Adding value to the patient experience in emergency medicine: What features of the emergency department visit are most important to patients?

Abstract

Objectives: To identify the features of the emergency department visit most important to patients, and to compare emergency staff ranking of the same features. Setting: The Royal Hobart Hospital, Tasmania is a 520-bed public hospital with an annual department of emergency medicine census of 33 000. Methods: Five hundred and fifty-five emergency patients, and 60 emergency department medical and nursing staff were surveyed, asking each to rank 10 features of the emergency department visit in order of importance to patients. Analysis was by Chi-squared test and Mann-Whitney U-test to compare survey responses between the patient and staff populations. Results: Response rates were 36% for patients and 78% for staff. Patients ranked waiting time as most important, followed by symptom relief, a caring and concerned attitude from staff and diagnosis of the presenting complaint. Staff identified the same four factors as important but ranked waiting time fourth. Waiting times during the survey week were within Australian College for Emergency Medicine performance benchmarks of 84% of the emergency department census. Conclusions: This survey identified a mismatch between patient concerns and emergency staff perceptions, particularly with regard to waiting times. The results justify the use of waiting times as a performance indicator for emergency medicine.