A Conceptual Model for Emergency Department Patient Experience.

Emergency department (ED) patient experience continues to be a growing area of focus for ED physicians, administrators, and regulatory agencies. Recent literature has suggested a strong correlation between positive ratings of patient experience and important health system goals, including improved clinical outcomes and care quality, increased staff satisfaction, and reduced medicolegal risk. However, given the myriad of factors driving ED patient experience, identifying effective and synergistic interventions can present a challenge, especially in the setting of limited ED resources. Utilizing the themes identified in a recent systematic review of the ED patient experience literature, we developed a conceptual "logic model" of ED patient experience in order to provide a broadly applicable framework for practical intervention and to guide further study of ED patient experience interventions. The logic model was modified in an iterative fashion through review by local patient and staff groups as well as a national interest group until arriving at the current, comprehensive version. Here, we describe the creation of the logic model and, with the aim of providing a framework for readers to develop similar models for their practice settings, provide a case discussion of its use by an ED medical director.

Training to Improve Communication Quality: An Efficient Interdisciplinary Experience for Emergency Department Clinicians.

Patient-provider communication has been recognized as a critical area of focus for improved health care quality, with a mounting body of evidence tying patient satisfaction and provider communication to important health care outcomes. Despite this, few programs have been studied in the emergency department (ED) setting. The authors designed a communication curriculum and conducted trainings for all ED clinical staff. Although only 72% of clinicians believed the course would be a valuable use of their time before taking it, 97% reported that it was a valuable use of their time after ( P < .001). Pre-course self-evaluation of knowledge, skill, and ability were high. Despite this, post-course self-efficacy improved statistically significantly. This study suggests that it is possible, in a brief training session, to deliver communication content that participants felt was relevant to their practice, improved their skills and knowledge, changed their attitude, and was perceived to be a valuable use of their time.