The last is currently receiving considerable government
attention in the UK,
30
with the anticipation that waiting
times will fall and, presumably, patient satisfaction will
improve. Future research could usefully study the effect of
this and similar interventions in the ED, as well as clarifying
the relative importance of the main service factors identified.
The preferred methodological approach to future interven-
tion studies will depend upon local circumstances and the
factor(s) under study. Over the past 10 years the design and
interpretation of satisfaction studies has become increasingly
sophisticated. Interest in qualitative, rather than quantita-
tive, research methods is growing, and some recent studies
have combined the two approaches in an attempt to develop
more reliable and valid tools for measuring satisfaction.
10 29
Multi-centre studies are generally preferable, because of their
inmproved external validity, but very few have been reported
to date. For some factors (such as patient information) a
randomised design is feasible, but for other interventions
(such as reductions in the perceived waiting time) alternative
or novel approaches may be required.
CONCLUSIONS
To a great extent, patients must trust their clinicians to
continuously review and improve their clinical and technical
skills. The emphasis now placed on evidence based practice
recognises this responsibility. However, in the quest to
improve the science of medicine, medicine as an art may be
suffering. The balance will be somewhat restored if we
succeed in identifying, and responding to, wider patient
needs. The study of patient satisfaction is a step in this
direction.
Research to date has identified which broad aspects of the
service our patients care most about. There are many
potential interventions that could be tailored to local needs,
and the papers already published can usefully inform future
strategies for assessing and improving patient satisfaction in
emergency medicine. We will never please ‘‘all of the people
all of the time’’, but within our own departments we can now
start investigating measures that will please more of our
patients most of the time.
Authors’ affiliations
.....................
C Taylor, J R Benger, Emergency Department, Royal United Hospital,
Bath, UK
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