Villalona Seiichi, Boxtha Carol, Webb W Alex, Cervantes Cirenio, Wilson Jason W
Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA.
Department of Anthropology, University of South Florida, Tampa, FL, USA.
J Patient Exp. 2020 Dec;7(6):1015-1021. doi: 10.1177/2374373520957123. Epub 2020 Oct 9.
Press Ganey survey data are used by institutions to understand patient experiences in the emergency department (ED). The present mixed-methods retrospective cohort study examined the effects of hallway placement, pain management reporting, communication approaches, time spent in the ED, and other demographic variables on predicting satisfaction ratings of doctors, nurses, and overall ED care. A total of 4940 patient responses between January 1, 2012, and December 31, 2017, were analyzed from 2 EDs associated with an academic institution and tertiary care center. Consensus coding was used to qualitatively capture patient responses that relate to communication issues pertaining to care/empathy and understandings of ED procedures. After controlling for multiple factors, hallway placement, pain management, and understanding of ED procedures were associated with higher odds of negative ratings for doctors, nurses, and overall assessment. Issues with patient communication, particularly regarding understanding of ED procedures, were found to be a strong predictor of negative ratings of doctors, nurses, and overall care. These findings point to the improvements in communication as a potential point of intervention in mitigating negative patient experiences.
医疗机构使用Press Ganey调查数据来了解患者在急诊科（ED）的体验。本混合方法回顾性队列研究考察了在走廊安置、疼痛管理报告、沟通方式、在急诊科的停留时间以及其他人口统计学变量对预测患者对医生、护士及整体急诊科护理满意度评级方面的影响。对2012年1月1日至2017年12月31日期间来自一所学术机构和三级护理中心附属的两家急诊科的共4940份患者回复进行了分析。采用共识编码定性获取与护理/同理心相关的沟通问题以及对急诊科程序理解方面的患者回复。在控制了多个因素后，走廊安置、疼痛管理以及对急诊科程序的理解与对医生、护士及整体评估的负面评级几率较高相关。发现患者沟通问题，尤其是在对急诊科程序理解方面的问题，是对医生、护士及整体护理负面评级的有力预测因素。这些发现表明改善沟通是减轻负面患者体验的一个潜在干预点。
