Emergency management of chest pain: Patient satisfaction with an emergency department based six hour rule out myocardial infarction protocol

Abstract

Objective: To measure the level of patient satisfaction with an emergency department based chest pain assessment unit. Design: Structured patient satisfaction surveys. Setting: Inner city university hospital emergency department. Participants: 383 consecutive patients aged over 25 years with probable cardiac chest pain of less than 12 hours duration at moderate to low risk of acute myocardial infarction. Intervention: Two structured questionnaires - the first addressing satisfaction with different aspects of the health care process, the second designed to assess global satisfaction outcomes. Results: 274 patients (74%) fully or partly answered the first questionnaire. There were high levels of satisfaction with all process of care issues (waiting time, information, discussion, explanation, pain management, personal needs, family needs, and discharge preparation). Altogether 258 patients fully or partly answered the second questionnaire. Global satisfaction was high. Subgroup data analysis showed white patients significantly more satisfied than non-white patients (p<0.0001), and over 45s significantly more satisfied than under 45s (p<0.01). A number of issues were raised in the free comment section of the second questionnaire. The lack of a definitive diagnosis at discharge was a recurring theme. Conclusion: Chest pain assessment units are acceptable from a patient perspective.