Elderly patients' perceptions of care in the emergency department

Watson, Wayne T.; Marshall, Elaine S.; Fosbinder, Donna

doi:10.1016/s0099-1767(99)70152-2

Cited by 72 publications

(61 citation statements)

References 23 publications

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“…7,10 Other studies have emphasized the importance of interpersonal factors and provision of information to patients while they are waiting as factors influencing overall patient satisfaction. 3,4,8,[11][12][13][14][15][16] Indeed, two studies were unable to demonstrate an association between overall patient satisfaction and actual waiting intervals. 8,13 Efforts to shorten actual waiting time intervals may be more costly than efforts to modify the perception that the waiting interval is ''too long.''…”

Section: Discussionmentioning

confidence: 99%

Satisfied Patients Exiting the Emergency Department (SPEED) Study

Hedges

2002

Academic Emergency Medicine

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Abstract. Background/Objective: Patient satisfaction has been associated with patient perceptions of emergency department (ED) wait intervals, but not necessarily actual wait intervals. The objective was to address the associations of actual versus perceived wait intervals in ED patients and the association of overall satisfaction with perceived and actual wait intervals. Methods: The authors performed a prospective, cross-sectional study using a volume-stratified sample of adult ED patients presenting to an urban, university teaching hospital. Patient wait intervals were monitored using a computerized tracking system. Patients were confidentially surveyed regarding their overall satisfaction with care and perceptions of wait intervals after a disposition decision was made by the treating physician. The Spearman's rho (twotailed, ␣ = 0.05) was used to evaluate the association between patient satisfaction and perceived wait intervals, estimated wait intervals, and measured wait intervals. Associations between these measures of wait intervals were similarly assessed. Results: One hundred twenty-six eligible patients (including 15 admissions) completed the survey. The median wait interval (interquartile range [IQR]) was 14 (7 to 22) minutes to a room. Overall satisfaction was more strongly associated with the perception that the wait interval to a room was shorter than expected (r = 0.44; p = 0.00001) than with the estimated wait interval (r = 0.03; p = 0.97) or the measured wait interval (r = Ϫ0.06; p = 0.49). Patients had a median wait interval of 13 (3 to 26) minutes in a room until seen by a physician. Overall satisfaction was more strongly associated with the perception of the physician wait interval's being shorter than expected (r = 0.37; p = 0.00001) than with the estimated wait interval (r = Ϫ0.09; p = 0.32) or the measured wait interval (r = 0.05; p = 0.58). Similar findings were found for the total time in the ED. For both the wait for a room interval and the wait for a physician interval, the measured wait intervals were more strongly associated with the estimated wait intervals (r = 0.63 and r = 0.34, respectively) than with the perception that the wait intervals were shorter than expected (r = Ϫ0.20 and r = Ϫ0.17, respectively). Conclusions: Efforts to improve ED patient satisfaction should focus on improving patients' perceptions that wait intervals are appropriate rather than simply shortening wait intervals per se. Key words: patient satisfaction; emergency department; administration; waiting time interval; length of stay. ACADEMIC EMERGENCY MEDICINE 2002; 9:15-21 P ATIENT satisfaction has increasingly been recognized as an important emergency department (ED) service goal. While numerous studies have indicated that patient perceptions of ED wait intervals are consistently associated with overall care satisfaction, the actual influence of wait intervals upon satisfaction is less clear.1 Although it is intuitive that extensive delays are undesirable both in initial evaluation and in the res- We perfo...

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Section: Discussionmentioning

confidence: 99%

Satisfied Patients Exiting the Emergency Department (SPEED) Study

Hedges

2002

Academic Emergency Medicine

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“…Studies in this area have mainly described patient satisfaction in the form of quantitative data, and while some proposed models have worked successfully, these results are restricted by a limited number of variables compared with qualitative research, and Nairn et al (2004) suggest further qualitative research to improve the depth of areas of concern. Confounding these findings, qualitative studies show that patients in ED have reason to be dissatisfied with the care situation (Watson et al, 1999;Crowley, 2000;Nydén et al, 2003;Nyström et al, 2003). Results regarding the quality of patient care in EDs thus appear to vary and should be brought into line in order to understand better the phenomenon of patient participation.…”

Section: Introductionmentioning

confidence: 97%

Patient participation in emergency care – A phenomenographic study based on patients’ lived experience

Frank

Asp

Dahlberg

2009

International Emergency Nursing

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“…14 In the follow-up and treatment of particularly geriatric patients, a geriatric consultation team in the ED can asses the needs of elderly patients regarding hospital admission, and community services. 15 Another solution is the transferring elderly patients to the palliative care units or nursing homes. Palliative care units can manage end of life care, and admit patients for symptom management.…”

Section: Resultsmentioning

confidence: 99%

Increased Length of Stay in Emergency Department in Turkey: Due to Inappropriate Emergency Department Use or Aging?

