emergency department patient experience: Same location, same provider, different scores by different survey methods

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