Data on patient's satisfaction from an emergency department: Developing strategies with the Multicriteria Satisfaction Analysis.
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ABSTRACT:
SUBMITTER: Manolitzas P
PROVIDER: S-EPMC6222085 | biostudies-other | 2018 Dec
REPOSITORIES: biostudies-other
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Data on patient's satisfaction from an emergency department: Developing strategies with the Multicriteria Satisfaction Analysis.
Manolitzas Panagiotis P Kostagiolas Petros P Grigoroudis Evangelos E Intas George G Stergiannis Pantelis P
Data in brief 20181023
This article presents data that examine the patient׳s satisfaction from the services of an Emergency Department in Greece during the economic crisis. 490 questionnaires have been collected for the assessment of patient satisfaction by taking into account criteria like cleanliness, waiting room, access to the hospital, courtesy, friendliness and professional attitude of the emergency department staff, service processes and waiting times. In order to examine the satisfaction levels of the patients ...[more]
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Project description: Not available
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Project description:BackgroundAbout one in five patients receiving home healthcare (HHC) services are hospitalized or visit an emergency department (ED) during a home care episode. Early identification of at-risk patients can prevent these negative outcomes. However, risk indicators, including language in clinical notes that indicate a concern about a patient, are often hidden in narrative documentation throughout their HHC episode.ObjectiveThe aim of the study was to develop an automated natural language processing (NLP) algorithm to identify concerning language indicative of HHC patients' risk of hospitalizations or ED visits.MethodsThis study used the Omaha System-a standardized nursing terminology that describes problems/signs/symptoms that can occur in the community setting. First, five HHC experts iteratively reviewed the Omaha System and identified concerning concepts indicative of HHC patients' risk of hospitalizations or ED visits. Next, we developed and tested an NLP algorithm to identify these concerning concepts in HHC clinical notes automatically. The resulting NLP algorithm was applied on a large subset of narrative notes (2.3 million notes) documented for 66,317 unique patients ( n = 87,966 HHC episodes) admitted to one large HHC agency in the Northeast United States between 2015 and 2017.ResultsA total of 160 Omaha System signs/symptoms were identified as concerning concepts for hospitalizations or ED visits in HHC. These signs/symptoms belong to 31 of the 42 available Omaha System problems. Overall, the NLP algorithm showed good performance in identifying concerning concepts in clinical notes. More than 18% of clinical notes were detected as having at least one concerning concept, and more than 90% of HHC episodes included at least one Omaha System problem. The most frequently documented concerning concepts were pain, followed by issues related to neuromusculoskeletal function, circulation, mental health, and communicable/infectious conditions.ConclusionOur findings suggest that concerning problems or symptoms that could increase the risk of hospitalization or ED visit were frequently documented in narrative clinical notes. NLP can automatically extract information from narrative clinical notes to improve our understanding of care needs in HHC. Next steps are to evaluate which concerning concepts identified in clinical notes predict hospitalization or ED visit.
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Project description:BACKGROUND: Due to increasing time constraints, the use of bedside presentations in resident education has declined. We examined whether patient satisfaction in the emergency department is affected when first-year residents present at the bedside with attendings. METHODS: We performed an observational, prospective, nonblinded study in the emergency department of a military teaching hospital. We alternately assigned first-year residents to present a convenience sample of 248 patients to the attending physician at the patient's bedside or away from the patient. We measured patient satisfaction by using the Patient Satisfaction Questionaire-18 (PSQ-18), a validated survey instrument that utilizes a Likert scale, and additional nonvalidated survey questions involving Likert and visual analog scales. RESULTS: While the median PSQ-18 score of 74 (95% confidence interval [CI], 72-76) was higher for patient satisfaction when residents made bedside presentations than that for standard presentations, 72 (95% CI, 70-74), the difference did not reach statistical significance (P = .33). CONCLUSION: There was no significant difference in overall patient satisfaction between residents' bedside presentations and presentations to attendings away from the patient. Although not significant, the differences noted in PSQ-18 subscales of communication, general satisfaction, and interpersonal manner warrant further investigation. Patients did not appear to be uncomfortable with having their care discussed and with having subsequent resident education at the bedside. Future research on patient satisfaction after implementation of standardized bedside teaching techniques 5 help further elucidate this relationship.
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Project description:IntroductionEmergency medicine (EM) physicians and trainees report high levels of burnout. Burnout negatively impacts physician well-being and career satisfaction but it remains unclear how burnout may influence patient care. We examined the degree to which EM trainee burnout at one institution was associated with patients' satisfaction with their emergency department (ED) care.MethodsIn this cross-sectional, pilot study conducted at a single institution, we measured EM trainee burnout using the Maslach Burnout Inventory through a confidential, electronic survey. We subsequently linked individual trainee burnout results with their individual Press Ganey (PG) ED patient satisfaction scores. We compared burnout scores across sex and postgraduate year using chi-square tests and PG results via analysis of variance.ResultsTwenty-seven of 53 (50.9%) eligible EM trainees completed the burnout assessment. Trainees reported an overall burnout rate of 77.8% (95% confidence interval = 59.2%-89.4%). There were no significant differences in burnout based on sex (p = 0.888) or postgraduate year (p = 0.671). Trainee burnout was significantly associated with lower trainee-specific PG scores, including patient ratings of resident physician courtesy (p = 0.011), taking the time to listen (p = 0.004), keeping informed of treatment (p = 0.014), and concern for patient comfort (p = 0.006). There was no significant association between trainee burnout and patients' overall likelihood to recommend the ED to others (p = 0.364).ConclusionEmergency medicine trainee burnout is associated with lower trainee-specific PG ED patient satisfaction scores across all four physician domains. In addition to its detrimental impact on physician wellness, burnout may play a significant adverse role in patients' perceptions of their ED providers' interpersonal and communication skills.
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