Provision of clinically based information improves patients' perceived length of stay and satisfaction with EP

Abstract

We conducted a focused, prospective, randomized study to evaluate whether periodic personal provision of clinically based information to patients during an Emergency Department (ED) visit improves patients' perceptions of physician's excellence and efficiency of patient care. Six hundred nineteen consecutive adult patients or proxy informants, who were evaluated in the ED and subsequently discharged, were randomized into the standard of care (n = 307) and intervention group (n = 312). Under supervision by ED attending physicians, a single research assistant periodically provided patients with process and medical information at 15-minute intervals, starting at arrival and continuing through until discharged from the ED. At discharge, patients were handed a previously validated questionnaire to fill out and drop off at the ED exit. Outcome measures included actual and patients' estimate of the wait time (WT) and length of stay (LOS), ratings of registration personnel, and ratings of bedside and technical skills of nurses and Emergency Physicians (EPs), by using a 5-point Likert scale (5 = excellent, 4 = very good, 3 = good, 2 = fair, 1 = poor). There were no statistically significant differences in age, sex, insurance data, intensity of service, actual WT, actual LOS, and patients' perceived WT to see a physician between the 2 groups. The perceived LOS was, however, significantly shorter (92.6 vs. 105.5 min, P =.027) and the proportion of patients who rated the Emergency Staff Physician as “excellent” or “very good” was significantly higher in the intervention group (Bedside: 87.1% vs. 80.5%, P =.033; Technical skill: 86.8% vs. 80.1%, P =.032). Patients' perception of nursing skills were, however, statistically similar in the 2 groups (Bedside: 83.1% vs. 83.0%, P =.942; Technical skill: 84.5% vs. 82.7%, P =.613). Given the sample size and observed proportions, the χ2 analysis of perception of nursing skill had a power of 4.8% (registered nurse [RN] bedside) and 7.5% (RN technical skill). Periodic personal interaction and provision of clinically based information in the ED is thought to improve patients' perceived LOS, efficiency, and clinical skills of EP after an ED visit. (Am J Emerg Med 2002;20:506-509. Copyright 2002, Elsevier Science (USA). All rights reserved.)