The quality perceived in Emergency departments between patients and caregivers according to waiting time: a cross sectional multicenter study
Keywords:
Attendance time, Caregiver, Emergency department, Patient, Quality PerceptionAbstract
Background and aim of the work: In recent years there has been a growing interest in risk management and the quality of services offered to the user in healthcare services, a concept that has undergone a series of changes following its diffusion, entering into all productive processes, especially in Emergency Departments (EDs). The present study aims to assess which indicators invalidate in the perception of the quality of care received by the sample, as well as how it varies according to differences in the characteristics of patients and caregivers. Methods: A multicenter, cross sectional observational study was conducted through the snowball sampling method. A link was created thanks to the Google forms platform and disseminated through the social platforms of Triage Training Group and of the University of Turin, Italy. Results: A total of 624 participants agreed to participate in this study, specifically, 390 were patients and 234 were caregivers. The quality level perception was assessed by referring to the first phases of the ED. Most of the patients interviewed considered information received at the triage phase as insufficient (15.9%) and very insufficient (5.3%), (p=0.008). Conclusions: Emerged data suggested a degree of user dissatisfaction, specifically in the triage and waiting phases, which aimed to strengthen the motivations to implement organizational solutions to decrease waiting times, not just increase a subjective feeling of satisfaction.
References
Giorgi G, Lecca LI, Alessio F, et al. COVID-19-Related Mental Health Effects in the Workplace: A Narrative Review. Int J Environ Res Public Health. 2020;17(21):7857. doi: 10.3390/ijerph17217857.
Gallo M, Panero C, Vaineri M. La segmentazione comportamentale dei pazienti non urgenti in Pronto Soccorso: specificità degli utenti frequent user ed occasionali. Economia e diritto del terziario, - FrancoAngeli Editore 2017; 29(3). [Italian].
Pearce S, Marchand T, Shannon T, Ganshorn H, Lang E. Emergency department crowding: an overview of reviews describing measures causes, and harms. Intern Emerg Med. 2023; 18(4):1137-1158. doi: 10.1007/s11739-023-03239-2. E
Salway RJ, Valenzuela R, Shoenberger JM, Mallon WK, Viccellio A. Emergency department (ED) overcrowding: evidence-based answers to frequently asked questions. Revista Médica Clínica Las Condes 2017; 28(2): 213-219.
Maillard Acker C. L’infirmier organisateur de l’accueil aux urgences, un poste en constante évolution [French]. Soins. 2018;63(825):30-33. French. doi: 10.1016/j.soin.2018.03.007.
Toscana ARS. Pronto Soccorso: Spazi, Processi, Relazioni." Una Visione Unitaria. Collana Dei Documenti Ars, 2017. [Italian].
Saban M, Dagan E, Drach-Zahavy A. The Relationship Between Mindfulness, Triage Accuracy, and Patient Satisfaction in the Emergency Department: A Moderation-Mediation Model. J Emerg Nurs. 2019; 45(6):644-660. doi: 10.1016/j.jen.2019.08.003.
Davenport PJ, O’Connor SJ, Szychowski JM, Landry AY, Hernandez SR. The Relationship between Emergency Department Wait Times and Inpatient Satisfaction. Health Marketing Quarterly 2017; 34: 97-112. doi: 10.1080/07359683.2017.1307066
Ministero della Salute- Direzione Generale della Programmazione Sanitaria. (2021). Linee di indirizzo nazionali per lo sviluppo del piano di gestione del sovraffollamento in pronto soccorso. Available from: https://www.salute.gov.it/imgs/C_17_pubblicazioni_3143_allegato.pdf Accessed on December 8, 2022.
Coluccia A, Ferretti F, Lorini F, Calamai M. Il questionario di qualità percepita (QQP). (The perceived quality questionnaire (QQP)). Mondo Sanitario 2002; 10: 14-19. (Italian).
Cochran, W.G. Sampling Techniques, 2nd Ed., New York: John Wiley and Sons, Inc, 1963.
Istituto Nazionale di Statistica (ISTAT). Indicatori demografici. Avallabile from: Popolazione residente al 1° gennaio (istat.it) Accessed on February 10, 2024. (Italian)
Fontova-Almató A, Suñer-Soler R, Juvinyà-Canal D. Factors associated with patients' and companions' satisfaction with a hospital emergency department: A descriptive, cross-sectional study. Nurs Open. 2019;6(3):834-841. doi: 10.1002/nop2.261.
D'Ettorre G, Pellicani V, Vullo A. Workplace violence against healthcare workers in Emergency Departments. A case-control study. Acta Biomed. 2019; 90(4):621-624. doi: 10.23750/abm.v90i4.7327.
D'Ettorre G, Pellicani V, Mazzotta M, Vullo A. Preventing and managing workplace violence against healthcare workers in Emergency Departments. Acta Biomed. 2018; 89(4-S):28-36. doi: 10.23750/abm.v89i4-S.7113.
Vitale E, Lupo R, Calabrò A, et al. Mapping potential risk factors in developing burnout syndrome between physicians and registered nurses suffering from an aggression in Italian Emergency departments. Journal of Psychopathology 2021; 27: 148-155. doi: 10.36148/2284-0249-425
Muñoz Del Carpio-Toia A, Begazo Muñoz Del Carpio L, Mayta-Tristan P, Alarcón-Yaquetto DE, Málaga G. Workplace Violence Against Physicians Treating COVID-19 Patients in Peru: A Cross-Sectional Study. Jt Comm J Qual Patient Saf. 2021;47(10):637-645. doi: 10.1016/j.jcjq.2021.06.002.
