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Effect of an Emergency Department Fast Track on Press-Ganey Patient Satisfaction Scores

Originally Published:
2014
Key Point Summary
Key Point Summary Author(s):
Pati, Sipra
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Key Concepts/Context

On the lines of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience surveys, the Centers for Medicare and Medicaid Services have announced a similar survey for Emergency Departments (EDs). This study examined Press-Ganey scores of patient satisfaction in an academic hospital that recently implemented an ED Fast Track program and found a clear association between the program and higher patient satisfaction.

Objectives

The objective of this study was to examine if the implementation of an ED Fast Track affects Press-Ganey scores of patient satisfaction.

Methods

The methodology involved a cross-sectional study of Press-Ganey surveys completed by low-acuity patients in an academic ED before and after the creation of a new ED Fast Track in July 2012. Data collected was from August-December 2011 questionnaires (pre-Fast Track) and from August-December 2012 questionnaires (post-Fast Track). There were a total of 140 respondents in the pre-Fast Track group and 85 in the post-Fast Track – an overall response rate of approximately 15%. The following were examined: wait times, nurse courtesy, doctor courtesy, being kept informed about delays, staff caring, pain control, and likelihood to recommend.

Design Implications
The study indicates that ED designs may incorporate spaces equipped for treating low-acuity patients under the fast track program.
Findings

The study identified a clear association between the implementation of an ED Fast Track program with increased patient satisfaction. More specifically, the study found that patient satisfaction with regard to:

  • Wait times increased from 68% to 88% (p=0.05).
  • Doctor courtesy increased from 90% to 95% (p=0.05).
  • Nurse courtesy increased from 87% to 95% (p<0.01).
  • Staying informed about delays increased from 66% to 83% (p<0.0001).
  • Staff caring increased from 82% to 91% (p<0.01).
  • Pain control increased from 79% to 87% (p=0.018).
  • Likelihood to recommend increased from 81% to 90% (p<0.01).
Limitations

The authors identified the following limitations of their study:

  • The sample for the pre-Fast Track group was taken from the triage index of the ED; it is not known if patients had been under-triaged or were suitable/eligible for Fast Track.
  • There was a large difference in the number of responses of the pre- and post- groups; this may have biased the results.
Design Category
Unit configuration and layout
Setting
Hospitals
Outcome Category
Patient / resident satisfaction and comfort
Key Point Summary Author(s):
Pati, Sipra
Primary Author
Hwang, C. E.