Building an ethical environment improves patient privacy and satisfaction in the crowded emergency department: a quasi-experimental study

Yen-Ko Lin,Tsung-Ying Lin,Yuan-Chia Cheng,Liang-Chi Kuo,Hsing-Lin Lin,Chao-Wen Chen,Wei-Che Lee,Chia-Ju Lin

doi:10.1186/1472-6939-14-8

Abstract

BackgroundTo evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting.MethodsA pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression.ResultsStructured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of “personal information overheard by others”, being “seen by irrelevant persons”, having “unintentionally heard inappropriate conversations from healthcare providers”, and experiencing “providers’ respect for my privacy”. There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis.ConclusionsSignificant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction.

Highlights

To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded Emergency departments (EDs) setting
Secondary measures concerned patient privacy and confidentiality, including “personal information overheard by others”, being “seen by irrelevant persons”, having “unintentionally heard inappropriate conversations from healthcare providers”, and experiencing “providers’ respect for my privacy” measured on an ordinal 5-point Likert scale
Our results confirmed significant improvements in patient perceptions of “personal information overheard by others”, being “seen by irrelevant persons”, having “unintentionally heard inappropriate conversations from healthcare providers”, and experiencing “providers’ respect for my privacy”

Summary

Introduction

To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Respect for patient privacy and assuring patient confidentiality have been regarded as essential obligations of healthcare providers and primary responsibilities of healthcare institutions [1,2,3]. Emergency departments (EDs) in hospitals, unlike other units, do not have private and semiprivate rooms to help protect privacy and confidentiality. The ED physical and environmental limitations and high volume of patients have made the protection of patient privacy and confidentiality even more difficult. When the ED becomes crowded, patients have to be placed in or near hallways, greatly exacerbating the challenges of protecting privacy and ensuring confidentiality [5,8,9]. It is the top priority for patientcentered health care to build a renovated ED with respect for ED patient privacy and confidentiality

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