scholarly journals P140: Investigating volunteer perspectives on leading patient-centred practices in the emergency department

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S114-S115
Author(s):  
L. Witt ◽  
T. Oyedokun ◽  
D. Goodridge ◽  
J. Stempien ◽  
T. Graham

Introduction: Patient satisfaction is an essential component of effective delivery of quality care in the emergency department (ED). Frequent reflection on current practices is required to detect areas in need of improvement. The Ontario Hospital Association (OHA) outlined five ‘Leading Practices’ (LPs) targeted to increase patient satisfaction in this setting. The ED volunteers are a group of individuals who have unique perspectives on ED practices that are unbiased by confounders affecting patients and staff. The goal of this study was to explore the unique perspectives of ED volunteers involving what they believe will improve the delivery of patient-centered care, as well as to examine to what extent Saskatoon EDs are embracing the principles outlined in the OHA LPs. Methods: A two-phase mixed methods approach, with a survey followed by interviews that allowed participants to expand on survey findings was used. The pool of 45 ED volunteers was extended the opportunity to participate resulting in 36 survey responses and 6 interviews. The 13 Likert-grade survey questions were generated to align to each of the LPs and allowed room for qualitative feedback. Interview questions were generated following 15 survey responses to expand on the LPs that were rated below average. Results: Analysis of responses identified inefficient ED processes leading to increased waiting times, inefficient patient location, inadequate signage, a lack of physical space, unclean environments, and a lack of staff and volunteer awareness regarding spiritual care and interpreter services, perceptions of received care by patients due to long wait times and level of cultural safety training of ED staff. Themes reduced from interviews yielded common themes such as patient frustration, disorganization, uncomfortable environment, overcrowding, prolonged wait times, and patient misconception of ED processes at Site 1. Themes common to Site 2 included organization, patient-friendly environment, patient misconception of ED processes, and prolonged wait times. Additionally, the volunteers suggested a plethora of interventions that could improve the current processes in Saskatoon's EDs to make them more patient friendly. Conclusion: Saskatoon EDs comply reasonably well to the OHA Leading practices. Surveying ED volunteers provides important insight into current practices and areas for improvement, and should be considered at other sites to improve adherence to the OHA LPs.

2005 ◽  
Vol 48 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Cuma Yildirim ◽  
Hasan Koçoğlu ◽  
Sıtkı Göksu ◽  
Nurullah Gunay ◽  
Haluk Savas

Objective: Patient satisfaction, an indicator of the quality of care provided by emergency department (ED) personnel, is a significant issue for EDs. The purpose of this study was to identify factors associated with patient satisfaction and dissatisfaction, and to describe demographic characteristics of those surveyed in a university hospital ED. Methods: All adult patients who consecutively presented to the ED between 8:00 a.m. and 5:00 p.m. on weekdays were included in the study. Patients were asked to complete a questionnaire prior to discharge. The questionnaire asked about the attitude, politeness, and efficiency of the medical and ancillary staff, the reason for preferring our centre and reasons for dissatisfaction. Results: Two-hundred and forty-five adult patients presenting to our ED were included in this study. Forty-five percent of patients preferred our ED because of the previous perception of higher quality of care, informed by other people previously treated in this ED unit, and 35% because of restrictions by their health insurance carrier. The main causes of patient dissatisfaction were lengthy waiting times (27%). Conclusion: As a result, lengthy waiting time was the major reason for patient dissatisfaction, and high quality care together with insurance restrictions were the main reasons for preference of this university hospital ED.


2021 ◽  
Vol 8 ◽  
pp. 237437352199698
Author(s):  
Sophia Aguirre ◽  
Kristen M Jogerst ◽  
Zachary Ginsberg ◽  
Sandeep Voleti ◽  
Puneet Bhullar ◽  
...  

Emergency physician empathy and communication is increasingly important and influences patient satisfaction. This study investigated if there is a need for improvement in provider empathy and communication in our emergency department and what areas could be targeted for future improvement. Patients cared for by emergency physicians with the lowest satisfaction scores were surveyed within 1 week of discharge. Patients rated their emergency provider’s empathy and communication and provided feedback on the patient–provider interaction. Compared to survey responses nationally, our providers fell between the 10th and 25th percentiles for all questions, except question 5 (making a plan of action with [the patient]) which was between the 5th and 10th percentile. Areas most frequently cited for improvement were “wanting to know why” (N = 30), “time is short” (N = 15), and “listen to the patient” (N = 13). Survey percentiles and open-ended suggestions demonstrate a need for providers to give thorough explanations, spend more time with the patient, and demonstrate active listening. These themes can be used to strengthen the provider–patient relationship.


2008 ◽  
Vol 21 (2) ◽  
pp. 120-130 ◽  
Author(s):  
Joseph S. Guarisco ◽  
Stefoni A. Bavin

PurposeThe purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.Design/methodology/approachThe case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.FindingsThe findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.Practical implicationsThese findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.Originality/valueThere are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.


