Internal Medicine Department, Ospedale Regionale di Lugano -EOC - via Tesserete 46, Lugano, 6900, Switzerland.
Emergency Medicine Department, Ospedale Regionale di Lugano - EOC - via Tesserete 46, Lugano, 6900, Switzerland.
BMC Emerg Med. 2024 May 20;24(1):85. doi: 10.1186/s12873-024-01001-1.
It is well known that patient satisfaction with medical communication in the emergency department (ED) improves patient experience. Investing in good communication practices is highly desirable in the emergency setting. In the literature, very few studies offer evidence of effective interventions to achieve this outcome. Aim of the study is to evaluate whether encouraging emergency physicians to ask if patients have questions at the end of the visit would improve patient satisfaction with medical communication.
The physicians of two EDs in Lugano, Switzerland, were invited by various methods (mailing, newsletter, memo pens and posters, coloured bracelets etc.) to implement the new practice of asking patients if they had questions before the end of the visit. Patients discharged were consecutively enrolled. Participants completed the modified CAT-T questionnaire rating their satisfaction with medical communication from 1 (very poor) to 5 (excellent). Data such as age, means of arrival, seniority of the physician etc. were also collected. Statistical analysis was performed with Bayesian methodology. The results were compared with those of a similar study conducted one year earlier.
517 patients returned the questionnaire. Overall, patients' satisfaction with communication in the ED was very good and improved from the previous year (percentage of fully satisfied patients: 68% vs. 57%). The result is statistically significant (C: I: 51.8 - 61.3% vs. 63.9 - 71.8% p = 0.000). Younger patients (< 30 ye22ars old) were slightly less satisfied. Waiting time did not affect perception of communication.
This study implements a concrete way to improve patients' satisfaction with medical communication in the ED. The intervention targeted only one item of the CAT-T ("Encouraged me to ask questions") but it generated an overall perception of better communication from patients discharged from the ED. The study also confirms that there are some objective elements that can alter perception of quality of medical communication by patients (age, seniority of the physician), in agreement with the literature. In conclusion, focusing physicians' attention on asking patients whether they have questions before discharge helps improving overall patient satisfaction with medical communication in the ED. This may lead to changes in physicians' clinical practice.
众所周知，患者对急诊科（ED）医疗沟通的满意度提高了患者的就诊体验。在急诊环境中，高度重视良好沟通实践是非常可取的。在文献中，很少有研究提供有效的干预措施来实现这一结果的证据。本研究旨在评估鼓励急诊医生在就诊结束时询问患者是否有问题是否会提高患者对医疗沟通的满意度。
瑞士卢加诺的两家急诊科的医生通过各种方法（邮件、通讯、备忘录笔和海报、彩色腕带等）被邀请实施新的实践，即在就诊结束前询问患者是否有问题。连续纳入出院患者。参与者完成改良 CAT-T 问卷，从 1（非常差）到 5（极好）对医疗沟通的满意度进行评分。还收集了年龄、到达方式、医生资历等数据。采用贝叶斯方法进行统计分析。将结果与一年前进行的类似研究进行比较。
517 名患者返回了问卷。总体而言，患者对 ED 医疗沟通的满意度非常好，并且比前一年有所提高（完全满意的患者比例：68%比 57%）。结果具有统计学意义（C：I：51.8-61.3%比 63.9-71.8%，p=0.000）。年轻患者（<30 岁）满意度略低。等待时间不会影响沟通的感知。
本研究实施了一种具体的方法来提高 ED 中患者对医疗沟通的满意度。干预措施仅针对 CAT-T 的一个项目（“鼓励我提问”），但从 ED 出院的患者对沟通的整体感知得到了改善。该研究还证实，有些客观因素会改变患者对医疗沟通质量的感知（年龄、医生资历），这与文献一致。总之，关注医生在患者出院前询问他们是否有问题有助于提高 ED 中患者对医疗沟通的整体满意度。这可能会导致医生临床实践的改变。
