Patient satisfaction in emergency departments

Patient Satisfaction in Emergency Departments and Wait Times This proposal is designed to answer the question of whether patients’ overall satisfaction with emergency room visits can be improved by reducing the time necessary to see a doctor or other emergency room practitioner. Socio-anecdotal accounts would appear to indicate the presence of this connection; field research will confirm or deny that proposition. The important factor of this study will be the applicability of information across a variety of emergency room locations.

This would eliminate some form of geographical or demographical effect that would disturb the research data returned. There is obviously a limitation upon the gamut of that aspect, but a thorough approach will yield the most accurate data and applicability. Research and the Body of Knowledge Research regarding the connection between decreased waiting time and increased satisfaction in an emergency department setting is vital to understanding the direction the medical field should go. A knowledge gap exists within current studies.

Similar reviews of waiting time do not go far enough in their efforts to focus specifically on the waiting time information. As a result the data is contaminated with that of many other variables and factors of emergency department visits. Many studies answer the general question of what factors influence patient satisfaction, but a convincing study has not been prepared to isolate this one variable. This study which focuses on both qualitative and quantitative reports will provide a depth of information about causality that does not exist in literature at this moment.

Additionally, through a use of a wide variety of sources and studies, both traditional and nontraditional in their focus, the information collected and data presented should imply further directions for new research. Literature Review A study by Boudreaux, E. D. , Friedman, J. , Chansky, M. E. , & Baumann, B. M. (2004), entitled Emergency Department Patient Satisfaction: Examining the Role of Acuity sought to describe the connection between acuity of emergent conditions and the satisfaction of patients in the emergency setting.

Also studied as correlational were the effects of the waiting time as related to acuity and resultant satisfaction. What was found was that the perceived waiting time of patients – which was notoriously unreliable – was more important than any other factor in the study as far as resultant patient satisfaction with the visit. This is a worthwhile study due to its indication of the reliability of perceived waiting time for patients, which will play a big part in both understanding the returned data and using the research for real world applications.

Waseem, Muhammad MD, Ravi, Lalitha MD, Radeos, Michael MD, & Ganti, Sandhya MD (2003) in their study Parental Perception of Waiting Time and its Influence on Parental Satisfaction in an Urban Pediatric Emergency Department: Are Parents Accurate in Determining Waiting Time? Also discovered a correlation between waiting time and satisfaction. However, this too came in the form of waiting time as a perception instead of a reported reality. 84% of patients’ parents perceived that their wait was much longer than the real time spent.

Any time period of over 2 hours, real or perceived, significantly impacted satisfaction negatively. This study is again valuable in discussing waiting time as both perceived and actual. This will support the recommendations that may call for fixing the perception more than the reality. The limitations of this study, however, are that the parents of patients who are young are the respondents. These respondents potentially are prejudiced by a perception of waiting longer when they are not the actual patient, and the perception of having to take care of the ill/injured child for a long period of time while waiting.

These cohort effects must be eliminated or reduced to make the study of more value. The study Effects of Actual Waiting Time, Perceived Waiting Time, Information Delivery, and Expressive Quality on Patient Satisfaction in the Emergency Department by David A Thompson, MD, Paul R Yarnold, PhD, Diana R Williams, MD, & Stephen L Adams, MD (1996) described the differences between actual and waiting times in emergency departments and their effects on patient satisfaction. The study found that actual waiting times were not predictive of satisfaction.

Perceived times were much more predictive. These perceived times were linked causally to the quality of staff expressions to the patients, along with the treatment received and the information clearly presented. This is an intriguing review for inclusion. Not only does it describe the differences between waiting as the other studies did, but it concluded that the actual waiting time was not predictive at all. In concluding that the perception was more vital than the reality, real-world considerations can be made.

In addition the study while not directly related to this research paper offers further options to raise satisfaction. Eun Jung Kim’s study Nurse-Patient Interaction Patterns and Patient Satisfaction in the Emergency Department (2010) described the reasons for overall patient satisfaction in emergency departments. The aim of the study was to remain objective and not over predict variables. The result of the study was that the ‘type’ or ‘style’ of the nursing care received far outweighed any other factor when it came to patient satisfaction.

The style the study called ‘facilitative’ which is characterized by a balance of presenting psychosocial and biomedical topics was the highest return of patient satisfaction. Studies of this sort are important to answering the research problem posed by this paper. In addition to focusing on patient satisfaction through or against waiting time, other factors behind satisfaction should be reviewed. It may be found that waiting time has no predictive satisfaction at all. Perhaps it is true that other things are much more important to patient satisfaction.

