The study shows factors that influence patient experience in emergency departments

The study shows factors that influence patient experience in emergency departments

A large study by researchers at the Regenstrief Institute and Indiana University School of Medicine has found that patient pain upon arrival to the emergency department (ED), as well as the use of hallway beds and radiology studies in the ED, are associated with patient experience, although not in the same way.

The study's tens of thousands of observations, including clinical and operational data, found that regardless of how quickly or successfully pain was treated in the ED, the amount of pain the patient was in upon arrival was associated with patient experience - the more pain the patient entered the ED, the worse the experience they reported.

All other things being equal, patients who had been placed in hallway beds, often used to facilitate care when a facility is overcrowded, reported having a less positive experience in the ED, whether or not they received timely care.

While pain upon arrival and placement in hallway beds was associated with a poorer patient experience, a radiology study such as an X-ray, ultrasound, CT or MRI scan produced more positive experiences in patients who were interviewed.

The study finds that these associations may represent proxies for interpersonal elements of care. For example, patients in hallway beds may receive more rushed communication from clinicians, or additional radiology orders may have been placed for ED patients when a thorough and patient-centered history was discharged.

Emergency departments are busy places where patients receive life-saving care. EDS have concerns such as cold and flu cases that are currently flooding EDS in many parts of the country. We recognize that it is difficult to have a good experience when you are sitting in the waiting room behind 40 other patients. However, as emergency clinicians, we want our patients to be confident in their knowledge that they are not experiencing a life-threatening problem, and for those who do have a serious problem, we have been able to catch and mitigate it. This is an important patient outcome.

We really want to improve the patient experience for patients in the emergency department. It matters to patients and it matters to clinicians. It is also important for the entire healthcare system. What we sought to understand in this study when asking patient experience survey questions contributes to answers. And it's not as obvious as it seems. Understanding some of the underlying factors—both clinical and operational factors in the ED and hospital—can help EDS and physicians improve their patients' experiences. “

Paul Musey, Jr., MD, MSc,Senior author studying,A research scientist and faculty member at the IU School of Medicine at Regenstrief Institute

A total of 58,622 patient visits to 13 Indiana University health EDs of varying sizes were included in the study's analysis of data obtained from surveys conducted after ED discharge. The survey population was 55 percent female. Approximately a quarter of all respondents were parents or guardians of a pediatric patient.

"We need patients as collaborators and as key stakeholders to help us solve problems we have identified in this article. However, the solution is not one size," said first author Diane Kuhn, MD. "There may be patients who would rather wait an hour and be seen in a private room than currently be seen in a hallway bed. There may be patients who have a critical work meeting or they have children they need to get home to now and they are absolutely fine being seen in a hallway as long as they can talk to the clinician now."

"We will involve patients in future research to figure out how we can do the best job for them because only patients know what is important to them. We also need to effectively engage clinicians because we all have the same goals to improve the patient experience. Dr. Kuhn is a partner in the Regenstrief Institute and an assistant professor of emergency medicine at the IU School of Medicine.

According to the Centers for Disease Control and Prevention (CDC), approximately 155 million visits were made in the United States in 2022 (the most recent year for which statistics are available).

Hallway beds are temporary beds often used in EDS during times of high demand for services to increase capacity and reduce waiting times.

“Use of hallway beds, radiology studies, and patients with pain upon arrival to the emergency department are associated with patient experience” is published in Annals of Emergency Medicine. The study was supported by the Ralph W. and Grace M. Showalter Research Trust and the IU School of Medicine.

Both Dr. Musey and Dr. Kuhn are emergency physicians who conduct research for health services and health policy.

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