title: Effect of an emergency department fast track on Press-Ganey patient satisfaction scores.
abstract: BACKGROUND
  Mandated patient surveys have become an integral part of Medicare remuneration, putting hundreds of millions of dollars in funding at risk. The Centers for Medicare & Medicaid Services (CMS) recently announced a patient experience survey for the emergency department (ED). Development of an ED Fast Track, where lower acuity patients are rapidly seen, has been shown to improve many of the metrics that CMS examines. This is the first study examining if ED Fast Track implementation affects Press-Ganey scores of patient satisfaction.
  
  
  METHODS
  We analyzed returned Press-Ganey questionnaires from all ESI 4 and 5 patients seen 11AM - 1PM, August-December 2011 (pre-fast track), and during the identical hours of fast track, August-December 2012. Raw ordinal scores were converted to continuous scores for paired student t-test analysis. We calculated an odds ratio with 100% satisfaction considered a positive response.
  
  
  RESULTS
  An academic ED with 52,000 annual visits had 140 pre-fast track and 85 fast track respondents. Implementation of a fast track significantly increased patient satisfaction with the following: wait times (68% satisfaction to 88%, OR 4.13, 95% CI [2.32-7.33]), doctor courtesy (90% to 95%, OR 1.97, 95% CI [1.04-3.73]), nurse courtesy (87% to 95%, OR 2.75, 95% CI [1.46-5.15]), pain control (79% to 87%, OR 2.13, 95% CI [1.16-3.92]), likelihood to recommend (81% to 90%, OR 2.62, 95% CI [1.42-4.83]), staff caring (82% to 91%, OR 2.82, 95% CI [1.54-5.19]), and staying informed about delays (66% to 83%, OR 3.00, 95% CI [1.65-5.44]).
  
  
  CONCLUSIONS
  Implementation of an ED Fast Track more than doubled the odds of significant improvements in Press-Ganey patient satisfaction metrics and may play an important role in improving ED performance on CMS benchmarks.
authors: Stanford University School of Medicine, Stanford/Kaiser Emergency Medicine Residency, Stanford, California.
authors: Calvin E
authors: CE
authors: Hwang
authors: Stanford University School of Medicine, Division of Emergency Medicine, Department of Surgery, Stanford, California.
authors: Grant S
authors: GS
authors: Lipman
authors: Stanford Hospital and Clinics, Department of Patient Care Services, Stanford, California.
authors: Marlena
authors: M
authors: Kane
mesh_terms: D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D019538:Health Care Surveys; D006801:Humans; D016017:Odds Ratio; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014218:Triage / Q000379:methods*; D014481:United States