2020 ◽  
pp. 102490792093170
Author(s):  
Ng Hing Yin ◽  
Fan Kin Ping ◽  
Lo Chor Man

Background: In a busy local emergency department, patients with certain non-life-threatening conditions which only require relatively quick and straightforward management may encounter long waiting times. A new service model called the “Fast Track” Nursing Service attempts to lessen the service load of the regular service queues and to improve patient outcomes. Objectives: This article reports the service outcomes of the Fast Track Nursing Service. Methods: Nurses at our department are selected and trained under clinical protocols specially developed for this service. Assessments and quality assurance audits ensure the quality of service. Results: This service resulted in comparatively shorter waiting times for patients included in predetermined clinical protocols. There was also a high level of patient satisfaction with this service. Conclusion: Our Fast Track Enhanced Nursing service is a model of tailored service diversification to shorten waiting times, thus improving patient satisfaction and outcome.


2013 ◽  
Vol 62 (4) ◽  
pp. S82 ◽  
Author(s):  
K. Saxon ◽  
K. London ◽  
A. Bacharouch ◽  
K. Smith ◽  
S. Santen ◽  
...  

2019 ◽  
Vol 129 (3) ◽  
pp. 238-244 ◽  
Author(s):  
Katherine R. Keefe ◽  
Jessica R. Levi ◽  
Christopher D. Brook

Objectives: Evidence shows that scribes can improve provider efficiency and satisfaction in several settings, but is mixed on whether scribes improve patient satisfaction. We studied whether scribes improved patient satisfaction in an academic otolaryngology clinic. Methods: The authors performed a retrospective review of patient responses to the Press Ganey survey between 12/2016 and 12/2017. Their responses about satisfaction with the provider and wait times were examined. Three providers worked with scribes during this year; each spent six months with a scribe and six without. The authors compared survey responses from periods with and without scribes using the Fischer exact test. Average overall provider ratings were compared using the Student’s t-test. Results: A total of 87 patients filled out Press Ganey surveys for the 3 providers over the year: 54 for visits without scribes, and 33 for visits with scribes. Fischer exact analysis demonstrated no significant difference in satisfaction with providers and wait times for both individual providers and all providers combined (all P > .05). There was also no difference in patients’ likelihood of recommending the provider’s office ( P = .91). Overall provider rating (0-10 scale) was high without scribes (9.48 ± 1.06) and was unchanged by the presence of scribes (9.53 ± 0.8) ( P = .97). Conclusion: Patient satisfaction with wait times and providers was high overall and was not affected by the presence of a medical scribe.


2021 ◽  
Author(s):  
Diana Manuela Roccaro-Waldmeyer ◽  
Philippe Schucht ◽  
Winfried Post ◽  
Michael Dahlweid

BACKGROUND Telehealth services can contribute to fulfilling the long-standing promise of patient-centered care, by delivering high-quality care at a location convenient to patients or by increasing patient access to healthcare-related information. In German-speaking countries, telehealth consultations were not particularly widespread before the outbreak of the Covid-19 pandemic. OBJECTIVE We aimed at investigating the experience of patients in German-speaking countries with telehealth consultations, especially with respect to patient satisfaction (expressed as their willingness to have another telehealth consultation, main study outcome) and aspects related to patient empowerment. We hypothesized particularly video consultations to increase patient satisfaction and empowerment related aspects. METHODS A standardized online questionnaire composed of seven quickly answerable questions was used to conduct an online survey in line with published recommendations. To estimate the proportion of patients willing to have another telehealth consultation, the necessary minimum sample size to be studied was determined to be 384 (confidence: 95%; error: 5%; population proportion: 50%, definitive sample size: 411). RESULTS We reached a total of 28,814 followers via social media to obtain more than 5,735 clicks and views, resulting in 411 complete survey responses. 93% of the respondents having had video consultations, but only 32% of those having had phone consultations (66% of all 411) indicated that they would want to have another telehealth consultation again. By far the most important predictor of this main outcome was, whether patients understood the conversation with their healthcare provider. CONCLUSIONS Our results demonstrate a high acceptance of telehealth consultations by patients in German-speaking countries and emphasize the importance of patients to thoroughly comprehend the communication with their healthcare provider, a prerequisite for patient empowerment. They further provide evidence for video consultations to lead to higher patient satisfaction (reflected by a higher willingness to have another telehealth consultation), and to a higher degree of patient empowerment, than phone consultations.


CJEM ◽  
2007 ◽  
Vol 9 (04) ◽  
pp. 286-295 ◽  
Author(s):  
Alix J.E. Carter ◽  
Alecs H. Chochinov

ABSTRACT Introduction: US emergency personnel cared for 106% more patients in 1990 than they did in 1980, and national emergency department census data show that 60%–80% of those patients presented with non-urgent or minor medical problems. The hiring of nurse practitioners (NPs) is one proposed solution to the ongoing overcrowding and physician shortage facing emergency departments (EDs). Methods: We conducted a systematic review of MEDLINE and Cinahl to find articles that discussed NPs in the ED setting, looking specifically at 4 key outcome measures: wait times, patient satisfaction, quality of care and cost effectiveness. Results: Although some questions remain, a review of the literature suggests that NPs can reduce wait times for the ED, lead to high patient satisfaction and provide a quality of care equal to that of a mid-grade resident. Cost, when compared with resident physicians, is higher; however, data comparing to the hiring additional medical professionals is lacking. Conclusion: The medical community should further explore the use of NPs, particularly in fast track areas for high volume departments. In rural areas, NPs could supplement overextended physicians and allow health centres to remain open when they might otherwise have to close. These strategies could improve access to care and patient satisfaction for selected urban and rural populations as well as make the best use of limited medical resources.


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