Compassion or speed, which is a more accurate indicator of healthcare quality in the emergency department from the patients’ perspective?

Abstract

Rationale, aims and objectives: Devising indicators to measure quality of care is challenging in Emergency Departments (ED). It is difficult to measure aspects of quality which are less amenable to measurement; hence waiting time has often been relied on. This study aimed to determine whether patients' perceptions of empathy are a measurable indicator of quality of care in comparison to waiting time within the ED. Method: A cross sectional survey of patients who attended an ED during a 10 day period was conducted to assess correlation between a measure of empathy (the CARE measure), waiting times and perception of care quality. Data other than waiting times were obtained using a questionnaire completed by patients immediately on completion of treatment. Waiting times were obtained from an existing database. Both waiting times and CARE scores were correlated with responses to a patient satisfaction question using Spearman's rho. Results: Of the 81 patients who participated the majority reported care to be good (21%) or very good (75%). Waiting times varied between 11 minutes and 5 hours 17 minutes. CARE scores ranged from 12 to 50 (mean 41.1). Analysis showed a statistically significant relationship (p less than 0.001) between ratings of patient satisfaction and CARE measure scores with a moderate correlation (Spearman's rho = 0.55), whereas no correlation was found between satisfaction and waiting time (Spearman's rho = -0.07, p=0.56). Conclusions: Length of time was not associated with patients' perceptions of care quality and hence would have been of limited value as a current measure of quality in the ED. Conversely, empathy was associated with care quality and thus should be considered as a means for assessing quality from the patients' perspective in the context of ED departments.