Günalp¹,

Gülünay²,

Polat³

et al. 2014

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Emergency department (ED) crowding has long been recognized as a "crisis" in Turkey. The reasons for overcrowding are high number of patients, limited capacity of inpatient clinics, patients aged 65 years of age or older, and a prolonged length of stay in ED. This study aimed to investigate the causes of increased ED stay in a university hospital, in Turkey. M Ma a--t te er ri ia al l a an nd d M Me et th ho od ds s: : This was a prospective observational study carried out over 3 months. We evaluated the data of the outpatients and patients transferred by ambulance to the ED of a university hospital in Turkey. Age, gender, triage scores, date and time of presentation, discharge date and time, definitive diagnosis time, diagnosis categories, and the length of stay in ED were analyzed. R Re e--s su ul lt ts s: : The mean age of 1311patients was 57.68±19.35 years.The mean diagnosis time of the patients was 459.38 minutes (7.39±0.73 hours), and the mean ED stay was 2134 minutes (35.29±3.29 hours). The rate of the patients over 65 years of age (41%) ranked the highest among three age groups. The early discharge rate of the older patients was significantly lower, and their hospitalization duration was significantly higher. At the end of initial 48 hours,625 patients (47.6%) were discharged; only 55 patients (4,1%) could be transferred and hospitalized in the related clinics, while 545 patients (41.5%) were followed-up at the Observation and Clinical Decision Unit by emergency physicians. C Co on nc cl lu us si io on n: : In our study, it was determined that longer than 48-hour delay in transferring the patients to the clinics, and the patients ≥ 65 years of age were the most important reasons for prolonged length of stay in the ED. K Ke ey y W Wo or rd ds s: : Length of stay; emergency medical services; aged Ö ÖZ ZE ET T A Am ma aç ç: : Günümüzde acil servislerdeki (AS) hasta kalabalığı Türkiye'de önemli bir sorun haline gelmiştir. AS'nin aşırı kalabalık olmasının birçok sebebi vardır. Bu faktörlerin bazıları, hasta sayısının fazlalığı, yataklı servislerin kapasitelerinin yetersizliği, ve 65 yaş ve üzeri hasta grubu ve acil serviste uzun süreli yatışlardır. Bu çalışmamızda, AS'de yaşanan aşırı yoğunluğun ve uzun yatışların sebepleri araştırılmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Ankara Üniversitesi Acil Tıp Anabilim Dalında 01 Temmuz 2010-01 Ekim 2010 tarihleri arasında yürütülen bu prospektif gözlemsel çalışmada, acil servise ayaktan ve ambulans ile başvuran hastaların kayıtları tutulmuştur. Hastalara ait yaş, cinsiyet, triaj skorları, başvuru tarih ve saati, taburcu tarih ve saati,tanılarının ne zaman kesinleştiği ve acil serviste kalış süreleri kaydedilmiştir. B Bu ul lg gu ul la ar r: : 1311 hastanın yaş ortalaması 57,68±19,35 yıl olarak tespit edildi. AS'de hastaların ortalama tanı alma süresi 459,38 dakika (7,39±0,73 saat) ve ortalama kalış süresi 2134 dakika (35,29±3,29 saat) olarak saptandı. Altmış beş yaş üzeri hasta grubu %41 ora...

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Elderly patients' perceptions of care in the emergency department

Cited by 72 publications

References 23 publications

Satisfied Patients Exiting the Emergency Department (SPEED) Study

Satisfied Patients Exiting the Emergency Department (SPEED) Study

Patient participation in emergency care – A phenomenographic study based on patients’ lived experience

Increased Length of Stay in Emergency Department in Turkey: Due to Inappropriate Emergency Department Use or Aging?

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