Emergency Department Patient Experiences During the COVID-19 Pandemic

Abstract

Emergency department (ED) utilization changed notably during the coronavirus disease 2019 (COVID-19) pandemic in the United States. The purpose of the study was to gain a more thorough understanding of ED patient experience during the early stages of the COVID-19 pandemic. This study used the consensual qualitative approach to analyze open-ended responses from post-ED patient experience surveys from February through July 2020. Comments were included in the analysis if they pertained to care during the pandemic (eg, mentioned “the virus,” “masks,” “PPE”). A total of 242 COVID-specific comments from 192 unique patients were analyzed (median age 49 years; 69% female). Six themes were identified: visually observed changes, experiences of process changes, expressions of understanding or appreciation, sense of security, COVID-19 disease-specific comments, and “classic” satisfaction comments that align with previous literature on patient experience. The COVID-19 pandemic has challenged health care systems across the world in unique and unprecedented ways. This study identified six themes that better elucidate ED patient experience during an unprecedented public health crisis.

Comparison of Satisfaction Levels between COVID-19 and Non-COVID-19 Patients in the Emergency Department

“…Patient satisfaction, which is directly associated with the quality of patient care, is a very important and challenging factor for emergency departments (13). Although would be expected for the increased workload and stress on healthcare workers due to the pandemic to have a negative effect on patient satisfaction (14), the present study found that the satisfaction level of the patients who were cared for in the emergency department due to COVID-19 was significantly higher than that of non-COVID-19 patients.…”

Impact of the COVID-19 Pandemic on the Experiences of Hospitalized Patients: A Scoping Review

“…Regarding the identification of feelings experienced during hospitalization , 71.9% (n = 23) of the articles indicated that the patients and family members experienced difficult moments 47 during the hospitalization period, with feelings of loneliness 16 , 17 , 21 , 31 and isolation 16 , 17 , 21 , 29 , 31 , 40 , 41 due to the restrictions regarding visits and companions and a lack of contact between professionals and patients. 20 Feelings such as sadness, 23 , 26 , 46 fear, 17 , 18 , 20 , 22 , 24 – 29 , 32 , 33 , 46 anxiety, 17 , 22 , 28 , 38 , 41 , 46 worry, 17 , 20 – 24 , 32 , 33 , 46 nervousness, 22 guilt, 26 , 46 anger, 23 , 26 tiredness, 24 hopelessness, 46 frustration, 43 discrimination, 18 , 22 vulnerability, 29 , 32 , 46 and uncertainty 22 were also reported, associated with lack of knowledge about the disease and with the situation in which they found themselves. It is noted that the articles described concerns about the personal 21 or family 20 socioeconomic situation as aggravating factors, because of uncertainty of the economic and housing situation.…”

“…27 , 34 In addition, in relation to the interaction between professionals and patients, the nurses reported depersonalization of care, focusing on the care of the clinical conditions inherent to COVID-19, 39 including assistance in emergency sectors. 43 Still, a study that sought the satisfaction of hospitalized patients showed the interpersonal skills of doctors and nurses as lower patient satisfaction ratings. 19 However, in a study, it was stated that the care experience was identical when compared with the service before the pandemic.…”

The impact of COVID-19 epidemic on emergency department visits of older patients in Taiwan

“…Recent studies have shown a signi cant reduction in ED visits over the rst weeks of the pandemic [11,19]. The reasons might be that either patients avoided hospital visits due to fear of contracting COVID-19 or transmission of certain communicable diseases had slowed because of fewer human contact [14,17,20]. However, these studies did not assess changes in clinical characteristics, emergency status, and admission rate among ED attendees.…”

“…In 2003, severe acute respiratory syndrome (SARS) outbreak affected the medical service system and decreased the ED visits by 40% [13]. Similar to that of SARS outbreak, people became reluctant to hospitals due to panic and fear of contracting COVID-19 [14,15]. Relative to the pre-pandemic period, the delay in treatment from symptom onset to hospital arrival is common during a pandemic, resulting in worse prognoses and more urgent clinical conditions of patients; thus, ultimately increasing morbidity and mortality associated with both chronic and acute health conditions.…”