Research Project

In Pursuit of Quality: Opportunities to improve patient experiences in British Columbia emergency departments

This report shares new insights about patient views on the care they received in BC emergency departments in 2007. The study is the first in BC to look beyond patient ratings of their emergency room care in order to understand what can be done to make that care better. It takes a close look at factors that drive patient ratings of quality – and specifically those that underlie their reports of positive experiences – in order to identify what health care professionals do well and should continue to do. The report also takes a close look at the minority of patients who report negative experiences, to provide perspective about what providers can do to prevent similar experiences in the future. Factors such as staff courtesy, team work, comprehensive care and availability of nurses, appear to be more important than do wait times in influencing patient ratings.

Approach

In order to identify factors that drive positive or negative patient ratings of the overall quality of care in emergency departments, we used results of a province-wide survey completed by more than 16,800 patients who visited one of 110 facilities in BC in 2007. The survey was conducted by NRC+Picker (www.nrcpicker.com) and overseen by the BC Patient Satisfaction Steering Committee between February and April of 2007. We conducted an independent analysis of the results to identify opportunities to improve patient ratings of the quality of their care.

Key Findings

In the spring of 2007, the vast majority (83%) of emergency room patients in BC reported the overall quality of their care as excellent, very good, or good. A much smaller percentage rated their care as fair (11%) or poor (5%). When asked if they had waited too long to see a doctor, over half of patients (52%) said “no”. One in four (28%) said “yes, somewhat”, and less than one in five (18%) said “yes, definitely”. The main factor underlying patient views on quality was staff courtesy. Team work, comprehensive care, availability of nurses and waiting too long to see a doctor also mattered - but to a lesser extent. Most patients said that health care professionals do well in these areas. Among the 16% of patients who reported fair or poor experiences with their care, many offered negative ratings of staff courtesy (62%) or team work (53%). One-third reported waiting over two hours to see a doctor (29%). Patients who presented in pain were much more likely to report negative experiences.

Project Team

Diane Watson Sandra Peterson Charlyn Black

Funding

British Columbia Patient Satisfaction Steering Committee