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Effect of an emergency department fast track on Press-Ganey patient satisfaction scores.

Hwang CE, Lipman GS, Kane M - West J Emerg Med (2014)

Bottom Line: We calculated an odds ratio with 100% satisfaction considered a positive response.An academic ED with 52,000 annual visits had 140 pre-fast track and 85 fast track respondents.Implementation of an ED Fast Track more than doubled the odds of significant improvements in Press-Ganey patient satisfaction metrics and may play an important role in improving ED performance on CMS benchmarks.

View Article: PubMed Central - PubMed

Affiliation: Stanford University School of Medicine, Stanford/Kaiser Emergency Medicine Residency, Stanford, California.

ABSTRACT

Introduction: Mandated patient surveys have become an integral part of Medicare remuneration, putting hundreds of millions of dollars in funding at risk. The Centers for Medicare & Medicaid Services (CMS) recently announced a patient experience survey for the emergency department (ED). Development of an ED Fast Track, where lower acuity patients are rapidly seen, has been shown to improve many of the metrics that CMS examines. This is the first study examining if ED Fast Track implementation affects Press-Ganey scores of patient satisfaction.

Methods: We analyzed returned Press-Ganey questionnaires from all ESI 4 and 5 patients seen 11AM - 1PM, August-December 2011 (pre-fast track), and during the identical hours of fast track, August-December 2012. Raw ordinal scores were converted to continuous scores for paired student t-test analysis. We calculated an odds ratio with 100% satisfaction considered a positive response.

Results: An academic ED with 52,000 annual visits had 140 pre-fast track and 85 fast track respondents. Implementation of a fast track significantly increased patient satisfaction with the following: wait times (68% satisfaction to 88%, OR 4.13, 95% CI [2.32-7.33]), doctor courtesy (90% to 95%, OR 1.97, 95% CI [1.04-3.73]), nurse courtesy (87% to 95%, OR 2.75, 95% CI [1.46-5.15]), pain control (79% to 87%, OR 2.13, 95% CI [1.16-3.92]), likelihood to recommend (81% to 90%, OR 2.62, 95% CI [1.42-4.83]), staff caring (82% to 91%, OR 2.82, 95% CI [1.54-5.19]), and staying informed about delays (66% to 83%, OR 3.00, 95% CI [1.65-5.44]).

Conclusion: Implementation of an ED Fast Track more than doubled the odds of significant improvements in Press-Ganey patient satisfaction metrics and may play an important role in improving ED performance on CMS benchmarks.

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Odds ratio comparison of 100% patient satisfaction responses (5 out of 5 on Press-Ganey Likert scale) after implementation of ED fast track.ED, emergency department
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f2-wjem-16-34: Odds ratio comparison of 100% patient satisfaction responses (5 out of 5 on Press-Ganey Likert scale) after implementation of ED fast track.ED, emergency department

Mentions: We analyzed 140 respondents in the pre-ED Fast Track group and 85 in the ED Fast Track group, with an overall 14.8% response rate. Patients in the pre-ED Fast Track and ED Fast Track cohort represented approximately 9% of the overall ED volume during each time period. There were significant improvements in patient satisfaction after the implementation of an ED Fast Track area in each of the seven categories selected for analysis (Figures 1 and 2). Patient satisfaction with wait times increased from 68% to 88% (OR 4.13, 95% CI [2.32–7.33], p<0.0001), doctor courtesy 90% to 95% (OR 1.97, 95% CI [1.04–3.73], p=0.05), nurse courtesy 87% to 95% (OR 2.75, 95% CI [1.46–5.15], p<0.01), staying informed about delays 66% to 83% (OR 3.00, 95% CI [1.65–5.44], p<0.0001), staff caring 82% to 91% (OR 2.82, 95% CI [1.54–5.19], p<0.01), pain control 79% to 87% (OR 2.13, 95% CI [1.16–3.92], p=0.018), and likelihood to recommend 81% to 90% (OR 2.62, 95% CI [1.42–4.83], p<0.01).


