title: The effects of a physician-nurse patient care team on patient satisfaction in an academic ED.
abstract: The objectives were to investigate the effects of a RN/MD patient care team operational change on ED patient satisfaction. In period 1, RNs had standard room assignments and MDs evaluated patients based upon physician availability and perceived patient load. In period 2, RNs and MDs were organized into 2 patient care "teams" and patients were assigned to teams on an alternating basis. Patient satisfaction was rated using the standard ED Press, Ganey survey instrument. A total of 508 surveys were returned in period 1 and 454 in period 2. From period 1 to 2, overall ED patient satisfaction improved from 78.2 +/- 20.4% to 82.2 +/- 17.2% (improvement from 23rd to 59th percentile, P <or=.01). Patient satisfaction with waiting time to treatment area improved from the 33rd to 52nd percentile (73.6 +/- 30.0% v 77.4 +/- 27.0%, P <or=.05). Satisfaction with waiting time to see the physician also improved from the 25th to the 62nd percentile (67.6 +/- 32.2% v 73.4 +/- 28.5%, P <or=.01). Patients feelings that staff cared about them as a person improved from the 20th to the 65th percentile (77.3 +/- 28.3% v 83.0 +/- 22.4%, P <or=.01) Patients were more likely to recommend the ED following the operational change, improving from the 26th to 69th percentile (75.8 +/- 32.7% v 82.83 +/- 25.3%, P <or=.01). ED patient care using a RN/MD patient care team improved patients' overall waiting time and length of stay satisfaction and improved the patients' satisfaction with staff and their likelihood of recommending the ED to others.
authors.affiliation: Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA. ddebehnk@mcw.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Debehnke
authors.forename: M Chris
authors.initials: MC
authors.lastname: Decker
mesh_terms: D000046:Academic Medical Centers; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019555:Physician-Nurse Relations; D011446:Prospective Studies; D014218:Triage; D014481:United States