HQCA releases Urban and Regional Emergency Department Patient Experience Report (2010-2013)

December 14, 2014

Posted Dec 15, 2014

Review the technical reports here.


Background

What is it? The HQCA surveyed emergency department (ED) patients every two weeks between June 2010 and July 2013. Over the three year period 21,013 patients were asked about their recent experience at one of the 13 busiest urban and regional EDs in the province in order to monitor variation and detect changes in the performance of the ED sites over time.

What were we hoping to achieve? Our objective was to provide regularly-collected information about ED patient experience to site-level stakeholders, helping them to improve the quality of emergency department care.

How long has HQCA been surveying Emergency Department satisfaction levels? Since 2007.

What change did HQCA make to survey method and why does it matter? The HQCA shifted from surveying patients over a single two-week period (as was the case in 2007 and 2009) to surveying patients continuously throughout the year (i.e., every two weeks). Therefore, the 2010-13 results cannot be compared to the 2007 or 2009 results.

Who did we survey? The HQCA surveyed adult patients* at urban and regional ED sites with, historically, the greatest crowding pressures, longest wait times, and the poorest patient experience. Which 13 hospitals were included in the survey? Chinook Regional Hospital, Medicine Hat Regional Hospital, Red Deer Regional Hospital, Peter Lougheed Centre, Rockyview General Hospital, Foothills Medical Centre, Sturgeon Community Hospital, Royal Alexandra Hospital, Grey Nuns Community Hospital, Misericordia Community Hospital, University of Alberta Hospital, Northern Lights Regional Health Centre, and Queen Elizabeth II Hospital.

*The Stollery and Alberta Children’s hospitals were also surveyed, but they are not included in this report - as family members were the respondents rather than the patient. The HQCA will be reporting this data in early 2015.


Report Results Summary

The following results are reported at the provincial level (combining responses from all 13 emergency department (ED) sites surveyed). Please note: Each emergency department is unique. Therefore, facility-level results are presented alongside provincial results in the full report available at www.hqca.ca.

Overall care rating

At the provincial level, results for the overall rating of care varied month-to-month, ranging from a low of 60% of patients rating their overall care as excellent or very good to a high of 72% over the three-year study period.

One ED saw a sustained improvement in the overall care rating over the 3 year period – Sturgeon Community Hospital.

Patient volumes

Emergency department patient volumes consistently increased for most of the 13 sites during our survey period. Length of stay in the emergency department varied between sites over the course of the study period.

What factors influenced patients’ overall rating of care over the three year survey period? The Emergency Department Patient Experience Survey collected information on patients’ overall rating of care, as well as several other factors (composites) that influence the overall rating of care. The following are the provincial results for the factors that influence the overall rating of care (in order of importance):

  1. Staff care and communication: Provincial results for the staff care and communication composite varied month-to-month, ranging from a low score of 75 to a high of 81 out of 100.

  2. Wait time and crowding: Provincial results for the wait time and crowding composite varied month-to-month, ranging from a low score of 61 to a high of 68 out of 100.

  3. Pain management: Provincial results for the pain management composite varied month-to-month, ranging from a low score of 56 to a high of 69 out of 100.

  4. Respect: Provincial results for the respect composite varied month-to-month, ranging from a low score of 83 to a high of 87 out of 100.

  5. Facility cleanliness: Provincial results for the facility cleanliness composite varied month-to-month, ranging from a low score of 76 to a high of 84 out of 100.

  6. Wait time communication: Provincial results for the wait time communication composite varied month-to-month, ranging from a low score of 42 to a high of 49 out of 100.

  7. Privacy: Provincial results for the privacy composite varied month-to-month, ranging from a low score of 79 to a high of 87 out of 100.

  8. Medication communication: Provincial results for the medication communication composite varied month-to-month, ranging from a low score of 66 to a high of 79 out of 100.

  9. Discharge communication: Provincial results for the discharge communication composite varied month-to-month, ranging from a low score of 47 to a high of 56 out of 100.

Other findings: Of the 182 site-level results, there were five that showed lasting improvement over the survey period (three sites are represented):

  • Improvement in wait time and crowding – Sturgeon Community Hospital and University of Alberta Hospital

  • Improvement in the percentage of patients who self-reported waiting more than two hours to be examined by a doctor – Sturgeon Community Hospital

  • Improvement in facility cleanliness – Queen Elizabeth II Hospital

  • Improvement in the percentage of patients who believed that ED staff did not do everything they could to help control their pain – Sturgeon Community Hospital

What other interesting zone-level patterns in patient experience did we see?

  • The emergency departments in Calgary generally had slightly higher patient experience scores than the other sites that were surveyed.

  • The Edmonton emergency departments, Chinook Regional Hospital, Medicine Hat Regional Hospital, and Red Deer Regional Hospital EDs generally had slightly lower patient experience scores than the Calgary sites.

  • The Northern sites generally had the lowest patient experience scores of all EDs surveyed.