12 Development of a Real-Time Patient Satisfaction Survey for Emergency Departments

Abstract

Conventional patient satisfaction surveying techniques are limited by poor response rates, patient memory decay, selection bias, delay to results, poor specificity to the emergency department (ED), and by arriving along with the hospital bill. Due to the increasing importance of patient satisfaction on health care quality improvement, we sought to overcome the problems of current survey methods by implementing a real-time patient satisfaction survey. We also wanted to observe whether real-time patient feedback would net actionable information before patients leave the ED. Our study was administered at several large, private metropolitan area hospitals by employed survey personnel at random dates and times. After disposition was determined, a 9-question survey was conducted via iPad® and results were uploaded to an online database. Surveys were offered to all patients, admitted or discharged, fast-track or acute care, Spanish or English. After an initial small scale beta test, we expanded to a total of 6 area hospitals and collected data from 11/2010 until 3/2011. 5611 surveys were possible, and we surveyed 5217 patients (5128 English, 89 Spanish), representing a 93.0% response rate. Patient refusal or altered consciousness accounted for those not surveyed. We demonstrated that our survey method is not only practical on a large scale, but can generate actionable data. Our database can be queried to evaluate different parameters, such as satisfaction comparison between providers, hospitals, or patient groups and evaluating how effectively we treat pain. Our surveys can be easily customized in order to answer unique questions specific to new policies or procedures. 96.5% (95% CI=94.3-98.6) of patients said that they would return to the same ED, and explanations were given by those who would not. 97.3% (95.1-99.3) said that everything was properly explained to them. 69.2% (67.7-70.3) said that their overall visit was better than expected, 27.5% (25.9-28.3) felt that their visit was as expected, and 3.2% (2.7-3.7) felt that their visit was worse than expected. 5.3% (4.6-5.9) of patients had concerns about their care, and 94% of these detailed their dissatisfaction. The weighted average of satisfied patients (as expected or better) at all hospitals was 96.7% (96.5-97.5), and 69.7% (68.8-71.3) were more satisfied than expected. In some instances, we found that certain providers were inadequately treating pain, or that some patients waited too long for their test results. Patient satisfaction was similar between patients regardless of whether they were triaged to fast track or acute care settings. Providers were alerted to patient questions or concerns in time to remedy relevant issues. Implementing our real-time patient satisfaction survey is economically feasible, more informative, and significantly more expedient than previous methodology. The instantaneous availability of results was particularly important, allowing providers and staff opportunities to intervene and mitigate problems quickly and efficiently. This new method for immediate intervention has far-reaching implications for patient care, service recovery, and risk management.