Survey of Patient Knowledge and Expectations about a Free-Standing Emergency Department (original) (raw)
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The American journal of emergency medicine, 2018
The popularity and number of freestanding emergency departments (FEDs) has substantially increased in the past few years. FEDs are typically open 24/7 and are staffed by qualified emergency care providers. FEDs generally offer faster throughput and more efficient hospital admission when necessary [1]. Because many communities have at least one FED and one HBED, patients are more frequently faced with the choice of seeking emergency care at one of these facilities. It is unclear what drives some patients to FEDs and others to HBEDs. There is literature on why patients come to an ED. The most common reasons cited are seriousness of condition,
Patient Expectation Survey at a Freestanding Emergency Department
Emergency medicine, 2012
There is currently limited information on patient expectations at Freestanding Emergency Departments (FSEDs). We wish to explore the determinants of patient expectations at a FSED. Methods: An expectation survey was administered to outpatient adults (≥19 yo) using convenience sampling at a Midwestern FSED with 14K/yr visits and a 4.71% admission rate. Patients were excluded if they were hospitalized, had altered mental status, or were subjects of a trauma or medical code activation. Patient response was recorded using a 5-point Likert scale (1-Not important, 5-Extremely important). Results (Means [95% CI]): 162/237 (68.4%) patient subjects returned the survey. The median age was 40 years, 89.4% Caucasian and 7.4% Hispanic. 46.8% had private insurance, 30.9% self-pay and 18.1% Medicare/Medicaid. Of those who preferred a particular healthcare provider, 93.3% preferred to be seen by a staff physician. Patients preferred a shorter visit (total length of stay 64.0 min), clear explanation of care (90.1%), competent (85.8%) and caring nurses (85.8%). A higher proportion of patients rated seeing a competent physician as "extremely important" compared to seeing a caring physician (94.
Use of an emergency department by nonurgent patients
The American Journal of Emergency Medicine, 2005
Objectives: The objectives of this study are (1) to determine whether patients seeking emergency department (ED) nonurgent care have primary care providers (PCP) or know of other care sources and (2) to determine the reasons why they choose to use the ED. Methods: A cross-sectional survey in a university ED was administered to self-referred nonurgent patients for 6 weeks. Use of a PCP, knowledge and attempts to seek other care, past use of the ED, urgency self-report, time of visit, and reasons for choosing an ED were recorded. Results: Of the 563 approached subjects, 314 were eligible and 279 agreed to participate. One hundred fifty-seven (56%) had PCPs. For 183 (66%) subjects, the ED was the only place they knew to go for their present problem, and 75 (27%) reported that they depended on the ED for all medical care. Of those patients with a PCP, 73 (47%) rated the ED better for unscheduled care. Eighty-one (52%) subjects thought their PCP would be more efficient and 66 (42%) thought their PCP would be cheaper. Conclusions: Although most ED nonurgent patients were not dependent upon the ED, the majority was unaware of other places to go for their current health problem. Even those patients with a PCP sought care in the ED because the ED was believed to provide better care despite its perceived increase in both waiting time and cost. D
Patient Expectations for Emergency Department Visits: Survey in Urban Emergency
Zenodo (CERN European Organization for Nuclear Research), 2022
Background: visits to Emergency Department (ED) are not uncommon in these times. With quality as a primary focus in Emergency Medicine, a detailed understanding of patient expectations is necessary to provide patientcentered care and increase patient satisfaction. In this study, we primarily examined patients' expectations regarding their arrival, the triaging process, while waiting for services, and while receiving services from staff. Methods: This study is an observational study focusing on visitors to the Ministry of Health hospitals (R1-Riyadh Cluster 1) in the southwest of Riyadh City. The inclusion criteria included all those who i) are Saudi citizens, ii) are eighteen years and older, iii) are receiving treatment in the Ministry of Health hospitals in the southwestern region of Riyadh. Data were collected by interviewing and completing a questionnaire, data were clarified, coded and entered using SPSS, version 25. Results: The study revealed that most of the participants 84.6% (430) expected someone to be at the front desk upon arrival at Emergency Department and 76% (386) expected welcoming and friendly staff while 63.5% (323) expected no language barriers. Although 75.3% (383) expect either a trolley, stretcher or wheelchair to take them from their car to the ED building, just over half of participants 52.3% (269) do not expect valet parking. The study also shows that almost two-thirds 63.5% (323) of the participants were not aware of triage and how it is done. The majority of the participants expected the presence of a waiting room 89%(453). Majority of the participants expected the presence of a television 42%(216), followed by educational pamphlets 41%(210), Wi-Fi 29%(148), books 28%(144). When participants were asked about the availability of food and beverages at ED, 37%(324) expected water, 23%(203) expected coffee. The majority of participants expected privacy between males and females 83% (423), similarly the majority of participants expected separation between male and female beds regardless of health 75% (381). Half of the participants 53% (268) expected that patients who arrive first should be seen first. When participants were asked if they expected to be diagnosed in the ED, 72% (367) expected to be diagnosed.
