Abstract

IntroductionPatient satisfaction is a commonly assessed dimension of emergency department (ED) care quality. The ability of ED clinicians to estimate patient satisfaction is unknown. We sought to evaluate the ability of emergency medicine resident physicians and nurses to predict patient-reported satisfaction with physician and nursing care, pain levels, and understanding of discharge instructions.MethodsWe studied a convenience sample of 100 patients treated at an urban academic ED. Patients rated satisfaction with nursing care, physician care, pain level at time of disposition and understanding of discharge instructions. Resident physicians and nurses estimated responses for each patient. We compared patient, physician and nursing responses using Cohen’s kappa, weighting the estimates to account for the ordinal responses.ResultsOverall, patients had a high degree of satisfaction with care provided by the nurses and physicians, although this was underestimated by providers. There was poor agreement between physician estimation of patient satisfaction (weighted κ=0.23, standard error: 0.078) and nursing estimates of patient satisfaction (weighted κ=0.11, standard error: 0.043); physician estimation of patient pain (weighted κ=0.43, standard error: 0.082) and nursing estimates (weighted κ=0.39, standard error: 0.081); physician estimates of patient comprehension of discharge instruction (weighted κ=0.19, standard error: 0.082) and nursing estimates (weighted κ=0.13, standard error: 0.078). Providers underestimated pain and patient comprehension of discharge instructions.ConclusionED providers were not able to predict patient satisfaction with nurse or physician care, pain level, or understanding of discharge instructions.

Highlights

  • Patient satisfaction is a commonly assessed dimension of emergency department (ED) care quality

  • We sought to evaluate the ability of emergency medicine resident physicians and nurses to predict patient-reported satisfaction with physician and nursing care, pain levels, and understanding of discharge instructions

  • Overall, patients had a high degree of satisfaction with care provided by the nurses and physicians, this was underestimated by providers

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Summary

Introduction

Patient satisfaction is a commonly assessed dimension of emergency department (ED) care quality. The ability of ED clinicians to estimate patient satisfaction is unknown. We sought to evaluate the ability of emergency medicine resident physicians and nurses to predict patient-reported satisfaction with physician and nursing care, pain levels, and understanding of discharge instructions. Patient satisfaction is an increasingly important metric that is being measured in emergency departments (ED) across the country. Previous studies have associated high levels of patient satisfaction with improved outcomes.[1] In terms of outcomes for providers, high satisfaction scores have been associated with a lower rate of patient complaints and possibly a lower rate of malpractice claims.[2,3] In addition, patient satisfaction scores are commonly tied to physician compensation. A recent study reported that 59% of physicians reported that their compensation was tied to their satisfaction scores in what is essentially a pay-for-performance model. 20% of providers reported that their employment had been threatened as a result of patient satisfaction data.[4]

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