TITLE:
A Lack of Effect on Patient Satisfaction Scores in One Large Urban Emergency Department
AUTHORS:
Peter W. Crane, Bryce Yerman, Sandra M. Schneider
KEYWORDS:
Emergency Department Crowding; Triage; Physician in Triage; Patient Satisfaction
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.3 No.7A,
January
2,
2013
ABSTRACT: Background: To
deal with emergency department crowding and long waits before patient care,
many institutions have placed a doctor in the triage area to initiate treatment
and testing. Objective: to determine
the effect of a doctor in triage on patient satisfaction scores. Methods: This is an observational study
comparing the patient satisfaction scores from days when a physician was in
triage to days when a physician was not present. The study was conducted in the
ED of an urban academic medical center with excellent primary care resources
and payer mix (7% self pay, 11% Medicaid). Results: There was a mean of 4 (95% CI 3.1 - 4.5) surveys
returned for each day when there was a doctor in triage and a mean of 5 (95% CI
4.3 - 5.7) surveys for each day without a
doctor in triage. Overall satisfaction for the days with a doctor in triage was
79.9 ± 10.5 (95% CI
77.7, 82.1) compared to 78.8 ± 9.2 (95% CI
76.5, 81.1) (p = 0.9) on days without a doctor in
triage. Conclusion: In this setting,
there was no effect of a doctor in triage on patient satisfaction scores. While
a doctor in triage may be valuable and cost effective in some settings, it may
not provide appropriate benefit in all settings. We suggest that facilities
trial a physician in triage program and measure predetermined outcomes such as
patient satisfaction scores, length of stay and the percentage of patients left
without being seen before investing in additional staffing and cost to sustain
such a program.