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Patients' satisfaction and wait times at Guelph General Hospital Emergency Department before and after implementation of a process improvement project

Published online by Cambridge University Press:  11 May 2015

Michèle Preyde ,
Kim Crawford  and
Laura Mullins
Michèle Preyde*
Affiliation:
College of Social and Applied Human Sciences, University of Guelph
Kim Crawford
Affiliation:
Ambulatory Care and the Emergency Department, Guelph General Hospital, Guelph, ON
Laura Mullins
Affiliation:
College of Social and Applied Human Sciences, University of Guelph
*
College of Social and Applied Human Sciences, University of Guelph, Guelph, ON N1G 2W1; [email protected]

Abstract

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Objective:

A process improvement program (PIP) was implemented in the emergency department (ED) at Guelph General Hospital in July 2009. The purpose of this study was to examine patients' satisfaction and wait times by level of Canadian Triage and Acuity Scale (CTAS) score before and 6 months after implementation of this program.

Methods:

Two samples were recruited: one was recruited before implementation of the PIP, January to June 2009 (T1), and one was recruited 6 months after implementation, January to June 2010 (T2). Patients were contacted by telephone to administer a survey including patient satisfaction with quality of care. Time to physician initial assessment, numbers left without being seen, and length of stay (LOS) were obtained from hospital records to compare wait times before and 6 months after implementation of the PIP.

Results:

Patients (n = 301) reported shorter wait times after implementation (e.g., 12% reported seeing a physician right away at T1 compared to 29% at T2). Time to physician initial assessment improved for patients with CTAS scores of III, IV, and V (average decrease from 2.1 to 1.7 hours), fewer patients (n = 425) left without being seen after implementation, and the mean and 90th percentile of LOS decreased for all patients except the mean LOS for discharged patients with a CTAS score of I. Total time spent in the ED for admitted patients decreased from 11.11 hours in the 2009 period to 9.95 in the 2010 period, and for nonadmitted patients, the total time decreased from 3.94 to 3.29 hours. The overall satisfaction score improved from a mean of 3.17 to 3.4 (of 4; p < 0.001).

Conclusion:

Implementation of the ED PIP corresponded with decreased wait times, increased patient satisfaction, and improved patient flow for patients with CTAS scores of III, IV, and V.

Keywords

emergency department patient flowlength of staynumbers left without being seenpatient satisfactionphysician initial assessmentprocess improvementwait times
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 14 , Issue 3 , March 2012 , pp. 157 - 168
Copyright
Copyright © Canadian Association of Emergency Physicians 2012

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