{"pk":7243,"title":"Emergency Department Crowding is Associated with Reduced Satisfaction Scores in Patients Discharged from the Emergency Department","subtitle":null,"abstract":"Introduction: Emergency department (ED) crowding has been shown to negatively impact patient outcomes. Few studies have addressed the effect of ED crowding on patient satisfaction. Our objective was to evaluate the impact of ED crowding on patient satisfaction in patients discharged from the ED.\n \nMethods: We measured patient satisfaction using Press-Ganey surveys returned by patients that visited our ED between August 1, 2007 and March 31, 2008. We recorded all mean satisfaction scores and obtained mean ED occupancy rate, mean EDWIN score and hospital diversion status over each 8-hour shift from data archived in our electronic tracking board. Univariate and multivariate logistic regression analysis was calculated to determine the effect of ED crowding and hospital diversion status on the odds of achieving a mean satisfaction score ≥85, which was the patient satisfaction goal set forth by our ED administration.\n \nResults: A total of 1591 surveys were returned over the study period. Mean satisfaction score was 77.6 (SD±16) and mean occupancy rate was 1.23 (SD±0.31). The likelihood of failure to meet patient satisfaction goals was associated with an increase in average ED occupancy rate (OR 0.32, 95% CI 0.17 to 0.59, P<0.001) and an increase in EDWIN score (OR 0.05, 95% CI 0.004 to 0.55, P=0.015). Hospital diversion resulted in lower mean satisfaction scores, but this was not statistically significant (OR 0.62, 95% CI 0.36 to 1.05). In multivariable analysis controlling for hospital diversion status and time of shift, ED occupancy rate remained a significant predictor of failure to meet patient satisfaction goals (OR 0.34, 95% CI 0.18 to 0.66, P=0.001).\n \nConclusions: Increased crowding, as measured by ED occupancy rate and EDWIN score, was significantly associated with reduced patient satisfaction. Although causative attribution was limited, our study suggested yet another negative impact resulting from ED crowding. [West J Emerg Med.2013;14(1):11-15.]","language":"en","license":{"name":"Creative Commons Attribution-NonCommercial  4.0","short_name":"CC BY-NC 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by-nc/4.0"},"keywords":[{"word":"patients satisfaction"},{"word":"emergency"},{"word":"crowding"},{"word":"administration"},{"word":"Medical"},{"word":"health sciences"}],"section":"Emergency Department Access","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5ks6092b","frozenauthors":[{"first_name":"Karis","middle_name":"L","last_name":"Tekwani","name_suffix":"","institution":"Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois","department":"None"},{"first_name":"Yaniv","middle_name":"","last_name":"Kerem","name_suffix":"","institution":"University of Chicago Medical Center, Section of Emergency Medicine, Chicago, Illinois","department":"None"},{"first_name":"Chintan","middle_name":"D","last_name":"Mistry","name_suffix":"","institution":"Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois","department":"None"},{"first_name":"Brian","middle_name":"M","last_name":"Sayger","name_suffix":"","institution":"Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois","department":"None"},{"first_name":"Erik","middle_name":"B","last_name":"Kulstad","name_suffix":"","institution":"Advocate Christ Medical Center, Department of Emergency Medicine, Oak Lawn, Illinois","department":"None"}],"date_submitted":"2011-11-27T19:06:27Z","date_accepted":"2011-11-27T19:06:27Z","date_published":"2012-11-17T07:05:45Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/7243/galley/4331/download/"}]}