Background and Hypothesis The authors investigate whether there is a difference in Press Ganey (PG; patient satisfaction scores) scores for the emergency physicians before and during the coronavirus disease 2019 (COVID‐19) outbreak at a regional group of emergency departments in the southeastern United States. The authors hypothesize that decreases in emergency department volume, less emergency department boarding of admissions, reduced use of hallway beds, and favorable attitudes toward emergency physicians during the COVID‐19 outbreak may influence patient satisfaction scores measured in the Press Ganey surveys. Study Design and Methods The authors performed a retrospective review of PG scores obtained over the prior 7 months at 8 larger teaching hospitals in the Southeast region (Florida, Georgia, and South Carolina). Averaged physician PG Scores and their 4 components—courtesy, time to listen, informative regarding treatment, concern for comfort—were collected. The authors evaluated the overall physician PG ratings for March through May 2020 (COVID outbreak) vs the prior 4 months. Overall emergency physician scores, using top box methodology of percent highest response, were averaged from 4 questions regarding the emergency physician's care. Results There were 6272 patient satisfaction surveys returned in the 7‐month study period; 4003 responses during the pre‐COVID months (November 2019–February 2020) and 2296 during the COVID months (March through May 2020). Results showed that in the “pre‐COVID time” the PG surveys scored in the 17% of all PGs in the country (63.9% “top‐box” or highest rating score) as compared to scoring in the 34% of all PGs (68.1% “top‐box”) during “COVID time.” These data were statistically significant using a chi‐square analysis with P < 0.001 Conclusions Emergency physician patient satisfaction scores, as represented by the PG score, were significantly higher during the COVID months, in comparison to the pre‐COVID months, for 8 teaching hospitals in the Southeast region of the United States.

Introduction We evaluated the impact of tele-neurologists on the time to initiating acute stroke care versus traditional bedside neurologists at an advanced stroke center. Methods This observational study evaluated time to treatment for acute stroke patients at a single hospital, certified as an advanced primary stroke centre, with thrombectomy capabilities. Consecutive stroke alert patients between 1 March, 2016 and 31 March, 2018 were divided into two groups based on their neurology consultation service (bedside neurology: 1 March, 2016–28 February, 2017; tele-neurology: 1 April, 2017–31 March, 2018). Door-to-tPA time and door-to-IR time for mechanical thrombectomy were compared between the two groups. Results Nine hundred and fifty-nine stroke patients met the inclusion criteria (436 bedside neurology, 523 tele-neurology patients). There were no significant differences in sex, age, or stroke final diagnosis between groups ( p > 0.05). 85 bedside neurology patients received tPA and 35 had mechanical thrombectomy, 84 and 44 for the tele-neurology group respectively. Door-to-tPA time (median (IQR)) was significantly higher among tele-neurology (64 min (51.5–83.5)) than bedside neurology patients (45 min (34–69); p < 0.0001). There was no difference in door-to-IR times (mean ± SD) between bedside neurology (87.2 ± 33.3 min) and tele-neurology (90.4 ± 33.4 min; p = 0.67). Discussion At this facility, our tele-neurology services vendor was associated with a statistically significant delay in tPA administration compared with bedside neurologists. There was no difference in door-to-IR times. Delays in tPA administration make it harder to meet acute stroke care guidelines and could worsen patient outcomes.