Journal article
The Impact of an Emergency Department Front-End Redesign on Patient-Reported Satisfaction Survey Results
The western journal of emergency medicine, Vol.18(6), pp.1068-1074
10/2017
DOI: 10.5811/westjem.2017.7.33664
PMCID: PMC5654876
PMID: 29085539
Abstract
For emergency department (ED) patients, delays in care are associated with decreased satisfaction. Our department focused on implementing a front-end vertical patient flow model aimed to decrease delays in care, especially care initiation. The physical space for this new model was termed the Flexible Care Area (FCA). The purpose of this study was to quantify the impact of this intervention on patient satisfaction.
We conducted a retrospective study of patients discharged from our academic ED over a one-year period (7/1/2013-6/30/2014). Of the 34,083 patients discharged during that period, 14,075 were sent a Press-Ganey survey and 2,358 (16.8%) returned the survey. We subsequently compared these survey responses with clinical information available through our electronic health record (EHR). Responses from the Press-Ganey surveys were dichotomized as being "Very Good" (VG, the highest rating) or "Other" (for all other ratings). Data abstracted from the EHR included demographic information (age, gender) and operational information (e.g. - emergency severity index, length of stay, whether care was delivered entirely in the FCA, utilization of labs or radiology testing, or administration of opioid pain medications). We used Fisher's exact test to calculate statistical differences in proportions, while the Mantel-Haenszel method was used to report odds ratios.
Of the returned surveys, 62% rated overall care for the visit as VG. However, fewer patients reported their care as VG if they were seen in FCA (53.4% versus 63.2%, p=0.027). Patients seen in FCA were less likely to have advanced imaging performed (12% versus 23.8%, p=0.001) or labs drawn (24.8% vs. 59.1%, p=0.001). Length of stay (FCA mean 159 ±103.5 minutes versus non-FCA 223 ±117 minutes) and acuity were lower for FCA patients than non-FCA patients (p=0.001). There was no statistically significant difference between patient-reported ratings of physicians or nurses when comparing patients seen in FCA vs. those not seen in FCA.
Patients seen through the FCA reported a lower overall rating of care compared to patients not seen in the FCA. This occurred despite a shorter overall length of stay for these patients, suggesting that other factors have a meaningful impact on patient satisfaction.
Details
- Title: Subtitle
- The Impact of an Emergency Department Front-End Redesign on Patient-Reported Satisfaction Survey Results
- Creators
- Michael D Repplinger - University of Wisconsin, Madison, Department of Radiology, Madison, WisconsinShashank Ravi - University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, WisconsinAndrew W Lee - University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, WisconsinJames E Svenson - University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, WisconsinBrian Sharp - University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, WisconsinMatt Bauer - University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, WisconsinMatthew J Bauer - University of Iowa, Internal MedicineAzita G Hamedani - University of Wisconsin, Madison, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin
- Resource Type
- Journal article
- Publication Details
- The western journal of emergency medicine, Vol.18(6), pp.1068-1074
- DOI
- 10.5811/westjem.2017.7.33664
- PMID
- 29085539
- PMCID
- PMC5654876
- NLM abbreviation
- West J Emerg Med
- ISSN
- 1936-900X
- eISSN
- 1936-9018
- Grant note
- KL2 TR000428 / NCATS NIH HHS UL1 TR000427 / NCATS NIH HHS K08 DK111234 / NIDDK NIH HHS
- Language
- English
- Date published
- 10/2017
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984119798502771
Metrics
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