By Todd Sloane, Senior Writer, Press Ganey Associates
Despite several recent reports on overcrowding in hospital emergency departments, Press Ganey’s 2009 Emergency Department Pulse Report finds that patient satisfaction with EDs rose in 2008, continuing a five-year trend of improvement. The average wait time also decreased slightly, by two minutes, last year after rising slightly in 2007. Patients spent an average of four hours and three minutes in the ED in 2008.
The period studied includes the beginning of the current recession. “One could imagine that the loss of jobs would lead to the loss of insurance and possibly overcrowding and less patient satisfaction in the ED,” said Christy Dempsey, senior vice president of clinical operations for Patient Flow, a unit of Press Ganey. “But from the patients’ perspective, this country’s EDs were prepared for the challenge in the early days of the current recession. This is a testament to providers’ focus on improving quality and meeting patient needs.”
In particular, the report—based on the experiences of nearly 1.4 million patients treated at 1,725 emergency departments nationwide in 2008—finds that patients report significantly higher satisfaction with their experiences surrounding clinical tests and the collecting of personal/insurance information.
On the flip side, patients report that EDs need to improve the arrival process and handle patients’ personal issues better. “Providing a comfortable, safe waiting area; informing patients about delays; helping to control their pain; and communicating with patients frequently and respectfully throughout their visits are all critical components of improving these two aspects of care,” said Deirdre Mylod, vice president of Press Ganey’s acute care services business unit.
South Dakota, Idaho, and Wyoming led the list for the shortest wait times, at 172 minutes, 173 minutes and 177 minutes, respectively; while Utah, Kansas, and Arizona brought up the rear with wait times of 408, 393, and 355 minutes, respectively. Two states had notable improvement in wait times in EDs over the year. Virginia patients spent twenty-three fewer minutes in the ED in 2008 than they had in 2007. Patients in Maryland spent fourteen fewer minutes in the ED last year.
The metro areas with the highest patient satisfaction in the ED were Miami, Detroit, and Philadelphia. Miami moved up from third on last year’s list, while Detroit went from fourth to second. Philadelphia was a new entry in the top ten.
Communication about delays in receiving emergency care is even more important than the actual length of the waiting time, Mylod said. “Patients who reported they received good or very good information about delays reported nearly the same levels of satisfaction regardless of whether the visit was four hours or less than one hour in the ED,” she said. “Interestingly, those who reported very poor communication about delays, even if they spent less than one hour in the ED, reported less satisfaction than those who had been there longer, but had been better informed. Patients need to feel both included and important.”
Even hospitals that cannot reduce wait times can recover some patient satisfaction by improving the comfort of their waiting rooms, the report finds. Whether a patient spent one hour or four hours in the emergency department, those who rated the waiting room as very poor in comfort had dramatically lower overall satisfaction with the visit than those who rated the comfort of the waiting room as very good.
“You need to analyze patients’ comments,” Mylod said. “Simple things such as fixing the air conditioning or putting in more comfortable chairs can have a noticeable effect on the patient’s perception of the ED.”
Another means of improving patient satisfaction and reducing ED wait times is to improve patient flow to inpatient beds, Dempsey said. PatientFlow works to achieve that by smoothing out the peaks and valleys of elective surgical procedures. “We move the focus for flow improvement out of the ED and into the operating room, where we’ll have the most dramatic impact on patient flow throughout the hospital,” she said. “This significantly shortens wait times in the ED and actually opens up capacity in the operating room and in the inpatient beds, so that extended stays in the ED are eliminated. The hospital has effectively increased its overall capacity without expanding the ED, building more operating rooms, adding inpatient rooms, or hiring more staff,” she said.
Along with the report, Press Ganey has put together a new website that includes resources and improvement solutions for hospital administrators looking to reduce ED waiting times and improve patient satisfaction. The site, ImproveMyER.com (also accessible at ImproveYourER.com), also includes tips for consumers to better prepare them for an ED visit.
