What do patients say about emergency departments in online reviews? A qualitative study

Abstract

BackgroundPatients have adopted web-based tools to report on the quality of their healthcare experiences. We seek to examine online reviews for US emergency departments (EDs) posted on Yelp, a popular consumer ratings website.MethodsWe conducted a qualitative analysis of unstructured, publicly accessible reviews for hospitals available onhttp://www.yelp.com. We collected all reviews describing experiences of ED care for a stratified random sample of 100 US hospitals. We analysed the content of the reviews using themes derived from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) inpatient care survey. We also used modified grounded theory to iteratively code the text of the reviews, identifying additional themes specific to emergency care. The data were double-coded, and discrepancies were evaluated to ensure consensus.ResultsOf the 1736 total reviews, 573 (33%) described patient experiences involving the ED. The reviews contained several themes assessed by the HCAHPS survey, including communication with nurses, communication with doctors, and pain control. The reviews also contained key themes specific to emergency care: waiting and efficiency; decisions to seek care in the ED; and events following discharge, including administrative difficulties.ConclusionsThese exploratory findings suggest that online reviews for EDs contain similar themes to survey-based assessments of inpatient hospital care as well as themes specific to emergency care. Consumer rating websites allow patients to provide rapid and public feedback on their experience of medical care. Web-based platforms may offer a novel strategy for assessing patient-centred quality in emergency care.

Online emergency department ratings, patient satisfaction and the age-old issue of communication

“…Kilaru et al 1 report a well-designed and well-executed, retrospective, qualitative study, which suggests that one-third of online (Yelp-sourced) patients’ hospital reviews address care in emergency departments (EDs). Using strong qualitative methods, the authors describe the themes emerging from Yelp users’ free-text ED reviews.…”

Social media and healthcare quality improvement: a nascent field

“…Twitter has previously been shown to provide real-time monitoring of conditions such as viral and foodborne illness,5 mental illness6 and substance use 7 8. The study by Hawkins et al ,2 showing a correlation between patient sentiment and readmission rates, has findings that are similar to Kilaru et al 's9 recent article in this journal that analysed Yelp reviews. While these methods provide insight into a variety of patient characteristics and behaviours, they are nonetheless limited and subject to misinterpretation.…”

Commentary on “Physician-Rating Web Sites: Ethical Implications”

“…9e11 Interestingly, some work also shows similarities between the issues mentioned in Yelp reviews and the domains on the Hospital Consumer Assessment of Healthcare Providers and Systems survey. 12 We know from our own experience that there is an important need for the patient's understanding and engagement in care, but is that more so than with other specialties?…”