The role of patient perception of crowding in the determination of real-time patient satisfaction at Emergency Department

Wang, Hao; Kline, Jeffrey A.; Jackson, Bradford E.; Robinson, Richard D.; Sullivan, Matthew; Holmes, Marcus; Watson, Katherine A.; Cowden, Chad D.; Phillips, Jessica Laureano; Schrader, Chet D.; Leuck, JoAnna; Zenarosa, Nestor R.

doi:10.1093/intqhc/mzx097

Cited by 33 publications

(35 citation statements)

References 20 publications

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“…Increased length of stay (LOS) in the emergency department (ED) is associated with worse patient outcomes, including worse patient satisfaction, higher inpatient mortality rates, and increased inpatient hospital LOS. [1][2][3][4] As a result, reducing ED LOS is of great interest to both health care systems and patients. Many hospitals are interested in quality improvement initiatives to optimize patient LOS and reduce costs.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Delayed Emergency Department Throughput Among Blunt Trauma Patients

Steren

Fleming

Zhou

et al. 2020

Journal of Surgical Research

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Section: Introductionmentioning

confidence: 99%

Predictors of Delayed Emergency Department Throughput Among Blunt Trauma Patients

Steren

Fleming

Zhou

et al. 2020

Journal of Surgical Research

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“…Future studies in this field should apply tools that are psychometrically robust 45. Further, real-time patient surveys in the ED may be biassed because of patients’ concerns about anonymity, potential consequences for subsequent care or current incapability to respond adequately 30. Third, we matched interruption rates and patient survey results within observation days.…”

Section: Discussionmentioning

confidence: 99%

“…Fourth, although we controlled analyses for ED workload, we acknowledge that our daily approximation may not entirely reflect actual workload during all individual 90 min observation sessions. However, our approach to adjust for ED workload is novel within this literature 30. Future studies should further elucidate the role of patient load or crowding as a potentially mediating or moderating factor in the relationship between provider interruptions and patient perceptions of ED care.…”

Section: Discussionmentioning

confidence: 99%

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Provider interruptions and patient perceptions of care: an observational study in the emergency department

2018

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BackgroundInterruptions are endemic in healthcare work environments. Yet, they can have positive effects in some instances and negative in others, with their net effect on quality of care still poorly understood. We aimed to distinguish beneficial and detrimental forms of interruptions of emergency department (ED) providers using patients’ perceptions of ED care as a quality measure.MethodsAn observational design was established. The study setting was an interdisciplinary ED of an academic tertiary referral hospital. Frequencies of interruption sources and contents were identified in systematic expert observations of ED physicians and nurses. Concurrently, patients rated overall quality of care, ED organisation, patient information and waiting times using a standardised survey. Associations were assessed with hierarchical linear models controlling for daily ED workload. Regression results were adjusted for multiple testing. Additionally, analyses were computed for ED physicians and nurses, separately.ResultsOn 40 days, 160 expert observation sessions were conducted. 1418 patients were surveyed. Frequent interruptions initiated by patients were associated with higher overall quality of care and ED organisation. Interruptions relating to coordination activities were associated with improved ratings of ED waiting times. However, interruptions containing information on previous cases were associated with inferior ratings of ED organisation. Specifically for nurses, overall interruptions were associated with superior patient reports of waiting time.ConclusionsProvider interruptions were differentially associated with patient perceptions of care. Whereas coordination-related and patient-initiated interruptions were beneficial to patient-perceived efficiency of ED operations, interruptions due to case-irrelevant communication were related to inferior patient ratings of ED organisation. The design of resilient healthcare systems requires a thorough consideration of beneficial and harmful effects of interruptions on providers’ workflows and patient safety.

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“…Taking a broad view of TTASs' influence, from a health system perspective, is fundamental . Patients attending services inappropriate to their need results in poorer health outcomes, through inefficiencies, overcrowding, frustrations, and complaints—from staffs, patients, and families . This is particularly critical for EDs, as they serve as the primary gateway to the acute health‐care system.…”

Section: Introductionmentioning

confidence: 99%

Calling for confirmation, reassurance, and direction: Investigating patient compliance after accessing a telephone triage advice service

Siddiqui

Greenfield

Lawler

2019

Health Planning & Management

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Understanding the influence of a telephone triage advice service (TTAS) on patients seeking care is critical to realize enhancements in patient care, functioning of emergency departments (EDs), and effectiveness of the health system. This study addresses the question: what influence does a TTAS have on a patient's attendance at an ED and the wider health system? Records from 2016 to 2017 of 12,741 calls from a national TTAS were linked to 72,577 ED presentations to a hospital in regional Australia, retrospectively. Matching criteria included patient within the hospital's statistical local area code, age, gender, and ED attendance within 8 hours of TTAS call. Five statistical analyses of the data were conducted. There were 2857 matches. TTAS patients accessing the ED had a slightly higher proportion of women and a greater proportion of children under 4 years than usual. When TTAS confirmed callers' inclination for ED care, however only up to 69% subsequently attended the ED. When TTAS redirected others initially less inclined to more urgent care, up to 62% attended the ED. TTAS empowers vulnerable patients to access appropriate and timely services and promotes clinical and functional integration of care. Improvements of TTAS can come through investigation of callers' compliance factors. K E Y W O R D S appropriate care, care integration, emergency department health system, telephone triage advice service

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The role of patient perception of crowding in the determination of real-time patient satisfaction at Emergency Department

Abstract: While heterogeneity exists in the degree of agreement between objective and patient perceived assessments of ED crowding, in our study we observed that higher degrees of ED crowding at admission might be associated with lower real-time patient satisfaction.

Cited by 33 publications

References 20 publications

Predictors of Delayed Emergency Department Throughput Among Blunt Trauma Patients

Predictors of Delayed Emergency Department Throughput Among Blunt Trauma Patients

Provider interruptions and patient perceptions of care: an observational study in the emergency department

Calling for confirmation, reassurance, and direction: Investigating patient compliance after accessing a telephone triage advice service

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