SVP/ Chief Regional Officer - Northwest Region at AMITA Health

Dissertation Title

The relationship between emergency department wait times and inpatient satisfaction.

Dissertation Abstract

This study examined patient perceptions of emergency department wait times and inpatient experiences. In many organizations across the country, the emergency department is now the "front door" to the hospital; therefore, understanding the impact of the ED experience on the inpatient experience is a critical aspect for leaders managing these complex settings in our hospitals today.

The Expectancy-Disconfirmation theory was utilized as a framework to examine six hypotheses regarding patient experiences in the emergency department as well as the inpatient unit in relation to the following: (1) patient actual emergency department wait times, (2) patient perceived ratings of ED wait times, (3) whether a positive emergency department experience influenced the inpatient experience, and (4) patient lengths of stay when admitted as inpatients. Data were utilized from actual patient responses from mailed inpatient surveys based on "very good" responses regarding patient inpatient experiences, emergency department experiences, and patient perceptions of emergency department wait times. Actual ED wait times were calculated from electronic medical records. Patient total lengths of stay were calculated from the time patients entered the ED until discharged from the inpatient unit.

Results showed statistically significant relationships between a very good ED experience and a very good inpatient experience. Perceived wait times in the ED, more so than actual ED wait times served as a predictor of a very good ED rating as well as a very good rating of the inpatient experience. As theorized, length of hospitalization was not a statistically significant predictor of influence on a very good rating of the inpatient experience for patients having a length of stay of less than four days. Length of stay had no influence on a very good rating in this sample.

As health care reimbursement continues to be tied to patient satisfaction, this quantitative study can serve as basis for leaders to improve processes in the ED to address patient perceptions of wait times as well as processes that influence actual emergency department wait times.