Operational factors associated with emergency department patient satisfaction: Analysis of the Academy of Administrators of Emergency Medicine/Association of Academic Chairs of Emergency Medicine national survey

Abstract

Background Patient satisfaction is a focus for emergency department (ED) and hospital administrators. ED patient satisfaction studies have tended to be single site and focused on patient and clinician factors. Inclusion of satisfaction scores in a large, national operations database provided an opportunity to conduct an investigation that included diverse operational factors. Methods We performed a retrospective analysis of the 2019 Academy of Administrators in Academic Emergency Medicine/Association of Academic Chairs of Emergency Medicine (AAAEM/AACEM) benchmarking survey to identify associations between operational factors and patient satisfaction. We identified 59 database variables as potential predictors of Press Ganey likelihood‐to‐recommend and physician overall scores. Using random forest modeling, we identified the top eight predictors in the models and described their associations. Results Forty‐three (57.3%) academic departments responding to the AAAEM/AACEM survey reported patient satisfaction scores for 78 EDs. Likelihood to recommend ranged from 30.0 to 93.0 (median = 74.8) and was associated with ED length of stay, boarding, use of hallway spaces, hospital annual admissions, faculty base clinical hours, proportion of patients leaving before treatment complete (LBTC), and provider in triage hours per day. Physician overall score ranged from 53.3 to 93.4 (median = 81.9) and was associated with faculty base clinical hours, x‐ray utilization, annual ED arrivals, LBTC, use of hallway spaces, arrivals per attending hour, and CT utilization. Conclusions ED patient satisfaction was associated with intrinsic and extrinsic factors, some being potentially manageable within the ED but others being relatively fixed or outside the control of ED operations. For likelihood to recommend, patient flow was dominant, with erosion of satisfaction observed with increased boarding and longer LOS. Factors associated with physician overall score were more varied. The use of hallway spaces and base clinical hours greater than 1,500 per year were associated with both lower likelihood‐to‐recommend and lower physician overall scores.

Identifying the prevalence and characteristics of diversity, equity, and inclusion leaders in academic emergency medicine

“…A list of academic EM programs in the United States was curated from the membership of an institution's department chair in the Association of Academic Chairs of Emergency Medicine (AACEM) and by participants in the Vice‐Chair Interest Group, Academy for Diversity and Inclusion in Emergency Medicine (ADIEM), and Equity and Inclusion Committee community listservs within the Society for Academic Emergency Medicine (SAEM). A total of 120 academic EM departments were identified, which is concordant with other academic EM survey studies 14 . Between April 2022 and July 2022, a Qualtrics survey was sent to members on the AACEM listserv, inquiring about the absence or presence of a departmental DEI leader and, if present, the DEI leader's contact information.…”

“…A total of 120 academic EM departments were identified, which is concordant with other academic EM survey studies. 14 Between April 2022 and July 2022, a Qualtrics survey was sent to members on the AACEM listserv, inquiring about the absence or presence of a departmental DEI leader and, if present, the DEI leader's contact information. Up to three reminder emails were sent to nonresponders to increase the number of participants.…”

Patient and hospital characteristics predict prolonged emergency department length of stay and in-hospital mortality: a nationwide analysis in Korea

“…According to the input-throughput-output conceptual model, this means that larger hospitals and higher levels of EDs have more “inputs” than smaller hospitals [ 57 ]. Indeed, there were more critically ill patients in larger hospitals and in hospitals with higher ED levels, and these patients also had a significantly longer median EDLOS [ 58 , 59 ].…”