Keys to patient satisfaction in the emergency department: results of a multiple facility study

Patient satisfaction is a significant issue for emergency departments. The special nature of the emergency encounter calls for a sound understanding of the factors that influence patient satisfaction. This study uses a national sample of emergency departments to identify specific elements that increase the likelihood of patients recommending the facility. We find that demographic variables such as age and sex do not significantly influence the decision to recommend. Nursing/staff items, physician issues, and waiting time are the key factors that drive satisfaction with emergency departments.

Patient satisfaction and the cost/quality equation

Measuring patient satisfaction with health care treatment and delivery and making necessary adjustments can pay back big dividends to employers, payers, and providers in the form of cost savings and improved quality of care.

Satisfied patients can spell financial well-being

As a healthcare performance indicator, patient satisfaction may be overlooked by providers that regard patients' perceptions as evidence of service quality rather than quality of care. Because a patient's trust in caregivers and overall attitude toward care received may affect outcome, however, healthcare providers are paying more attention to interpersonal issues of care delivery. Meanwhile, changes in the industry, such as increased competition, consumerism, and demand for accountability, mean patient satisfaction can contribute to a healthcare organization's bottom line.

Levels of explanation and cautions for a critical clinical anthropology

The appearance of a critical approach to clinical anthropology raises a question of relevance. Critical medical anthropology itself has developed with a primary concern for the impact of capitalism on Third World health, the inequality of medical resource distribution both in the U.S. and abroad, and the hegemony of Western biomedicine over local medical systems. Such an orientation may be of but modest relevance for an understanding of clinical phenomena in the heartland of capitalism itself. In the U.S., both patients and clinicians tend to share multiple values, including commitment to capitalism and the biomedical paradigm. Moreover, various negative behavioral characteristics visible in the clinical setting (such as racism) are common outside medicine, and may not be profitably understood through usual critical orientations. A heuristic model that gives excessive weight to a single element (capitalism) of a single (macro) level of explanation may not be as useful as one that utilizes a multi-level, multi-element approach. The argument is made that such a broader, more holistic approach may offer greater understanding of so-called micro level processes--specifically the patient/clinician interaction in specific clinical settings. An example is provided from a midwest hospital. It is suggested that if change in the biomedical system is a goal of a critical clinical anthropology, the impact will be greater where objective and broad causal connections can be demonstrated with minimal use of rote or polemic arguments.