scholarly journals Inappropriate Antibiotic Prescribing for Respiratory Conditions Does Not Improve Press Ganey Patient Satisfaction Scores in the Emergency Department

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Michael S Pulia ◽  
Steven Hesse ◽  
Rebecca J Schwei ◽  
Lucas T Schulz ◽  
Ajay Sethi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Respiratory Tract ◽  
Satisfaction Score ◽  
Antibiotic Prescribing ◽  
Score Distribution ◽  
Electronic Health Record Data ◽  
Data Set ◽  
Patient Satisfaction Score ◽  
Patient Satisfaction Scores

Abstract Background The literature has mixed results regarding the relationship between antibiotic prescribing and patient satisfaction in the emergency department (ED) for antibiotic-inappropriate respiratory diagnoses. The objective of the study was to determine if ED patients who receive nonindicated antibiotic prescriptions for respiratory tract conditions have increased Press Ganey patient satisfaction scores compared with those who do not receive antibiotics. Methods This was a retrospective observational study. Using an administrative electronic health record data set from 2 EDs in the Midwest, we identified 619 ED encounters resulting in discharge for antibiotic-inappropriate respiratory diagnoses with a corresponding Press Ganey patient satisfaction survey. We compared sociodemographics, encounter variables, and overall Press Ganey patient satisfaction scores between those who did and did not receive antibiotics. We analyzed Press Ganey scores by categorical score distribution and as a dichotomized scale of top box (5) vs other scores. A logistic regression estimated the odds of a top box Press Ganey patient satisfaction score based on antibiotic prescribing while controlling for other covariates. Results In the final sample, 158 (26%) encounters involving antibiotic-inappropriate respiratory diagnoses involved an antibiotic prescription. There were no differences in sociodemographic, encounter or categorical, or top box Press Ganey overall patient satisfaction scores between the groups that did and did not receive inappropriate antibiotics. In the fully adjusted regression model, antibiotic prescriptions were not associated with increased odds of top box Press Ganey patient satisfaction score (odds ratio, 0.78; 95% CI, 0.53–1.14). Conclusions Our findings suggest that nonindicated antibiotic prescribing for respiratory tract conditions is not a primary driver of overall Press Ganey scores in the ED.

scholarly journals Assessment patient satisfaction towards emergency medical care and its determinants at Ayder comprehensive specialized hospital, Mekelle, Northern Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0243764
Author(s):  
Goitom Molalign Takele ◽  
Negash Abreha Weldesenbet ◽  
Nahom Girmay ◽  
Habtamu Degefe ◽  
Rigbe Kinfe
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Emergency Room ◽  
Medical Care ◽  
Waiting Time ◽  
Satisfaction Score ◽  
Emergency Medical Care ◽  
Patient Satisfaction Score ◽  
Factors Associated ◽  
Emergency Medical

Background As the healthcare industry shifts toward patient-centered models, providers will need to fully understand patient satisfaction and how they affect their practices. This study aimed to assess patient satisfaction towards the emergency medical care and factors associated with at Ayder specialized comprehensive hospital, Emergency room, Mekelle, Ethiopia. Methods An institution-based cross-sectional study was conducted from March 1–30, 2019. A systematic random sampling method was used to enroll 299 study participants. Data were collected using a standard Brief Emergency Department Patient Satisfaction Scale questionnaire by trained data collectors. Data was entered into EpiData 3.1 then exported and analyzed by SPSS version 22. Binary and multiple logistic regression were used to assess the factors associated with patient satisfaction. Where the p-value of <0.05 was considered significant. Results A total of 299 participants were enrolled in the study with a response rate of 99.3%. On overall patient satisfaction score majority (81.9%) of them were satisfied with the emergency medical care provided. The satisfaction rate towards emergency staff courtesy, emergency room environment, physician care satisfaction, general patient satisfaction, and patient family satisfaction was 80.3%, 37.5%, 75.9%, 70.9%, and 49.8% respectively. Those who arrived during the morning time of the day tend to be satisfied more with the emergency services (AOR = 4.8, 95% CI: 2.08, 11.4), while having low educational status (able to read and write) (AOR = 0.12, 95% CI: 0.03, 0.50) and waiting time till seen by a doctor (AOR = 1.3, 95% CI: 1.003, 1.4) was found to affect patient satisfaction negatively. Conclusions The total patient satisfaction score towards emergency medical care was found to be good. The hospital management and emergency room staff should act on the identified factors especially on minimizing the patients waiting time to improve the quality of care in the emergency department.

