Association Between Clinicians' Average Patient Length of Stay and Patient Experience Scores

Abstract

Objective: Given the current emphasis on patient-centered care, emergency physicians are seeking ways to improve patients’ experience in the emergency department (ED). Length of stay (LOS) in the ED has previously been associated with patient experience ratings, however there is limited literature on this relationship at the clinician level. The objective of this study was evaluate the association between ED clinicians’ mean LOS and their individual patient experience scores. Methods: This was a cross-sectional observational study of 240 ED clinicians’ average LOS and patient experience scores which took place across a regional healthcare system in the United States from July 1, 2020 through June 30, 2022. We performed both a univariate and a multivariate regression to assess for a correlation between our primary patient experience measure, Net Promoter Score (NPS), and mean LOS at the clinician level. In the multivariate regression, we controlled for triage acuity level, hospital site, clinician type (physician or physician assistant/nurse practitioner), and computed tomography (CT) usage. Results: We found a significant negative association between clinicians’ average LOS and NPS scores, such that every minute increase in LOS was associated with a decrease in NPS of 0.07 (p = 0.001). This association was unchanged in the multivariate model. Conclusions: In this cohort of 240 clinicians, longer average patient LOS was associated with lower patient experience scores. Further study is warranted to determine safe, effective, and patient important ways to improve ED throughput and decrease patient LOS.