Emergency Department Overcrowding Lowers Patient Satisfaction Scores

Details

• Personal Author:
  Harland KK ; Junker C ; King DM ; Nugent AS ; Vakkalanka JP
• Description:
  Crowding in emergency departments (EDs) is a concern for hospital administrators, emergency providers, and patients. Many factors contribute to crowding, including variable patient volume and acuity along with contributing hospital factors such as inadequate nursing support and insufficient inpatient beds resulting in prolonged ED boarding times. To better study and define characteristics indicative of crowding, the National Emergency Department Overcrowding Study (NEDOCS) established a standardized and validated scoring system to quantify crowding in an academic setting. Although individual components attributed to crowding and patient satisfaction have been studied, including studies utilizing the NEDOCS score in relation to patient satisfaction, none to our knowledge have investigated the Press Ganey Associates, Inc. (PGA) surveys and NEDOCS scores. The use of patient satisfaction scores for evaluating physician performance and subsequent reimbursement is common. Determining the impact of variables beyond the ED physicians control such as inpatient boarding and severe ED crowding is extremely important as these factors may have negative impacts on perceived quality of care and incentive programs. This study examines the association of the NEDOCS score with PGA patient satisfaction survey scores. We conducted a cross-sectional study of adult patients (>/=18 years) treated in a 60,000-visit Midwestern, academic, tertiary referral ED between January 1, 2017, and October 31, 2018. Patients who were discharged home from the ED were mailed a self-administered PGA ED satisfaction survey by two-stage mail, via e-mail and postal mail. Patient-level administrative data were linked deterministically to patient satisfaction scores. This study was deemed not human subjects research by the institutional review board. ... In conclusion, ED crowding primarily decreases system-level satisfaction scores and affects not only patients who are admitted and boarding but also discharged patients. Therefore, hospital administrators interested in improving PGA patient satisfaction scores should focus on improving ED throughput and reducing inpatient boarding. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Health Care Facilities Workforce And Services Hospitals Occupational Health Safety Surveys And Questionnaires Workplace
• Keywords:
  Administration Emergency Care Health Care Facilities Health Standards Health Surveys Hospital Equipment Medical Facilities Overloading Patient Handling Quantitative Analysis Questionnaires Standards Work Environment Work Operations

  More +
• ISSN:
  1553-2712
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Iowa ; OSHA Region 7
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  363-366
• Volume:
  28
• Issue:
  3
• NIOSHTIC Number:
  nn:20062516
• Citation:
  Acad Emerg Med 2021 Mar; 28(3):363-366
• Contact Point Address:
  Dana M. King, MD, Department of Emergency Medicine, University of Iowa College of Medicine, Iowa City, IA
• Email:
  dana-king@uiowa.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  University of Iowa
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Academic Emergency Medicine
• End Date:
  20290630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e8c1fc46e7c762cc5287c6e0e02f250f7894b80a6175968e82c9f6618bf4d8e46ff19379a80a71af2e8c746fbf1fbb16960dfa4ef7f7b5211b769fdff4012e2f
• Download URL:
  https://stacks.cdc.gov/view/cdc/225751/cdc_225751_DS1.pdf
• File Type:
  [PDF - 82.29 KB ]