Use of a Semi-Automatic Text Message System to Improve Satisfaction with Wait Time in the Adult Emergency Department: A Cross-Sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Frederic Ehrler ◽  
Jessica Rochat ◽  
Johan Nicolas Siebert ◽  
Idris Guessous ◽  
Christian Lovis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Text Message ◽  
Wait Time ◽  
Cross Sectional Survey ◽  
Waiting Room ◽  
Cross Sectional ◽  
Hospital Acquired Infection ◽  
Hospital Acquired ◽  
Automatic Text

BACKGROUND Many factors influence patient satisfaction during an emergency department (ED) visit, but the perception of the waiting time plays a central role. A long wait time in the waiting room increases the risk of hospital-acquired infection, as well as the risk of a patient leaving before being seen by a physician, particularly those with a lower level of urgency who may have to wait for a longer time. OBJECTIVE We aimed to improve the perception of waiting time through the implementation of a semi-automatic text message (SMS) system that allows patients to wait outside the hospital and facilitates the recall of patients closer to the scheduled time of meeting with the physician. METHODS We performed a cross-sectional survey to evaluate the system using a tailored questionnaire to assess the patient perspective and the Unified Theory of Acceptance and Use of Technology questionnaire (UTAUT) for the caregiver perspective. We also monitored the frequency of system use with logs. RESULTS In total, 110 usable responses were collected (patients, 100; caregivers, 10). Findings revealed a very high level of patient satisfaction (97%), with most patients waiting outside the ED, but inside the hospital. Caregiver evaluation showed that it was very easy to use, but adoption of the system was more problematic because of the perceived additional workload associated with its use. CONCLUSIONS Although not suitable for all patients, our system allows those with a low severity sign to wait outside the waiting room and to be recalled according to the dedicated time defined in the Swiss Emergency Triage Scale. It not only reduces the risk of hospital-acquired infection, but also improves the patient experience and was perceived as a real improvement. Further automation of the system needs to be explored in order to reduce caregiver workload and increase its utilization.

scholarly journals Are Further Interventions Needed to Prevent and Manage Hospital-Acquired Hyponatraemia? A Nationwide Cross-Sectional Survey of IV Fluid Prescribing Practices

2020 ◽  
Vol 9 (9) ◽  
pp. 2790
Author(s):  
Per Sindahl ◽  
Christian Overgaard-Steensen ◽  
Helle Wallach-Kildemoes ◽  
Marie Louise De Bruin ◽  
Hubert GM Leufkens ◽  
...  
Keyword(s):  
Emergency Department ◽  
Inappropriate Prescribing ◽  
Plasma Sodium ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Scenarios ◽  
Hypotonic Fluids ◽  
Hospital Acquired ◽  
The Impact

Background: Hyponatraemia is associated with increased morbidity, increased mortality and is frequently hospital-acquired due to inappropriate administration of hypotonic fluids. Despite several attempts to minimise the risk, knowledge is lacking as to whether inappropriate prescribing practice continues to be a concern. Methods: A cross-sectional survey was performed in Danish emergency department physicians in spring 2019. Prescribing practices were assessed by means of four clinical scenarios commonly encountered in the emergency department. Thirteen multiple-choice questions were used to measure knowledge. Results: 201 physicians responded corresponding to 55.4% of the total population of physicians working at emergency departments in Denmark. About a quarter reported that they would use hypotonic fluids in patients with increased intracranial pressure and 29.4% would use hypotonic maintenance fluids in children, both of which are against guideline recommendations. Also, 29.4% selected the correct fluid, a 3% hypertonic saline solution, for a patient with hyponatraemia and severe neurological symptoms, which is a medical emergency. Most physicians were unaware of the impact of hypotonic fluids on plasma sodium in acutely ill patients. Conclusion: Inappropriate prescribing practices and limited knowledge of a large number of physicians calls for further interventions to minimise the risk of hospital-acquired hyponatraemia.

scholarly journals Does a waiting room video about what to expect during an emergency department visit improve patient satisfaction?

