Considerations for Improving Emergency Department Patient Experience Data

According to a recent study published by researchers at George Washington University (GW), data that is gathered on patient experience is unreliable.

This study, titled Measurement Under the Microscope: High Variability and Limited Construct Validity in Emergency Department Patient-Experience Scores, analyzed patient experience data from 2012 to 2015 across 42 emergency department facilities and 242 physicians totaling 1,758 facility-months and 10,328 physician-months of data.

The conclusion of the research indicated that patient experience data varied greatly from month-to-month for both facilities and physicians, indicating a gap in the way this data was collected. This highlights the fact that the way it is gathered should be further optimized.

The Importance Of ED Patient Experience Data

Jesse Pines, MD, MBA, a lead author of the study and director of the Center for Healthcare Innovation and Policy Research and professor of emergency medicine at the GW School of Medicine and Health Sciences, mentions that “The concept of measuring patient experience and rewarding providers who deliver a better experience is absolutely right on. No one argues with that. Yet what we found is that the data currently being gathered is not particularly reliable nor valid.”

He further elaborates that physician scores should remain relatively stable from month-to-month. However, the research found the opposite was true. In some of the findings, physician ratings fluctuated from the 20th percentile all the way up to the 80th percentile, indicating gaps in the way the data is being gathered.

Patient experience data has gotten more attention as of late as it is evaluated at government and inner facility operations. The U.S. Centers for Medicare and Medicaid Services use the data for public reporting as well as value-based purchasing models for inpatient hospital care. Patient experience data will also be used in the Medicare Access and CHIP Reauthorization Act (MACRA), a statute that changes the payment system for doctors who treat Medicare patients.

Additionally, this data is used by many management teams to find a quantifiable metric to evaluate physician and hospital performance as well as set compensation models.

What’s Driving The Issues In The Measurement Data?

Co-author Arvind Venkat, MD, chair of research at US Acute Care Solutions, commented that what was happening with the data was that only the very happy and very unhappy were returning their surveys.

“What you get is a very biased sample. That makes it difficult to come to any meaningful conclusions from the data.”

There was some data that predicted higher scores that emergency departments should be familiar with:

For Facilities:

  • teaching status
  • more older, male, and discharged patients without Medicaid insurance
  • lower patient volume
  • less requirement for physician night coverage
  • shorter lengths of stay for discharged patients

For Physicians:

  • younger physician age
  • participating in satisfaction training
  • increasing relative value units per visit
  • more commercially insured patients
  • ​higher computed tomography or magnetic resonance imaging use
  • working during less crowded times
  • fewer night shifts

Pine, Venkat, and other researchers concluded that the existing survey process has marginally validity and that many factors that predicted scores were out of a hospital’s control.

As the patient’s voice is becoming even more important, the data suggests that better processes need to be put in place to measure, capture, and report patient experience data.

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