Patient Experience in the Emergency Department

Foundations

Patient experience is a growing area of focus in emergency medicine (EM). Increasingly, it is recognized that the traditional paradigm defining adequate care in the emergency department (ED) as providing the right diagnosis and medical management no longer suffices. Instead, there is a growing appreciation for the importance of providing a high-quality experience for patients that encompasses many aspects of their care in addition to their medical management. In addition, there is a new understanding that patient experience is a key driver of best care and is integral to many of the shared goals of both patients and health care providers. To that end, regulatory bodies have begun to embrace the importance of patient experience, and a new Center for Medicare and Medicaid Services (CMS) measure of patient experience in the ED, the Emergency Department Patient Experiences with Care (EDPEC) Survey, is currently under development.

One impetus for increased focus on ED patient experience stems from the growing body of literature linking superior patient experience to important health outcomes. Optimal emergency clinician empathy and communication skill has been shown to impact composite outcomes such as health-related quality of life, various pain scores, anxiety, depression, as well as specific disease conditions such as asthma, blood pressure, diabetes, osteoarthritis, and weight loss. In addition to these important health outcomes, ED patient experience is also linked to staff experience and satisfaction, including staff burnout, prompting some to refer to these themes as “flip sides of the same coin.” ^, For example, poor patient experience has been shown to increase patient complaint frequency and malpractice risk; at the same time, physician burnout has been associated with suboptimal patient care, and poor patient experience. On the other end of the spectrum, optimal patient experiences and positive patient feedback can reduce depersonalization and emotional exhaustion, and increase joy at work.

Specific Issues