Public use and perceptions of emergency departments: A population survey
Emergency Medicine Australasia, 2015
Objectives: To inform demand management strategies aimed at reducing congestion in emergency departments (EDs) by: (i) identifying public use of EDs, decision-making and reasons; and (ii) measuring acceptance of alternative care models. Methods: A cross-sectional telephone survey of a random sample of Queensland population aged 18 years or older residing in a dwelling unit in Queensland that could be contacted on a land-based telephone service was conducted. One person per household was selected according to a predetermined algorithm to ensure gender and regional balance was interviewed. The main outcome measures were: ED use, attitudes towards ED staff and services, and alternative models of care. Results: The final sample included a total of 1256 respondents (response rate= 40.3%). 21% attended EDs in the preceding 12 months. The decision to attend was made by patients (51%), health and medical professionals (31%), and others (18%). The main reasons included perceived severity of the illness (47%), unavailability of alternative services (26%) and better care (11%). Most respondents agreed with more flexible care models of service delivery including incentives for GPs (90%), private health insurance coverage for ED use (89%) and enhanced roles for paramedics and nurses. Conclusions: Main reason for attending ED is perceived severity of illness, followed by lack of alternative care. The majority of both consumers and the public are in favour of more flexible care models. However, further research is necessary to detail those alternatives and to test and validate their effectiveness.
2014
Background: Emergency Department (ED) provides crucial services for life threatening conditions. The number of patient utilizing ED is increasing. Patients’ expectations are important aspects to be considered in order to improve their satisfaction and willingness to return to ED in case of future events. The objective of this study was to explore patients’ expectations, level of satisfaction and willingness to reuse the ED. Methods: A descriptive, cross-sectional design was employed with a convenience sample of 110 subjects who visited the ED at King Fahd Hospital, King Abdu Aziz Medical City, Riyadh, Kingdom of Saudi Arabia. Demographic characteristics and data on patients’ expectations, satisfaction and willingness to reuse the ED were assessed during patients’ interview. Results: The majorities of participants were in the age group 30 to 49 years old, females, married, graduated from high school, Saudi, residents of Riyadh, have health insurance with the same ED, and were not wor...
Reasons for Using the Emergency Department: Results of the EMPATH Study
Academic Emergency Medicine, 2005
Objectives: Emergency Medicine Patients' Access To Healthcare (EMPATH) was a cross-sectional, observational study conducted to identify the principal reasons why patients seek care in hospital emergency departments (EDs) in the United States. Methods: Twenty-eight U.S. hospitals, stratified by geographic region and hospital characteristics, participated in this study. Demographic, clinical, and insurance data were collected for a 24-hour period at each site, using chart reviews and a structured interview administered to all consenting adult patients seeking treatment during that period. Patients' reasons for presenting to the ED were assessed by their level of agreement (on a threepoint Likert scale) with 21 carefully worded statements designed to capture a range of possible reasons for seeking care in the ED. Factor analysis was used to consolidate highly correlated responses and to identify the principal factors explaining patients' reasons for coming to the ED. Results: A total of 1,579 patient interviews and 2,004 chart reviews were obtained from a diverse sample that was 55.4% female, 58.3% white, 28.3% African American, 7.0% Hispanic, and 6.0% other ethnic groups. This exploratory analysis yielded five factors characterizing patients' principal reasons for seeking ED care, with medical necessity the most frequent, followed by ED preference, convenience, affordability, and limitations of insurance. Conclusions: Use of the ED is, for most people, an affirmative choice over other providers rather than a last resort; it is often a choice driven by lack of access to or dissatisfaction with other sources of care.
Qualitative study of patients' choice between public and private hospital emergency departments
Emergency medicine Australasia : EMA, 2016
The aim of this study was to gather patients' perceptions regarding their choice between public and private hospital EDs for those who hold private health insurance. The findings of this study will contribute to knowledge regarding patients' decision-making processes and therefore may contribute to the development of evidence based public policies. An in-depth semi-structured guide was used to interview participants at public and private hospital EDs. Questions sought to identify the issues that were considered by the participants to decide to attend that hospital ED, previous ED experience, expectations of ED services and perceived benefits and barriers to accessing services. Interviews were audio recorded, transcribed verbatim and analysed using content and thematic approaches. Four core themes emerged: prior good experience with the hospital, perceived quality of care, perceived waiting times and perceived costs that may explain patients' choice. Patients' choice ...
CJEM, 2016
The emergency department (ED) left-without-being-seen (LWBS) rate is a performance indicator, although there is limited knowledge about why people leave, or whether they seek alternate care. We studied characteristics of ED LWBS patients to determine factors associated with LWBS. We collected demographic data on LWBS patients at two urban hospitals. Sequential LWBS patients were contacted and surveyed using a standardized telephone survey. A matched group of patients who did not leave were also surveyed. Data were analysed using the Fisher exact test, chi-square test, and student t-test. The LWBS group (n=1508) and control group (n=1504) were matched for sex, triage category, recorded wait times, employment and education, and having a family physician. LWBS patients were younger, more likely to present in the evening or at night, and lived closer to the hospital. A long wait time was the most cited reason for leaving (79%); concern about medical condition was the most common reason ...
Demand for hospital emergency departments: a conceptual understanding
World journal of emergency medicine, 2011
Emergency departments (EDs) are critical to the management of acute illness and injury, and the provision of health system access. However, EDs have become increasingly congested due to increased demand, increased complexity of care and blocked access to ongoing care (access block). Congestion has clinical and organisational implications. This paper aims to describe the factors that appear to influence demand for ED services, and their interrelationships as the basis for further research into the role of private hospital EDs. Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) and relevant journals were searched using terms related to EDs and emergency health needs. Literature pertaining to emergency department utilisation worldwide was identified, and articles selected for further examination on the basis of their relevance and significance to ED demand. Factors influencing ED demand can be categorized into those describing the health needs of the patien...