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International Journal for Quality in Health Care Advance Access published online on March 14, 2006
International Journal for Quality in Health Care, doi:10.1093/intqhc/mzl002
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© The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Accepted February 15, 2006

Article

A multifaceted intervention improves patient satisfaction and perceptions of emergency department care

David Taylor 1 *, Marcus P. Kennedy 2, Elizabeth Virtue 2, and Geraldine Mcdonald 3

1 Department of Emergency Medicine, Royal Melbourne Hospital, Grattan St, Parkville, Victoria 3050, Australia
2 Emergency Department, Parkville, Victoria, Australia
3 Royal Melbourne Hospital, Parkville, Victoria, Australia

* To whom correspondence should be addressed.
David Taylor, E-mail: david.taylor{at}mh.org.au


  Abstract

Objectives. We aimed to evaluate the effectiveness of a multifaceted intervention, targeting staff-patient communication, in improving emergency department patient satisfaction.

Methods. We undertook a pre- and post-intervention study in a university-affiliated emergency department, over a 12-month period. The intervention included communication workshops, a patient education film, and a patient liaison nurse. At the patient level, the patient liaison nurse ensured optimal staff-patient community communication and played a role in staff communication education. The intervention was evaluated using patient surveys (containing general and communication-specific satisfaction items scored out of 100), complaint rates, and patient liaison nurse activity data.

Results. A total of 321 and 545 patients returned questionnaires in the pre- and post-intervention periods, respectively. Significant improvements were observed in patients’ perceptions of being ‘informed about delays’ [score difference, 5.3; 95% confidence interval (CI), 0.6-10.0], that ‘staff cared about them as a person’ (difference, 4.4; 95% CI, 0.7-8.1), the overall emergency department facility assessment (difference, 3.9; 95% CI, 0.4-7.5) and overall emergency department care (difference, 3.8; 95% CI, 0.3-7.3). Non-significant improvements were seen in all other satisfaction items. In the post-intervention period, there was a 22.5% (95% CI, 14.6-32.8) decrease in the number of complaints received and a decrease in the complaint rate of 0.7 (95% CI, -0.3 to 1.6) complaints per 1000 patients. The patient liaison nurse activities included orientation of the patient including (i) explanation of tests, procedures, and delays; (ii) communication with a range of hospital staff; and (iii) general comfort measures including analgesia quality control.

Conclusion. Significant improvements in a variety of patient satisfaction measures were achieved with an intervention comprising staff communication workshops, a patient education film, and a patient liaison nurse.

Keywords: communication, complaints, emergency department, satisfaction.
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