Quality Reviews® Data presented at Society for Academic Emergency Medicine 17th Annual Conference in Orlando, FL

May 25, 2017

Background: Emergency departments (EDs) assess patient satisfaction by surveying patients after discharge. Commonly-used paper methods suffer from small numbers of responses and slow data collection. We hypothesized that a short, electronically administered survey would allow collection of more responses and improve response times while capturing similar information compared with a long paper-based survey.

Methods: We received Admit-Discharge-Transfer (ADT) data of all patients seen at 6 EDs in a large urban health system over an 18-month period. We texted a link to all patients 13+ years with cell numbers either after discharge or 24 hours after check-in, inviting them to participate in a 10 question electronic survey (ES) about their ED visit. Independently, patients selected via a traditional protocol were mailed paper surveys (PS) with 43 questions about their ED visit. ES and PS respondent demographics, response numbers and times were compared with chi-square, Cramer’s V, and Mann-Whitney rank tests. Among ES and PS responses corresponding to the same visit, answers were analyzed with Spearman correlation.

Results: There were 681,072 ED visits logged via the ADT feed (excluding visits in which the patient was under 13 years, responses in which all answers were missing, and responses in which the birthdate or sex fields were missing). The ES had significantly more responses (20,663 representing 3.0% of ED visits) and significantly shorter response times (median = 1.0 day) compared to the PS (8,816 responses representing 1.3% of ED visits, median response time = 26.0 days) (P < 0.001 and P < 0.001, respectively). Both surveys oversampled females compared to males. The ES undersampled patients 65+ years and oversampled patients 25-65 years, while the PS undersampled patients 13-45 years and oversampled patients 55-90 years. Among responses to ES and PS that corresponded to the same ED visits, answers for overall score of the ED visit and likelihood of recommendation were highly correlated between the two surveys (Spearman’s rho = 0.78 and 0.80, respectively).

Conclusion: A short, electronically administered survey significantly improves response numbers and times compared to a long, paper-based survey. Key patient satisfaction indicators are highly correlated between the surveys demonstrating the concurrent validity of the shorter electronic survey.