Pearce S, Marchand T, Shannon T, Ganshorn H, Lang E. Emergency department crowding: an overview of reviews describing measures causes, and harms. Intern Emerg Med. 2023;18(4):1137-1158. doi: 10.1007/s11739-023-03239-2.
Solakoglu GA, Aciksari K, Nuhoglu C, Doker KO. Evaluation of factors affecting the length of stay of geriatric patients in the emergency department. North Clin Istanb. 2023;10(4):444-450. doi: 10.14744/nci.2023.59319
Eidstø A, Ylä-Mattila J, Tuominen J, Huhtala H, Palomäki A, Koivistoinen T. Emergency department crowding increases 10-day mortality for non-critical patients: a retrospective observational study. Intern Emerg Med. 2023. doi: 10.1007/s11739-023-03392-8.
Peguero-Rodriguez G, Polomeno V, Backman C, Chartrand J, Lalonde M. The Experience of Families Accompanying a Senior to the Emergency Department: A Scoping Review. J Emerg Nurs. 2023; 49(4):611-630. doi: 10.1016/j.jen.2023.03.005.
Cetin-Sahin D, Ducharme F, McCusker J, et al. Experiences of an Emergency Department Visit Among Older Adults and Their Families: Qualitative Findings From a Mixed-Methods Study. J Patient Exp. 2020; 7(3):346-356. doi: 10.1177/2374373519837238
Salehi T, Nayeri ND, Mohammadi E, Mardani-Hamooleh M. Exploring patients and family members' experiences of care in the emergency department. Emerg Nurse. 2020 Sep 8;28(5):23-27. doi: 10.7748/en.2020.e2008.
Vanacore N. L’accoglienza al pronto soccorso per le persone non autosufficienti. Recenti Prog Med 2022;113(4):277-281. doi: 10.1701/3792.37769
Bagaglia C, Polcri C. Il problema degli accessi “impropri” in pronto soccorso: un’indagine antropologica. Scenario 2017; 34. [Italian].
Lupo R, De Mitri O, Merola D, et al. L’accesso improprio in Pronto Soccorso e analisi delle possibili cause: studio osservazionale. Italian Journal of Emergency Medicine 2018; 03. doi: 10.23832/ITJEM.2018.032
Bonetti M, Melani C. Il ruolo degli accessi impropri in pronto soccorso nella provincia autonoma di Bolzano. Epicentro Ben ISS. 2019 Available from: https://www.epicentro.iss.it/ben/2019/aprile/accessi-impropri-ps-bolzano Accessed on December 9, 2022.
Laskowski-Jones L. E’ un'emergenza per loro, Assistenza infermieristica 2016; 46(3): 6. doi: 10.1097/01.NURSE.0000480606.68134.19
Williams CA, Haffizulla F. Factors associated with avoidable emergency department visits in broward county, Florida. Cureus. 2021;13(6): e15593. doi: 10.7759/cureus.15593.
Bianco A, Pileggi C, Angelillo IF. Non-urgent visits to a hospital emergency department in Italy. Public Health 2003;117(4):250-5.
Bissoni G, Moirano F. Editoriale. I Quaderni di Monitor: elementi di analisi e osservazione del sistema salute. Maggio 013;32(II supplemento): 5-8. Available from: ttps://www.agenas.gov.it/images/agenas/monitor/quaderno/pdf/13_ASSISTENZA_H24.pdf Accessed on February 25, 2024.
Källberg AS, Berg LM, Skogli S, Bjurbo C, Muntlin Å, Ehrenberg A. Prevalence of frailty and associated factors in older adults seeking care at Swedish emergency departments. BMC Geriatr. 2023 Dec 4;23(1):798. doi: 10.1186/s12877-023-04545-2. Perea-Pérez B, Garrote Díaz JM, Hernández Gil Á, Martínez Hernández S, García Martín ÁF, Santiago-Sáez A. Medicina defensiva en los Servicios de Urgencias Hospitalarias [Defensive medicine in hospital emergency services.]. Rev Esp Salud Publica. 2021;95:e202106080. Spanish.
Aljohani B, Burkholder J, Tran QK, Chen C, Beisenova K, Pourmand A. Workplace violence in the emergency department: a systematic review and meta-analysis. Public Health. 2021 Jul;196:186-197. doi:10.1016/j.puhe.2021.02.009.
Sonis JD, White BA. Optimizing Patient Experience in the Emergency Department. Emerg Med Clin North Am. 2020;38(3):705-713. doi: 10.1016/j.emc.2020.04.008.
Vainieri M, Panero C, Coletta L. Waiting times in emergency departments: a resource allocation or an efficiency issue? BMC Health Serv Res. 2020; 20(1):549. doi: 10.1186/s12913-020-05417-w.
Osservatorio Nazionale sulla Salute nelle Regioni Italiane. Rapporto Osservasalute 2016. Osservatorio sulla Salute. 2017 (consultato il 31 luglio 2022). Available from: https://osservatoriosullasalute.it/osservasalute/rapporto-osservasalute-2016 Accessed on December 5, 2022.
Vitale E. Nursing perception and work effectiveness evaluation relating to a novel nursing role in the Italian scenario: the family nurse. Medicina Historica 2023; 7(3):e2023047.
Panero C, Nuti S, Marcacci L, Rosselli A. Il quaderno del Pronto Soccorso, Edizioni Polistampa, 2016. [Italian].
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Copyright (c) 2024 Roberto Lupo, Daniele Marchisio, Francesca Busto, Alessia Lezzi, Simone Zacchino, Teresa Rea, Stefano Botti, Ivan Rubbi, Giovanna Artioli, Ornella De Mitri, Antonino Calabrò, Luana Conte, Maicol Carvello, Maria Chiara Carriero, Elsa Vitale
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