Despite several recent reports on overcrowding in hospital emergency departments, Press Ganey’s 2009 Emergency Department Pulse Report finds that patient satisfaction with EDs rose in 2008, continuing a five-year trend of improvement. The average wait time also decreased slightly, by two minutes, last year after rising slightly in 2007. Patients spent an average of four hours and three minutes in the ED in 2008.
The period studied includes the beginning of the current recession. “One could imagine that the loss of jobs would lead to the loss of insurance and possibly overcrowding and less patient satisfaction in the ED,” said Christy Dempsey, senior vice president of clinical operations for Patient Flow, a unit of Press Ganey. “But from the patients’ perspective, this country’s EDs were prepared for the challenge in the early days of the current recession. This is a testament to providers’ focus on improving quality and meeting patient needs.”
In particular, the report—based on the experiences of nearly 1.4 million patients treated at 1,725 emergency departments nationwide in 2008—finds that patients report significantly higher satisfaction with their experiences surrounding clinical tests and the collecting of personal/insurance information.
On the flip side, patients report that EDs need to improve the arrival process and handle patients’ personal issues better. “Providing a comfortable, safe waiting area; informing patients about delays; helping to control their pain; and communicating with patients frequently and respectfully throughout their visits are all critical components of improving these two aspects of care,” said Deirdre Mylod, vice president of Press Ganey’s acute care services business unit.
South Dakota, Idaho, and Wyoming led the list for the shortest wait times, at 172 minutes, 173 minutes and 177 minutes, respectively; while Utah, Kansas, and Arizona brought up the rear with wait times of 408, 393, and 355 minutes, respectively. Two states had notable improvement in wait times in EDs over the year. Virginia patients spent twenty-three fewer minutes in the ED in 2008 than they had in 2007. Patients in Maryland spent fourteen fewer minutes in the ED last year.
The metro areas with the highest patient satisfaction in the ED were Miami, Detroit, and Philadelphia. Miami moved up from third on last year’s list, while Detroit went from fourth to second. Philadelphia was a new entry in the top ten.
Communication about delays in receiving emergency care is even more important than the actual length of the waiting time, Mylod said. “Patients who reported they received good or very good information about delays reported nearly the same levels of satisfaction regardless of whether the visit was four hours or less than one hour in the ED,” she said. “Interestingly, those who reported very poor communication about delays, even if they spent less than one hour in the ED, reported less satisfaction than those who had been there longer, but had been better informed. Patients need to feel both included and important.”
Even hospitals that cannot reduce wait times can recover some patient satisfaction by improving the comfort of their waiting rooms, the report finds. Whether a patient spent one hour or four hours in the emergency department, those who rated the waiting room as very poor in comfort had dramatically lower overall satisfaction with the visit than those who rated the comfort of the waiting room as very good.
“You need to analyze patients’ comments,” Mylod said. “Simple things such as fixing the air conditioning or putting in more comfortable chairs can have a noticeable effect on the patient’s perception of the ED.”
Another means of improving patient satisfaction and reducing ED wait times is to improve patient flow to inpatient beds, Dempsey said. PatientFlow works to achieve that by smoothing out the peaks and valleys of elective surgical procedures. “We move the focus for flow improvement out of the ED and into the operating room, where we’ll have the most dramatic impact on patient flow throughout the hospital,” she said. “This significantly shortens wait times in the ED and actually opens up capacity in the operating room and in the inpatient beds, so that extended stays in the ED are eliminated. The hospital has effectively increased its overall capacity without expanding the ED, building more operating rooms, adding inpatient rooms, or hiring more staff,” she said.
Along with the report, Press Ganey has put together a new website that includes resources and improvement solutions for hospital administrators looking to reduce ED waiting times and improve patient satisfaction. The site, ImproveMyER.com (also accessible at ImproveYourER.com), also includes tips for consumers to better prepare them for an ED visit.
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