What Are We Measuring? Evaluating Physician-Specific Satisfaction Scores Between Emergency Departments.

Brian Sharp,Brian Patterson,Azita Hamedani,Emilia Hakes,Jordan Johnson

doi:10.5811/westjem.2019.4.41040

Brian Sharp, Brian Patterson + Show 3 more

Open Access

https://doi.org/10.5811/westjem.2019.4.41040

Copy DOI

Abstract

IntroductionMost emergency departments (ED) use patient experience surveys (i.e., Press Ganey) that include specific physician assessment fields. Our ED group currently staffs two EDs – one at a large, tertiary-care hospital, and the other at a small, affiliated, community site. Both are staffed by the same physicians. The goals of this study were to determine whether Press Ganey ED satisfaction scores for emergency physicians working at two different sites were consistent between sites, and to identify factors contributing to any variation.MethodsWe conducted a retrospective study of patients seen at either ED between September 2015 and March 2016 who returned a Press Ganey satisfaction survey. We compiled a database linking the patient visit with his or her responses on a 1–5 scale to questions that included “overall rating of emergency room care” and five physician-specific questions. Operational metrics including time to room, time to physician, overall length of stay, labs received, prescriptions received, demographic data, and the attending physician were also linked. We averaged scores for physicians staffing both EDs and compared them between sites using t-tests. Multiple logistic regression was used to determine the impact of visit-specific metrics on survey scores.ResultsA total of 1,012 ED patients met the inclusion criteria (site 1=457; site 2=555). The overall rating-of-care metric was significantly lower at the tertiary-care hospital ED compared to our lower volume ED (4.30 vs 4.65). The same trend was observed when the five doctor-specific metrics were summed (22.06 vs 23.32). Factors that correlated with higher scores included arrival-to-first-attending time (p=0.013) and arrival-to-ED-departure time (p=0.038), both of which were longer at the tertiary-care hospital ED.ConclusionPress Ganey satisfaction scores for the same group of emergency physicians varied significantly between sites. This suggests that these scores are more dependent on site-specific factors, such as wait times, than a true representation of the quality of care provided by the physician.

Highlights

Most emergency departments (ED) use patient experience surveys (i.e., Press Ganey) that include specific physician assessment fields
Press Ganey satisfaction scores for the same group of emergency physicians varied significantly between sites. This suggests that these scores are more dependent on site-specific factors, such as wait times, than a true representation of the quality of care provided by the physician. [West J Emerg Med. 2019;20(3)454-459.]
We used patient responses to physician-specific questions. These questions included the following: overall rating of care; courtesy of the doctors who cared for you; degree to which these doctors took the time to listen to you; concern these doctors showed to keep you informed about your treatment; concern these doctors showed for your comfort while treating you; and degree to which these doctors advocated for your care

Summary

Introduction

Most emergency departments (ED) use patient experience surveys (i.e., Press Ganey) that include specific physician assessment fields. Our ED group currently staffs two EDs – one at a large, tertiary-care hospital, and the other at a small, affiliated, community site. Both are staffed by the same physicians. The goals of this study were to determine whether Press Ganey ED satisfaction scores for emergency physicians working at two different sites were consistent between sites, and to identify factors contributing to any variation. Evaluating Physician-Specific Scores Between EDs scores assessing both the overall experience and specific aspects of the emergency department (ED) visit, including a physicianspecific section. Attitude and interpersonal skills demonstrated by ED staff are associated with increased patient satisfaction scores, factors such as wait time, patient demographics and acuity, as well as crowding, influence scores.[6,7,8,9,10,11,12,13,14,15,16,17,18,19,20] Some studies have even suggested that higher patient satisfaction scores are tied to more drug prescriptions and advanced imaging.[3,4,21]

Objectives

Methods

Results

Discussion

Conclusion