e Abstract—This article reviews the empirical literature on patient satisfaction in the Emergency Department (ED). It explores the implications for clinical practice, discusses limitations and weaknesses of the literature, and provides direction for future research. Articles resulting from a comprehensive electronic search were obtained, their ref-erences examined, and all other relevant articles not al-ready discovered via the electronic search were acquired and reviewed. Articles were included if: 1) the stated goal of the study was to investigate satisfaction with at least one aspect of ED care, 2) the study was conducted in the United States, 3) it provided enough information on the study methods, design, and statistical analyses to conduct a crit-ical review, and 4) it used quantitative methods. Fifty stud-ies met the above criteria. Based on the multivariate pre-dictive studies, the most robust predictor of global satisfaction is the quality of interpersonal interactions with the ED provider. Perceived waiting times are more closely associated with satisfaction than actual waiting times. Sev-eral methods for improving satisfaction have shown prom-ise, but none has garnered sufficient support to recommend unequivocally. Promising interventions include: providing information on how the ED functions through visual media, improving ED processes through performance improve-ment methodologies, and improving the interpersonal skills of providers. Interventions designed to reduce actual wait-ing times have not been sufficiently studied, but results from several well-designed studies suggest that such a strat-egy is unlikely to have as great an impact as those targeting perceived waiting times. To advance this area of research, investigators must use: 1) larger, more representative sam-ples; 2) reliable and valid assessment instruments; 3) theo-ry-driven hypothesis testing; and 4) randomized, controlled trials.
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