title: What do patients say about emergency departments in online reviews? A qualitative study.
abstract: BACKGROUND
  Patients have adopted web-based tools to report on the quality of their healthcare experiences. We seek to examine online reviews for US emergency departments (EDs) posted on Yelp, a popular consumer ratings website.
  
  
  METHODS
  We conducted a qualitative analysis of unstructured, publicly accessible reviews for hospitals available on http://www.yelp.com. We collected all reviews describing experiences of ED care for a stratified random sample of 100 US hospitals. We analysed the content of the reviews using themes derived from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) inpatient care survey. We also used modified grounded theory to iteratively code the text of the reviews, identifying additional themes specific to emergency care. The data were double-coded, and discrepancies were evaluated to ensure consensus.
  
  
  RESULTS
  Of the 1736 total reviews, 573 (33%) described patient experiences involving the ED. The reviews contained several themes assessed by the HCAHPS survey, including communication with nurses, communication with doctors, and pain control. The reviews also contained key themes specific to emergency care: waiting and efficiency; decisions to seek care in the ED; and events following discharge, including administrative difficulties.
  
  
  CONCLUSIONS
  These exploratory findings suggest that online reviews for EDs contain similar themes to survey-based assessments of inpatient hospital care as well as themes specific to emergency care. Consumer rating websites allow patients to provide rapid and public feedback on their experience of medical care. Web-based platforms may offer a novel strategy for assessing patient-centred quality in emergency care.
authors.affiliation: Department of Emergency Medicine, Highland Hospital, Oakland, California, USA.
authors.forename: Austin S
authors.initials: AS
authors.lastname: Kilaru
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Zachary F
authors.initials: ZF
authors.lastname: Meisel
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Breah
authors.initials: B
authors.lastname: Paciotti
authors.affiliation: Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, Pennsylvania, USA Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Yoonhee P
authors.initials: YP
authors.lastname: Ha
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Smith
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Benjamin L
authors.identifier: http://orcid.org/0000-0002-9565-6939
authors.initials: BL
authors.lastname: Ranard
authors.affiliation: Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA Penn Medicine Social Media and Health Innovation Lab, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Raina M
authors.initials: RM
authors.lastname: Merchant
mesh_terms: D003142:Communication; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D020407:Internet; D059408:Pain Management / Q000379:methods; D017060:Patient Satisfaction; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration; D014850:Waiting Lists
keywords: Emergency department; Patient satisfaction; Patient-centred care; Qualitative research; Quality measurement