scholarly journals Development of a combined paediatric emergency department and observation unit

2020 ◽  
Vol 9 (1) ◽  
pp. e000688
Author(s):  
Czer Anthoney Enriquez Lim ◽  
Julie Oh ◽  
Erick Eiting ◽  
Catherine Coughlin ◽  
Yvette Calderon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Patient Satisfaction ◽  
Patient Outcomes ◽  
Close Monitoring ◽  
Observation Unit ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Patient Satisfaction Scores ◽  
Conversion Rates

BackgroundRecent trends towards more cost-efficient and patient-centred treatment are converging to provide opportunities to improve the care of children. Observation units are hospital areas dedicated to the ongoing evaluation and management of patients for a brief period of time for well-defined conditions. We describe the implementation of a paediatric observation unit (POU) adjacent to a paediatric emergency department (PED) in an urban, academic, community hospital.MethodsStaffing models were designed to provide paediatric services to patients in both the PED and POU. Admission criteria, workflow and transfer guidelines were developed. Quality improvement initiatives were undertaken and evaluated. Unit throughput, patient outcomes and patient satisfaction data were collected and analysed.ResultsOver a 2-year period, there were 24 038 patient visits to the PED. Of these, 1215 (5.1%) patients required admission. Seven hundred and seventy-seven (64.0%) of these children were admitted to the POU. One hundred and nineteen (15.3%) of these patients were subsequently converted to inpatient hospitalisation. The average length of stay (LOS) was 25.7 hours in 2017 and 26.5 hours in 2018. Ten patients returned to the PED within 72 hours of discharge from the POU and four were readmitted. Patient satisfaction scores regarding ‘likelihood to recommend’ improved from the 36th to the 92nd percentile rank over a 1-year period. Close monitoring of patient outcomes allowed for the adjustment of admission guidelines, increased unit census and optimised utilisation.ConclusionA combined PED-POU has been successful at our institution in meeting benchmark goals set for LOS and conversion rates. In addition, quality improvement interventions increased patient census and improved patient satisfaction scores while reducing the inpatient burden on the referring children’s hospital.

scholarly journals Fetomaternal outcome in high-risk parturients receiving epidural analgesia using fentanyl with ropivacaine versus iv tramadol: a comparative study

2017 ◽  
Vol 6 (7) ◽  
pp. 2836
Author(s):  
Ashima Taneja ◽  
Kamaldeep Arora ◽  
Isha Chopra ◽  
Anju Grewal ◽  
Sushree Samiksha Naik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
High Risk ◽  
Epidural Analgesia ◽  
Comparative Study ◽  
Satisfaction Score ◽  
Epidural Group ◽  
Patient Satisfaction Score ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with ropivacaine and fentanyl combination during labour is not available.Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A (iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score, and complications were recorded.Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a higher degree of satisfaction score in group B compared to group A.Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly higher in epidural group as compared to the tramadol group.

238: An Analysis of Emergency Department Observation Units Impact on Patient Satisfaction Scores

2009 ◽  
Vol 54 (3) ◽  
pp. S74-S75
Author(s):  
A. Chandra ◽  
D. Harrison ◽  
A. Boardwine ◽  
J. Villani ◽  
C. Gerardo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Observation Units ◽  
Patient Satisfaction Scores

scholarly journals COMPARING THE EFFECTS OF BUPIVACAINE AND ROPIVACAINE INSTILLATION FOR POST OPERATIVE ANALGESIA IN PATIENTS UNDERGOING LUMBER SPINE SURGERY: A PROSPECTIVE RANDOMISED DOUBLE BLIND STUDY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shashikant Sharma ◽  
T. Prabhakar ◽  
Usha Shukla ◽  
Shagufta Naaz
Keyword(s):  
Heart Rate ◽  
Patient Satisfaction ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Respiratory Rate ◽  
Visual Analogue Score ◽  
Study Groups ◽  
Satisfaction Score ◽  
Patient Satisfaction Score ◽  
Surgeon Satisfaction

