The Impact of Selecting Specific Cohorts for Benchmarking and Interpretation of Emergency Department Patient Satisfaction Scores

Abstract

ObjectivesEmergency departments (EDs) patient satisfaction metrics are highly valued by hospitals, health systems, and payers, yet these metrics are challenging to analyze and interpret. Accurate interpretation involves selection of the most appropriate peer group for benchmark comparisons. We hypothesized that the selection of different benchmark peer groups would yield different interpretations of Press Ganey (PG) patient satisfaction scores.MethodsEmergency department PG summary ratings of “doctors section” and “likelihood‐to‐recommend” raw scores and corresponding percentiles were derived for three benchmark peer groups from three academic years (2016, 2017, and 2018). The three benchmarks are: 1) the PG Large database; 2) the PG University HealthSystem Consortium (UHC) database; and 3) the Academy of Administrators in Academic Emergency Medicine (AAAEM) database, which is composed only of EDs from academic health centers with emergency medicine residency training programs. Raw scores were converted to percentile ranks for each distribution and then compared using Welch’s ANOVA and Games‐Howell pairwise comparisons.ResultsFor both patient satisfaction raw scores evaluated, the AAAEM database was noted to have significantly higher percentile ranks when compared to the PG Large and PG UHC databases. These results were consistent for all three time frames assessed.ConclusionsBenchmarking with different peer groups provides different results, with similar patient satisfaction raw scores resulting in higher percentile ranks using the AAAEM database compared to the two PG databases. The AAAEM database should be considered the most appropriate peer group for benchmarking academic EDs.

Operational factors associated with emergency department patient satisfaction: Analysis of the Academy of Administrators of Emergency Medicine/Association of Academic Chairs of Emergency Medicine national survey

“…Prior literature has suggested that ED volume, hospital size, and academic versus nonacademic status may influence patient experience and ED flow. 9,14,15 Our results supported the prior literature up to 15,000 annual admissions. The reason for our observed flattening of likelihood-torecommend scores for EDs in hospitals with greater than 15,0000 admissions remained unclear.…”

“…Within our study population, there appeared to have been an inflection point at approximately 15,000 annual admissions into the hospital, with progressively higher likelihood‐to‐recommend scores as annual admissions decreased from 15,000. Prior literature has suggested that ED volume, hospital size, and academic versus nonacademic status may influence patient experience and ED flow 9,14,15 . Our results supported the prior literature up to 15,000 annual admissions.…”

Minimal Differences in Responses but Big Differences in Rankings: Press Ganey Versus Professional Research Consultants

“…PRC uses a 23‐question Likert‐scale measurement conducted via telephone. These domains were identified with the goal of comparing proportion of top box responses in PG versus PRC surveys; peer groups were not disclosed from either company 5 . While wording was not completely identical between PG and PRC, overlap was sufficiently matched to allow comparison for 12 domains including the all‐important “likelihood to recommend” and “overall” domains (Data Supplement , available as supporting information in the online version of this paper, which is available at http://onlinelibrary.wiley.com/doi/10.1111/acem.14121/full).…”

“…We have no way of knowing this with certainty or knowing who our benchmarking peers are. This information is proprietary to these companies 5 . Also of note, this is the first report examining ED PRC patient satisfaction proportion of responses in top box scores and percentile rankings.…”