CJEM ◽  
2008 ◽  
Vol 10 (04) ◽  
pp. 347-354 ◽  
Author(s):  
Linda Papa ◽  
David C. Seaberg ◽  
Elizabeth Rees ◽  
Kevin Ferguson ◽  
Richard Stair ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Outpatient Clinic ◽  
Process Of Care ◽  
Waiting Room ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The Mean ◽  
Referral Line ◽  
Room Time

ABSTRACT Objective: We created an instructional waiting room video that explained what patients should expect during their emergency department (ED) visit and sought to determine whether preparing patients using this video would 1) improve satisfaction, 2) decrease perceived waiting room times and 3) increase calls to an outpatient referral line in an ambulatory population. Methods: This serial cross-sectional study took place over a period of 2 months before (control) and 2 months after the introduction of an educational waiting room video that described a typical patient visit to our ED. We enrolled a convenience sample of adult patients or parents of pediatric patients who were triaged to the ED waiting room; a research assistant distributed and collected the surveys as patients were being discharged after treatment. Subjects were excluded if they were admitted. The primary outcome was overall satisfaction measured on a 5-point Likert scale, and secondary outcomes included perceived waiting room time, and the number of outpatient referral-line calls. Results: There were 1132 subjects surveyed: 551 prevideo and 581 postvideo. The mean age was 38 years (standard deviation [SD] 18), 61% were female and the mean ED length of stay was 5.9 hours (SD 3.6). Satisfaction scores were significantly higher postvideo, with 65% of participants ranking their visit as either “excellent” or “very good,” compared with 58.1% in the prevideo group (p = 0.019); however, perceived waiting room time was not significantly different between the groups (p = 0.24). Patient calls to our specialty outpatient clinic referral line increased from 1.5 per month (95% confidence interval [CI] 0.58–2.42) to 4.5 per month (95% CI 1.19–7.18) (p = 0.032). After adjusting for possible covariates, the most significant determinants of overall satisfaction were perceived waiting room time (odds ratio [OR] 0.41, 95% CI 0.34–0.48) and having seen the ED waiting room video (OR 1.41, 95% CI 1.06–1.86). Conclusion: Preparing patients for their ED experience by describing the ED process of care through a waiting room video can improve ED patient satisfaction and the knowledge of outpatient clinic resources in an ambulatory population. Future studies should research the implementation of this educational intervention in a randomized fashion.

scholarly journals Prevalence, risk factors and sources of anxiety among Emergency Department healthcare workers in Pakistan during COVID-19 pandemic: A single center survey

2021 ◽  
Vol 2 ◽  
Author(s):  
N. Haroon ◽  
S. S. Owais ◽  
A. S. Khan ◽  
J. Amin
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Health Care Providers ◽  
Healthcare Workers ◽  
Work Performance ◽  
Nonparametric Tests ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frontline Workers

Summary COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.

scholarly journals The Comparison of Role Conflict Among Registered Nurses and Registered Practical Nurses Working in Acute Care Hospitals in Ontario Canada

2021 ◽  
pp. 084456212110144
Author(s):  
Behdin Nowrouzi-Kia ◽  
Mary T. Fox ◽  
Souraya Sidani ◽  
Sherry Dahlke ◽  
Deborah Tregunno
Keyword(s):  
Emergency Department ◽  
Role Conflict ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Cross Sectional Survey ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Medical Unit ◽  
Scale Scores ◽  
Surgical Unit

Objectives The study aimed to describe and compare nurses’ perceptions of role conflict by professional designation [registered nurse (RN) vs registered practical nurse (RPN)] in three primary areas of practice (emergency department, medical unit, and surgical unit). Methods This analysis used data (n = 1,981) from a large cross-sectional survey of a random sample of RNs and RPNs working as staff nurses in acute care hospitals in Ontario, Canada. Role conflict was measured by the Role Conflict Scale. Results A total of 1,981 participants (RN = 1,427, RPN = 554) met this study’s eligibility criteria and provided complete data. In general, RN and RPN mean total scale scores on role conflict hovered around the scale’s mid-point (2.72 to 3.22); however, RNs reported a higher mean score than RPNs in the emergency department (3.22 vs. 2.81), medical unit (2.95 vs 2.81) and surgical unit (2.90 vs 2.72). Where statistically significant differences were found, the effect sizes were negligible to medium in magnitude with the largest differences noted between RNs and RPNs working in the emergency department. Conclusions The results suggest the need to implement strategies that diminish role conflict for both RNs and RPNs.

Current Models for Inpatient and Emergency Room Ophthalmology Consultation in U.S. Residency Programs

2020 ◽  
Vol 12 (02) ◽  
pp. e171-e174
Author(s):  
Donna H. Kim ◽  
Dongseok Choi ◽  
Thomas S. Hwang
Keyword(s):  
Emergency Department ◽  
Medical Education ◽  
Emergency Room ◽  
Program Directors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Direct Supervision ◽  
Residency Programs ◽  
Residency Program Directors ◽  
Competency Assessments

