title: Determinants of patient satisfaction in an Australian emergency department fast-track setting.
abstract: OBJECTIVE
  To describe the relationship between waiting time and patient satisfaction, and to determine predictors of overall care rating in an emergency department (ED) fast-track setting.
  
  
  METHODS
  A convenience sample of patients triaged to a fast-track unit were surveyed. Patient satisfaction was scored using a validated survey instrument, as well as a single overall care rating (poor to excellent). Median satisfaction scores were compared between each incremental hour of waiting time. Bivariate analysis was conducted between those who waited 1 h or less, and those who waited longer. Ordered logistic regression was used to determine predictors of improved overall care rating.
  
  
  RESULTS
  236 patients completed surveys (response rate of 74%). Of these, 84% rated their care as either very good or excellent. There was a linear decrease in median satisfaction scores for each incremental hour of waiting time associated with half the odds of higher overall care rating after adjusting for presenting problem type, triage category, and treating clinician type (OR 0.53 95% CI 0.37 to 0.75 p<0.001). English language (OR 2.43 95% CI 1.33 to 4.42 p=0.004) and initial consultation by a nurse practitioner (NP) (OR 1.81 95% CI 1.03 to 3.31 p=0.038) were also found to be significant predictors of improved overall care rating.
  
  
  CONCLUSIONS
  Waiting time was found to be highly predictive of patient satisfaction in an emergency fast-track unit with English language and NPs also associated with improved overall care rating. Future measures to improve patient satisfaction in fast-track units should focus on these factors.
authors.affiliation: Emergency Department, Registrar Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. dinh.mm@gmail.com
authors.forename: Michael M
authors.initials: MM
authors.lastname: Dinh
authors.forename: Nicholas
authors.initials: N
authors.lastname: Enright
authors.forename: Andrew
authors.initials: A
authors.lastname: Walker
authors.forename: Ahilan
authors.initials: A
authors.lastname: Parameswaran
authors.forename: Matthew
authors.initials: M
authors.lastname: Chu
mesh_terms: D000328:Adult; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D014218:Triage / Q000458:organization & administration*; D014850:Waiting Lists
keywords: emergency care systems, primary care