Role of Provider-at-Triage on ED Efficiency and Quality of Care

Study Summary

The United States spends over $8,000 per capita annually on health care and its health care system is more expensive than other developed countries. Even with high per capita costs and a high proportion of physician specialists, the US lags in health care performance from patients' perspectives. The hospital emergency department (ED) is often the portal of entry for patients seeking health care services and is therefore an ideal setting for initiatives to improve efficiency of care delivery and patient satisfaction. Reduction in wait times, enhanced information delivery and ED staff service quality all have a positive influence on patient perception of health care quality and satisfaction. Prior studies have attempted to increase patient satisfaction by improving staff communication and courtesy, implementing a patient satisfaction team in triage, and delivering information to patients in a timely manner. Another strategy to increase the efficiency of ED operations is adding a physician to triage to perform brief medical screenings and initiate necessary patient testing and treatment. This contrasts to usual practice in which physicians evaluate patients only following registration and nurse assessment of illness or injury severity.

Primary Outcome

Patient Satisfaction Score- brief survey measured on a Likert Scale * 1= Never * 2= Sometimes * 3= Usually * 4= Always * 5= Not applicable - I did not see a doctor today

Interventions

• OTHER Usual Care
• BEHAVIORAL Physician at triage