Abstract
Background: Although the implementation of fast tracks for acute patients aims at improving quality and satisfaction in Emergency Departments (EDs), it is unknown whether patients' expectations are being met. Using an interview concept suitable for assessing acute fast-track patients' satisfaction, the study aimed to assess patient-experienced quality in EDs. Method: A multicentre cross-sectional questionnaire survey including 750 patients from five emergency departments in a region in Denmark. The 18 content items and 18 priority items concerned reception, treatment and involvement, information, and time after discharge. Data were collected in telephone interviews. Results: The response rate for the 750 interviews was 65.4%. Responders' mean age was 57.2 years; 42.7% were men. With more than 90% top ratings, patient satisfaction was highest for feeling welcome, comprehensibility of information, and staff courtesy and respect. Confidence in discharge decision increased with admission length (p=0.02), with women expressing significantly better confidence than men (p<0.0001). Conclusion: Staff conduct and information are key issues in the acute patient pathway. Best evaluations and highest priority are given to feeling welcome, comprehensible information, and courtesy and respect. Confidence at discharge increases with hospitalization length. Telephone interviewing is a reliable and valid method.
Highlights
The implementation of fast tracks for acute patients aims at improving quality and satisfaction in Emergency Departments (EDs), it is unknown whether patients’ expectations are being met
Systematic procedures for examination, diagnosis, treatment and discharge/referral have been implemented to improve the quality of pathways [5], as documented in vision papers and recommendations for Emergency Departments (EDs) [5,6], the expected positive effects of fast tracks for acute patients have yet not materialized [6], possibly because patients’ experiences are not fully described by technical and organizational aspects; important are the circumstances under which tasks are performed
There is ample evidence that patient satisfaction is essential for recovery; personalized care [8] and perceptions of the adequacy [9,10,11] and comprehensibility of the information provided by doctors [10,12] should be prioritized
Summary
The implementation of fast tracks for acute patients aims at improving quality and satisfaction in Emergency Departments (EDs), it is unknown whether patients’ expectations are being met. Systematic procedures for examination, diagnosis, treatment and discharge/referral have been implemented to improve the quality of pathways [5], as documented in vision papers and recommendations for Emergency Departments (EDs) [5,6], the expected positive effects of fast tracks for acute patients have yet not materialized [6], possibly because patients’ experiences are not fully described by technical and organizational aspects; important are the circumstances under which tasks are performed. A reliable assessment of the quality of patient pathways must be based on knowledge of patients’ satisfaction and priorities [13,14,15,16], which offers a way towards improvement in the planning and organization of health care. Treatment compliance tends to improve with satisfaction [17,18]
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