185 Everyone Loves a Popsicle: A Simple and Affordable Intervention to Improve Patient Satisfaction

Abstract

Value-based purchasing (VBP) is a quality incentive program under the Affordable Care Act that is funded by a 2% reduction from diagnosis-related group (DRG) payments for the 2018 fiscal year. One-quarter of this fund is determined by patient and caregiver-centered experience and care coordination. Therefore, patient satisfaction scores have become an increasingly important component of health care delivery. Few studies have sought to identify low-cost interventions that improve patient experience and subsequently patient satisfaction scores. Here, we aim to explore the impact of popsicle administration in pediatric emergency department (ED) patients on Press Ganey satisfaction scores. A prospective trial was conducted at a tertiary academic pediatric ED and one mid-sized community ED between January 2018 to March 2018. The intervention was to give a popsicle to all eligible patients 0-14 years of age on even-numbered days (popsicle days) versus conventional practice on odd-numbered days. Press Ganey top box scores (response to the question was a “5” or the highest value) between even- and odd-numbered days were then compared using 2-sample t and chi-square tests. Among the 152 pediatric patients included (0-14 years of age), 84 surveys were filled out on even days and 68 surveys were filled out on odd days. Baseline demographics were similar between the groups with an average age of 7.3 ± 6.0 years and no statistical difference between the number of male and female patients. Overall, there was a significant increase in patient satisfaction scores on popsicle administration days for questions that asked about physician’s concern for comfort 74% versus 58% (p < 0.05), physician’s courtesy 77% versus 62% (p < 0.04), and physician taking time to listen 74% versus 57% (p < 0.03). No statistical difference was observed for questions that asked about overall rating of care 64% versus 61% (p= 0.64), likelihood of recommending 66 versus 59% (p=0.37), or informed of treatment 74% versus 60% (p=0.07). Offering popsicles to all eligible pediatric emergency department patients resulted in an increase in Press Ganey patient satisfaction score regarding physician’s concern for comfort, courtesy, and listening. Further studies should increase sample size, assess subsets of age groups, and assess economic rate of return for this and other low-cost interventions that might significantly impact perceived health care quality.