Emergency Departments Are Effective In Monitoring Doctor

Simple button terminals featuring “emoji” reflecting a range of emotions and sentiments stationed around emergency departments (EDs) are effective in monitoring doctor and patient sentiments in real time, a Penn Medicine study found. Traditionally, surveys are mailed or sent electronically to evaluate patient experiences; but response rates can be low and those that respond do so well after the visit.

Using touch terminals could help inform immediate adjustments in the emergency departments that would not just better serve patients; but also the clinicians treating them. The findings of this trial were publish Sept. 4 in Annals of Emergency Medicine. “This study begins to shed light on simple, fast ways of identifying trends and providing high-level information on how patients and providers are feeling in real time,” said Anish Agarwal, MD, an assistant professor of Emergency Medicine at Penn Medicine.

The emergency departments

“They want to see if people would even notice these buttons; which they did and they push them a lot.” The terminals Agarwal and his fellow researchers use are similar to those use to gauge visitor satisfaction in sports arenas and airports. Each terminal features four buttons; ranging from very positive (green, with a happy face) to very negative (red, with a frowning face).

They were establish in three different locations in an urban emergency department to capture the sentiments of three specific groups: doctors, nurses, and patients. As such, one was set up near physician workstations; another at nurses‘ workstations; also the last at the patient exit. During the five-month study period in 2018, nearly 14,000 sentiments were record across the three terminals, with roughly 68% coming from the provider-facing terminals.

The nurses’ station terminal record the most sentiments; accounting for 53% of those capture for the study; but across all three terminals, an average of 108 sentiments were record per day; numbers which were encouraging to the researchers. “This work suggests that we can collect real-time provider and patient feedback that we haven’t previously been able to identify,” said the study’s senior author, Raina Merchant, MD, the director of the Penn Medicine Center for Digital Health and an associate professor of Emergency Medicine.

The patient exit terminal

“This can allow for support when things are going well and addressing challenges when they occur.” Although primarily a feasibility study, the researchers did uncover some associations between the record sentiments; also things like identity and patient volume. For instance, high satisfaction numbers; hence were with the patient exit terminal; where positive responses outnumber the negative each day by 25%; on average.

“They think our staff are happier when things are working smoothly; times where we can quickly treat people and keep things moving,” Agarwal said. Now with evidence that button terminals are use at a high level in the emergency departments; Agarwal hopes to dive deeper on his findings with future work to determine why sentiment shifts happen; also determine the best ways that they can be quickly respond to.

“Frictionless feedback is key in helping drive quality improvement in healthcare; also they need to explore more ways in which we can expand it,” Agarwal said. “They would argue that the day-to-day frustrations and joy clinicians experience likely contributes to their long-term satisfaction or burnout. So they need to rethink how we engage with providers and patients.”