Abstract Objective This article examines models of patient care and supervision for hospital-based ophthalmology consultation in teaching institutions. Design This is a cross-sectional survey. Methods An anonymous survey was distributed to residency program directors at 119 Accreditation Council for Graduated Medical Education accredited U.S. ophthalmology programs in the spring of 2018. Survey questions covered consult volume, rotational schedules of staffing providers, methods of supervision (direct vs. indirect), and utilization of consult-dedicated didactics and resident competency assessments. Results Of the 119 program directors, 48 (41%) completed the survey. Programs most frequently reported receiving 4 to 6 consults per day from the emergency department (27, 55.1%) and 4 to 6 consults per day from inpatient services (26, 53.1%). Forty-seven percent of programs reported that postgraduate year one (PGY-1) or PGY-2 residents on a dedicated consult rotation initially evaluate patients. Supervising faculty backgrounds included neuro-ophthalmology, cornea, comprehensive, or a designated chief of service. Staffing responsibility is typically shared by multiple faculty on a daily or weekly rotation. Direct supervision was provided for fewer of emergency room consults (1–30%) than for inpatient consults (71–99%). The majority of programs reported no dedicated didactics for consultation activities (27, 55.1%) or formal assessment for proficiency (33, 67.4%) prior to the initiation of call-related activities without direct supervision. Billing submission for consults was inconsistent and many consults may go financially uncompensated (18, 36.7%). Conclusion The majority of hospital-based ophthalmic consultation at academic centers is provided by a rotating pool of physicians supervising a lower level resident. Few programs validate increased levels of graduated independence using specific assessments.

Hospital-acquired infection awareness and control practices among healthcare staff: an evaluation

2021 ◽  
Vol 27 (11) ◽  
pp. 296-302
Author(s):  
Pallavi Saraswat ◽  
Rajnarayan R Tiwari ◽  
Muralidhar Varma ◽  
Sameer Phadnis ◽  
Monica Sindhu
Keyword(s):  
Infection Control ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Control Measures ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Control Policies ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Background/Aims Hospital-acquired infections pose a risk to the wellbeing of both patients and staff. They are largely preventable, particularly if hospital staff have adequate knowledge of and adherence to infection control policies. This study aimed to assess the knowledge, awareness and practice of hospital-acquired infection control measures among hospital staff. Methods A cross-sectional study was conducted among 71 staff members in a tertiary healthcare facility in Karnataka, India. The researchers distributed a questionnaire containing 33 questions regarding knowledge of hospital-acquired infections, awareness of infection control policies and adherence to control practices. The results were analysed using the Statistical Package for the Social Sciences, version 16.0 and a Kruskal–Wallis test. Results Respondents' mean percentage score on the knowledge of hospital-acquired infections section was 72%. Their mean percentage scores on the awareness and practice of infection prevention measures sections were 82% and 77% respectively. Doctors and those with more years of experience typically scored higher. Conclusion The respondents had an acceptable level of knowledge, awareness and adherence to infection control practices. However, continued training is essential in the prevention of hospital-acquired infections. The majority of the respondents stated that they were willing to undertake training in this area, and this opportunity should be provided in order to improve infection control quality.

Relationship between the Responsiveness of Service Providers with Patient Satisfaction at Three Conventional Radiography Services in Denpasar

2016 ◽  
pp. 75
Author(s):  
Cokorda Istri Ariwidyastuti ◽  
P.P. Januraga ◽  
Dyah Pradnyaparamita Duarsa
Keyword(s):  
Patient Satisfaction ◽  
Service Providers ◽  
Univariate Analysis ◽  
Conventional Radiography ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
The Relationship

Background and purpose: Patient satisfaction, including on radiography services, is an important component of health care provision. Surveys on patient satisfaction have been carried out particularly in government hospitals, but a more detailed study to determine the relationship between patient satisfaction with the responsiveness of service providers has yet to be carried out. This study aims to determine the relationship between the six domains of responsiveness of service providers and outpatient satisfaction at three conventional radiography facilities in Denpasar.Methods: Study was conducted by cross-sectional survey of 158 respondents selected consecutively in three conventional radiography services, namely a government hospital, a private hospital and a private radiology clinic. Data were collected through interviews using modified questionnaires on responsiveness from WHO. Data were analyzed by univariate, bivariate (chi-square test) and multivariate logistic regression method.Results: Univariate analysis indicated that patient satisfaction was 69% but still below the minimum service standards (>80,0%). Multivariate analysis showed that factors associated with satisfaction were the domain of attention (AOR= 3.77; 95%CI: 1.62-8.76), the quality of infrastructure (AOR=4.57; 95%CI: 1.61-12.93) and communication (AOR=6.30; 95%CI: 1.75-22.64).Conclusion: Patient satisfaction was generally still below the standard. Domains of responsiveness associated with patient satisfaction were the quality of infrastructure, level of attention and communication skills of service providers.

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