Twenty Years of Patient Satisfaction Research Applied to the Emergency Department: A Qualitative Review

Intermountain Institute for Healthcare Delivery Research, 36 South State Street, Salt Lake City, UT 84111, USA.
American Journal of Medical Quality (Impact Factor: 1.25). 12/2009; 25(1):64-72. DOI: 10.1177/1062860609352536
Source: PubMed


This clinical review article examines the patient satisfaction literature for the past 20 years. This literature is summarized for qualitative themes and general trends. Intended for the practicing clinician, these themes are then applied to the emergency department (ED) milieu. According to the Agency for Healthcare Research and Quality, the ED is the point of entry for more than half of all patients admitted to the hospital in the United States. Indeed, the ED is the "front door" to the hospital. According to Press Ganey, satisfaction with ED care is at an all-time low. A review of the literature revealed 5 major elements of the ED experience that correlate with patient satisfaction: timeliness of care, empathy, technical competence, information dispensation, and pain management. The literature supporting these 5 elements is summarized and applications to the ED setting are suggested. Other minor correlates with patient satisfaction are also presented.

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    • "Tutkimuksessamme potilaat eivät juuri kuvanneet henkilökunnan ammattitaitoa kliinisiin hoitotoimenpiteisiin liittyvinä teknisinä taitoina, joka taas aiemmissa muihin päivystyspotilaisiin kohdentuneissa tutkimuksissa on tullut vahvasti esille (esim. Welch 2010). Potilaat eivät myöskään tuoneet esille toimenpiteisiin ja tutkimuksiin liittyviä puutteita. "
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    ABSTRACT: Nearly one in three emergency department visits may involve intoxicant use or substance abuse. The quality of care of patients with substance abuse can be improved and possible problems alleviated with a sobering unit in the emergency department. The key task of the unit is to intervene in intoxicant use, motivate patients for follow-up treatment and arrange suitable follow-up treatment. The purpose was to explore the experiences of patients treated in the sobering unit of the emergency department. Data were collected by interviewing patients (n=57) via telephone three months after the care episode. Patients were asked to recount their experiences freely. Data were analysed by inductive content analysis. Patients’ descriptions of the care in the sobering unit were divided into four categories: clinical care procedures, interaction, general treatment and care environment. Care procedures were mainly regarded as good and useful. General discussion, considering patients’ mental state, and bringing up intoxicant use were important for patients and useful in reducing future alcohol use. The study also showed that patients appreciated general treatment that was professional, understanding and not intended to generate guilt. Key words: emergency nursing, substance-related disorders, patient's perspective, quality of care, interview
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    • "Thus, evaluation and management of acute pain is a fundamental element in the ED and acute care medicine. Good pain management is one of the major elements that correlate with patients’ satisfaction in the ED [13]. "
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    ABSTRACT: Parecoxib sodium is the first parenteral COX-2 inhibitor used for pain management licensed for postoperative pain. However, no study has assessed the usage of parecoxib for acute traumatic pain in the emergency department (ED). The objective of this study was to investigate a potential alternative analgesic agent in the ED by determining the mean reduction of pain score between acute traumatic pain patients who were administered with intravenous (IV) parecoxib sodium versus IV morphine sulfate. The onset of perceptible analgesic effect and side effects were also evaluated. A randomized, double-blinded study comparing IV parecoxib 40 mg versus IV morphine at 0.10 mg/kg was conducted in adult patients presented with acute traumatic pain with numeric rating scale (NRS) of 6 or more within 6 hours of injury. Patients were randomized using a computer-generated randomization plan. Drug preparation and dispensing were performed by a pharmacist. Periodic assessment of blood pressure, pulse rate, oxygen saturation, and NRS were taken at 0, 5, 15, and 30 minute intervals after the administration of the study drug. The primary outcome was the reduction of NRS. Side effect and drug evaluation was conducted within 30 minutes of drug administration. There was no statistically significant difference in the reduction of mean NRS between patients in the IV parecoxib group or IV morphine group (P = 0.095). The mean NRS for patients treated with IV morphine were 7.1 at 0 minutes, 4.5 at 5 minutes, 3.1 at 15 minutes, and 2.0 at 30 minutes. Whereas mean NRS for patients who received IV parecoxib were 7.8 at 0 minutes, 5.7 at 5 minutes, 4.7 at 15 minutes, and 3.9 at 30 minutes. The onset of perceptible analgesic effects could be seen as early as 5 minutes. Dizziness was experienced in 42.9% of patients who received IV morphine compared to none in the parecoxib group. There was non-significant trend toward superiority of IV morphine over IV parecoxib. Looking at its effectiveness and the lack of opioid-related side-effects, the usage of IV parecoxib sodium may be extended further to a variety of cases in the ED.
    Full-text · Article · Jan 2014 · International Journal of Emergency Medicine
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    • "There are various reasons why it may be profitable for a hospital to perform surveys on patient satisfaction [3]. Several studies have found that satisfied patients suffer less pain [4, 5]; they require fewer (secondary) operations and more rarely have complications [4, 5]. Moreover, satisfied patients exhibit better compliance [4–6]. "
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    ABSTRACT: Introduction. In this era of high-tech medicine, it is becoming increasingly important to assess patient satisfaction. There are several methods to do so, but these differ greatly in terms of cost, time, and labour and external validity. The aim of this study is to describe and compare the structure and implementation of different methods to assess the satisfaction of patients in an emergency department. Methods. The structure and implementation of the different methods to assess patient satisfaction were evaluated on the basis of a 90-minute standardised interview. Results. We identified a total of six different methods in six different hospitals. The average number of patients assessed was 5012, with a range from 230 (M5) to 20 000 patients (M2). In four methods (M1, M3, M5, and M6), the questionnaire was composed by a specialised external institute. In two methods, the questionnaire was created by the hospital itself (M2, M4).The median response rate was 58.4% (range 9–97.8%). With a reminder, the response rate increased by 60% (M3). Conclusion. The ideal method to assess patient satisfaction in the emergency department setting is to use a patient-based, in-emergency department-based assessment of patient satisfaction, planned and guided by expert personnel.
    Full-text · Article · Jul 2013
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