Effect of an emergency department fast track on Press-Ganey patient satisfaction scores.

Hwang CE, Lipman GS, Kane M - West J Emerg Med (2014)

Odds ratio comparison of 100% patient satisfaction responses (5 out of 5 on Press-Ganey Likert scale) after implementation of ED fast track.ED, emergency department
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307722&req=5

f2-wjem-16-34: Odds ratio comparison of 100% patient satisfaction responses (5 out of 5 on Press-Ganey Likert scale) after implementation of ED fast track.ED, emergency department
Mentions: We analyzed 140 respondents in the pre-ED Fast Track group and 85 in the ED Fast Track group, with an overall 14.8% response rate. Patients in the pre-ED Fast Track and ED Fast Track cohort represented approximately 9% of the overall ED volume during each time period. There were significant improvements in patient satisfaction after the implementation of an ED Fast Track area in each of the seven categories selected for analysis (Figures 1 and 2). Patient satisfaction with wait times increased from 68% to 88% (OR 4.13, 95% CI [2.32–7.33], p<0.0001), doctor courtesy 90% to 95% (OR 1.97, 95% CI [1.04–3.73], p=0.05), nurse courtesy 87% to 95% (OR 2.75, 95% CI [1.46–5.15], p<0.01), staying informed about delays 66% to 83% (OR 3.00, 95% CI [1.65–5.44], p<0.0001), staff caring 82% to 91% (OR 2.82, 95% CI [1.54–5.19], p<0.01), pain control 79% to 87% (OR 2.13, 95% CI [1.16–3.92], p=0.018), and likelihood to recommend 81% to 90% (OR 2.62, 95% CI [1.42–4.83], p<0.01).

Bottom Line: We calculated an odds ratio with 100% satisfaction considered a positive response.An academic ED with 52,000 annual visits had 140 pre-fast track and 85 fast track respondents.Implementation of an ED Fast Track more than doubled the odds of significant improvements in Press-Ganey patient satisfaction metrics and may play an important role in improving ED performance on CMS benchmarks.

View Article: PubMed Central - PubMed

Affiliation: Stanford University School of Medicine, Stanford/Kaiser Emergency Medicine Residency, Stanford, California.

ABSTRACT

Introduction: Mandated patient surveys have become an integral part of Medicare remuneration, putting hundreds of millions of dollars in funding at risk. The Centers for Medicare & Medicaid Services (CMS) recently announced a patient experience survey for the emergency department (ED). Development of an ED Fast Track, where lower acuity patients are rapidly seen, has been shown to improve many of the metrics that CMS examines. This is the first study examining if ED Fast Track implementation affects Press-Ganey scores of patient satisfaction.

Methods: We analyzed returned Press-Ganey questionnaires from all ESI 4 and 5 patients seen 11AM - 1PM, August-December 2011 (pre-fast track), and during the identical hours of fast track, August-December 2012. Raw ordinal scores were converted to continuous scores for paired student t-test analysis. We calculated an odds ratio with 100% satisfaction considered a positive response.

Results: An academic ED with 52,000 annual visits had 140 pre-fast track and 85 fast track respondents. Implementation of a fast track significantly increased patient satisfaction with the following: wait times (68% satisfaction to 88%, OR 4.13, 95% CI [2.32-7.33]), doctor courtesy (90% to 95%, OR 1.97, 95% CI [1.04-3.73]), nurse courtesy (87% to 95%, OR 2.75, 95% CI [1.46-5.15]), pain control (79% to 87%, OR 2.13, 95% CI [1.16-3.92]), likelihood to recommend (81% to 90%, OR 2.62, 95% CI [1.42-4.83]), staff caring (82% to 91%, OR 2.82, 95% CI [1.54-5.19]), and staying informed about delays (66% to 83%, OR 3.00, 95% CI [1.65-5.44]).

Conclusion: Implementation of an ED Fast Track more than doubled the odds of significant improvements in Press-Ganey patient satisfaction metrics and may play an important role in improving ED performance on CMS benchmarks.

Show MeSH