Study identifies significant issues with ED patient experience measures

There are significant measurement issues with the data collected to assess the patient experience in emergency departments, according to a study published in the Annals of Emergency Medicine.

For the study, researchers examined Press Ganey patient experience data from a national sample of emergency departments compiled from 2012 to 2015. The data was composed of responses to patient satisfaction surveys designed to measure patient perceptions of providers and the ED as a whole. Analysis revealed multiple issues with the quality of the data, including high variability, low response rate and limited construct validity.

"Presumably, if a physician produces a particular experience for his or her patients, then scores should be relatively stable over time," said Arvind Venkat, MD, an emergency medicine physician with Pittsburgh-based Allegheny Health Network and one of the study's authors. "But from month-to-month, physician scores bounced around tremendously. In some cases, a physician was rated in the 20th percentile one month, then 80th percentile the next month, then in the 30th percentile. Facility scores also bounced around, but less so."

Another significant issue detected by researchers was a low response rate — 3 to 16 percent — among patients surveyed. The low response rate results in biased survey results, as patients who are either highly satisfied or highly upset about their care are more likely to respond.

"The concept of measuring patient experience and rewarding providers who deliver a better experience is absolutely right on. No one argues with that," said Jesse Pines, MD, professor of emergency medicine at the George Washington University School of Medicine and Health Sciences in the District of Columbia and one of the study's authors. "Yet what we found is that the data currently being gathered is not particularly reliable nor valid. … What is clear from our study is there needs to be a better process to measure, capture, and report patient experience data."

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