Satisfied Patients Exiting the Emergency Department (SPEED) Study.
OBJECTIVE
Patient satisfaction has been associated with patient perceptions of emergency department (ED) wait intervals, but not necessarily actual wait intervals. The objective was to address the associations of actual versus perceived wait intervals in ED patients and the association of overall satisfaction with perceived and actual wait intervals.


METHODS
The authors performed a prospective, cross-sectional study using a volume-stratified sample of adult ED patients presenting to an urban, university teaching hospital. Patient wait intervals were monitored using a computerized tracking system. Patients were confidentially surveyed regarding their overall satisfaction with care and perceptions of wait intervals after a disposition decision was made by the treating physician. The Spearman's rho (two-tailed, alpha = 0.05) was used to evaluate the association between patient satisfaction and perceived wait intervals, estimated wait intervals, and measured wait intervals. Associations between these measures of wait intervals were similarly assessed.


RESULTS
One hundred twenty-six eligible patients (including 15 admissions) completed the survey. The median wait interval (interquartile range [IQR] was 14 (7 to 22) minutes to a room. Overall satisfaction was more strongly associated with the perception that the wait interval to a room was shorter than expected (r = 0.44; p = 0.00001) than with the estimated wait interval (r = 0.03; p = 0.97) or the measured wait interval (r = -0.06; p = 0.49). Patients had a median wait interval of 13 (3 to 26) minutes in a room until seen by a physician. Overall satisfaction was more strongly associated with the perception of the physician wait interval's being shorter than expected (r = 0.37; p = 0.00001) than with the estimated wait interval (r = -0.09; p = 0.32) or the measured wait interval (r = 0.05; p = 0.58). Similar findings were found for the total time in the ED. For both the wait for a room interval and the wait for a physician interval, the measured wait intervals were more strongly associated with the estimated wait intervals (r = 0.63 and r = 0.34, respectively) than with the perception that the wait intervals were shorter than expected (r = -0.20 and r = -0.17, respectively).


CONCLUSIONS
Efforts to improve ED patient satisfaction should focus on improving patients' perceptions that wait intervals are appropriate rather than simply shortening wait intervals per se.
Hedges
Jerris R
JR
Department of Emergency Medicine, Oregon Health Sciences University (OHSU), Portland, OR 97201-3098, USA.
Trout
Andrew
A
Magnusson
A Roy
AR
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006784:Hospitals, Teaching / Q000592:standards; D006786:Hospitals, Urban / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D009922:Oregon; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011336:Probability; D011446:Prospective Studies; D017748:Time Management