As it is a comparative study of Bupivacaine and Ropivacaine therefore Ropivacaine is a long-acting amide local anaesthetic with a potentially improved safety profile when compared to bupivacaine . Ropivacaine is less lipophilic than bupivacaine and is less likely to penetrate large myelinated motor fibres, resulting in a relatively reduced motor blockade. Subject and Methods:  90 patients, who belongs to American society of Anesthesiologist grade I & II of age 18-65 years randomized into three groups (n=30). All three groups received propofol bolus 0.75mg/kg IV followed by IV infusion at 0.025 mg/kg/min. group A received Nalbuphine 50 μg/kg IV bolus, group B fentanyl 1.5 μg/kg IV bolus and group C received Dexmedetomidine infusion 1 μg/kg given over 10 min as bolus followed by 0.1 mg/kg/hr IV infusion for maintenance. Ramsay sedation score and Visual analogue scale measured for sedation and analgesia respectively at 10 minute interval for 1st hour of surgery then every 30 minutes upto the end of surgery. Desired RSS was defined 3-5. Intraoperative hemodynamic variables viz. Heart Rate (HR), Respiratory Rate (RR), Mean Arterial Pressure (MAP) and SPO2 were recorded every 10 min till the end of surgery. Recovery was assessed using Modified Aldrete Score in the recovery room. Time to achieve Aldrete recovery score of 10 was recorded. Patient satisfaction score and Surgeon satisfaction score were noted using a 7-point Likert verbal rating scale. Results: The groups were comparable with respect to demographic parameters. Ramsay sedation was significantly higher in Dexmedetomidine group (P<0.05) than Nalbuphine and fentalyl group, while Visual analogue score was comparable in all three study groups (p>0.05). Heart rate and Mean arterial pressure both significantly decreased in Dexmedetomidine group from the baseline during study period (p<0.05). Respiratory rate and SPO2 were comparable in all three groups. In this study MAP was never <60 mmhg, SPO2 was never <94% and Respiratory rate was never <12 bpm. Time to achieve modified alderate score in Dexmedetomidine (0.93±2.33 min) was significantly least as compare to Nalbuphine (1.80±2.65) & Fentanyl group (3.50±4.76) (p=0.016). Patient satisfaction score in Dexmedetomidine was significantly higher (6.53±0.44) (p=0.005). Surgeon satisfaction score in Dexmedetomidine was also significantly higher (6.73±0.52) (p=0.000). Two patients in Dexmedetomidine group had episode of bradycardia which was managed with injection Atropine 0.6 mg effectively Conclusion: From these observations and analyses of the present study, it can be inferred that: ❖ Sedation in Dexmedetomidine was acceptable when used for MAC for middle ear surgeries. ❖ Visual analogue score was similar in all three study groups. ❖ Heart rate & Mean arterial pressure in Dexmedetomidine was lower than baseline value. ❖ Changes in Respiratory rate and SPO2 were similar in all three study groups. ❖ Time to achieve Modified alderate score of 10 in group Dexmedetomidine was least, suggesting quicker recovery from anesthesia. ❖ Patient and surgeon satisfaction score in Dexmedetomidine was significantly higher. Keywords: Dexmedetomidine, Nalbuphine, Bupivacaine, Ropivacaine

scholarly journals Patient Satisfaction, Needs and Preferences Concerning Information Dispensation at the Emergency Department; A Cross-Sectional Observational Study