In that case the ramifications of the study would vast different but no less important. If the goal is to identify ways in which patient satisfaction could be increased then it is necessary to review tangentially related research as well. The 2010 research study Patient satisfaction in an acute medicine department in Morocco (Soufi, Belayachi, Himmich, Ahid, Soufi, Zekraoui, & Redouane) found that patient satisfaction relative to acute care department visits depended more upon number of stays, prior health status, and facilities at the department such as double occupancy rooms to be much more determinant than other factors.

As in Kim’s study (Ibid) this is a related study not directly focused on waiting time and patient satisfaction. This study and its data are vital to maintaining objectivity and broad scientific thought when approaching the position of this paper. Focusing directly on waiting time and satisfaction is key, but determining if other variables are strongly affecting the results is just as vital. That being said, too many of these commentaries will potentially water down the data collected and result in a mixed or contrary answer to the research problem.

Therefore the number of these studies is being limited and used as secondary research. Studies directly relating to the wait times will retain primary importance. Edwin D. Boudreaux, PhD, & Erin L. O’Hea, PhD (2004) found in their review Patient satisfaction in the Emergency Department: a review of the literature and implications for practice that perceived waiting times are the most telling factor to express patient satisfaction. Furthermore they related that interventions that are designed to reduce actual waiting times have not been studied sufficiently enough to warrant a final decision.

However the results from several well-designed studies suggest that such a strategy is unlikely to have as great an impact as those targeting perceived waiting times. The Annals of Emergency Medicine (Sun, Adams, Orav, Rucker, Brennan, ; Burstin, 2000) reported that the overall wait time of patients was not the primary factor behind patient satisfaction in emergency departments. Instead the information presented to the patients regarding cause of illness, planned treatment or a timetable for return to normal activity were much more expressive of satisfaction.

This work is an ideal source to back up or disprove the research question of this paper. It covers a range of informative variables related to patient satisfaction but focuses especially on waiting times. It makes a conclusive statement regarding the importance and level of causality of waiting times relative to patient satisfaction. Its value though lays chiefly in its implications. For a study to have value as this paper seeks there must be an implication to its success. Even studies that disprove their own hypothesis through its findings can use those data to create new areas and avenues of study in the future.

This gives the research new life and adds vitality to the field. Concluding Remarks The studies and literature reviewed thus far support the hypothesis regarding the knowledge gap described above. Many researchers have undertaken efforts to explore several variables that may be connected to satisfaction of patients in the emergency room setting, but none have specifically isolated the waiting time variable. This makes the issue unclear. Further research is necessary to contribute to the understanding of this topic in the medical field.

This paper’s study will fill in the gap and bridge the factual data that has thus far been collected. References Boudreaux, E. D. , Friedman, J. , Chansky, M. E. and Baumann, B. M. (2004). Emergency Department Patient Satisfaction: Examining the Role of Acuity [Electronic version]. Academic Emergency Medicine, 11: 162–168. Edwin, D. , ; Ohea, L. (2004). Patient satisfaction in the Emergency Department: a review of the literature and implications for practice. Journal of Emergency Medicine, 26: 13- 26. Kim, E. (2010).

Nurse-Patient Interaction Patterns and Patient Satisfaction in the Emergency Department. Journal of Korean Academic Nursing, 40: 99-109. Soufi, G. , Belayachi, J. , Himmrich, S. , Ahid, S. , Soufi, M. , Zekraoui, A. , ; Abouqall, R. (2010). Patient Satisfaction in an Acute Medicine Department in Morocco. BMC Health Serv Res, 10:149. Sun, B. , Adams, J. , Orav, E. , Rucker, D. , Brennan, T. , ; Burstin, H. (2000). Determinants of Patient Satisfaction and Willingness to Return With Emergency Care. The Annals of Emergency Medicine, 35: 426-434.

Thompson, D. , Yarnold, P. , Williams, D. , ; Adams, S. (1996). Effects of Actual Waiting Time, Perceived Waiting Time, Information Delivery, and Expressive Quality on Patient Satisfaction in the Emergency Department. Annals of Emergency Medicine, 28: 657-665. Waseem, M. , Ravi, L. , Radeos, M. , ; Ganti, S. (2003). Parental Perception of Waiting Time and its Influence on Parental Satisfaction in an Urban Pediatric Emergency Department: Are Parents Accurate in Determining Waiting Time? Southern Medical Journal, 96: 880-883

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