2021 ◽  
Author(s):  
Marank de Steenwinkel ◽  
Juanita A Haagsma ◽  
Esther C.M. van Berkel ◽  
Lotte Rozema ◽  
Pleunie P.M. Rood ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Observational Study ◽  
Medical Information ◽  
General Information ◽  
Cross Sectional ◽  
Patient Satisfaction Score ◽  
Important Indicator ◽  
Practical Information ◽  
To Receive

Abstract Background Patient satisfaction is an important indicator of emergency care quality and has been associated with information dispensation at the Emergency Department (ED). Optimal information dispensation could improve patient experience and expectations. Knowing what kind of information patients want to receive and the preferred way of information dispensation are essential to optimize information delivery at the ED. The purpose of this cross-sectional observational study was to evaluate patient satisfaction concerning information dispensation (including general, medical and practical information), the need for additional information and preferences with regards to the way of information dispensation at the ED of a teaching hospital in the Netherlands. Results423 patients (patients ≥18 years with Glasgow Coma Scale 15) were enrolled (response rate 79%). The median patient satisfaction score concerning the overall information dispensation at the ED was 7.5 on a rating scale 0-10. Shorter length of ED stay was associated with higher patient satisfaction in multivariate analysis (P<0.001). The majority of respondents was satisfied regarding medical (N=328; 78%) and general information (N =233; 55%). Patients were less satisfied regarding practical information (N =180; 43%). Respondents who indicated that they received general, medical and practical information were significantly more often satisfied compared to patients who did not receive this information (P<0.001). Two thirds (N=260; 62%) requested more general information. Half of the respondents (N=202; 48%) requested more practical information and a third (N=152; 36%) requested more medical information. The preferred way for receiving information was orally (N=189; 44.7%) or by leaflets (N=108; 25.5%).ConclusionThe majority of respondents were satisfied concerning information dispensation at the ED, especially regarding medical information. Respondents requested more general and practical information and preferred to receive the information orally or by leaflets.

scholarly journals Lumbar canal stenosis: analyzing the role of stabilization and the futility of decompression as treatment

2019 ◽  
Vol 46 (5) ◽  
pp. E7 ◽  
Author(s):  
Atul Goel ◽  
Shashi Ranjan ◽  
Abhidha Shah ◽  
Abhinandan Patil ◽  
Ravikiran Vutha
Keyword(s):  
Patient Satisfaction ◽  
Nodal Point ◽  
Satisfaction Score ◽  
Spinal Instability ◽  
Fixation Technique ◽  
Patient Satisfaction Score ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Spinal Segments

OBJECTIVEThe authors report their current experience with their previously published novel form of treatment in 70 cases of lumbar canal stenosis. The treatment consisted of only fixation of the spinal segments by the transarticular screw fixation technique. No bone, ligament, osteophyte, or disc resection was done for spinal canal and neural foraminal decompression. The proposed treatment is based on the concept that vertical instability that results in telescoping of the facets on physical activity forms the nodal point of pathogenesis of lumbar canal stenosis.METHODSDuring the period June 2014 to May 2018, 70 patients presenting with the classically described symptoms of lumbar canal stenosis were treated surgically by only fixation of involved spinal segments. Apart from clinical and radiological guides, instability was diagnosed on the basis of physical observation of the status of articulation by direct manipulation of bones of the region. The operation involved transarticular insertion of 2 or 3 screws for each articulation. The Oswestry Disability Index and visual analog scale were used to assess the patients before and after surgery and at follow-up. Additionally, a personalized patient satisfaction score was used to assess the outcome of surgery.RESULTSClinical symptomatic recovery was observed in all patients in the immediate postoperative period. During the average follow-up period, 100% of patients had varying degrees of symptomatic relief. The patient satisfaction score suggested that all patients were very satisfied with the surgical procedure. The transarticular fixation technique provided strong spinal segment fixation and a reliable ground for bone arthrodesis. No patient needed any additional modality of treatment or reoperation for recurrence of symptoms.CONCLUSIONSSpinal instability is the nodal point of pathogenesis of spinal degeneration–related lumbar canal stenosis. Only fixation of the involved spinal segments is necessary—decompression by bone or soft-tissue resection is not necessary.

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