Abstract
Poster presentation
Session E presented Tuesday, October 1, 10:00-11:00 am
Purpose: Triage interruptions have been shown to significantly delay treatment and are perceived by healthcare workers to negatively impact care quality. However, it is unknown whether patients perceive that interruptions negatively affect their care or satisfaction. The purpose of this study was to test whether there is a difference between how patients perceive interruptions and the number of observed interruptions; whether there is a relationship between the number of interruptions and the quality of care; and whether interruption length impacts patients perceptions of the interruptions.
Design: Prospective, observational, time-and-motion cohort study.
Setting: This study was conducted in an adult 728 bed academic Level 1 trauma center with 55 ED beds seeing 75,000 patients per year.
Participants/Subjects: The participants included ED nurses, physicians, and mid-level providers and patients seeking emergency treatment. Patients were excluded if they were prisoners, under 18 years old, non-english speaking, extremely high acuity (Emergency Severity Index of 1), or combative.
Methods: Triage observations were conducted for both nurse triage interviews and initial physician assessments. Observational data was collected using the Triage Interruption Assessment Tool. ED patients were approached after the triage interview and initial physician assessment were complete and completed patient satisfaction and perceptions of care survey.
Results/Outcomes:Observations were completed on 105 providers caring for 122 patients. 103 surveys were completed on the nursing triage process and 90 on the physician assessments. Of the 193 interactions between patients and providers, 119 (61.7%) were interrupted with a total of 205 interruptions. Patients reported interruption 84 times (43.5%) with 120 interruptions. The difference between the observed and perceived interruptions was significantly different (X2 = 6.893, p=0.011). Patients perceived that nurses and physicians were interrupted with similar frequency at 55.8% and 57%, respectively. However, we observed a significant difference (X2 = 7.298, p=0.007). Nurse triage was interrupted 70% of the time while physicians were interrupted 51.6%. T-tests were conducted to determine if the number or duration of interruptions differed if an interruptions was perceived. There was a significant difference in the number of times triage was interrupted between the perceived vs no interruption perceived groups (t=3.500, p=0.001). Interruption duration did not impact the perception of interruptions between these 2 groups (t=-1.162, p=0.248). Paired sample t-test were done to compare observed and perceived interruption length. Interruptions lasted a mean of 2.75 minutes (SD= 3.683). Patients perceived interruptions to last less time (mean 1.58 minutes (SD=2.55). However, there was a relationship between the two variables (t= 3.377, p=0.002). Of the interrupted interactions, patients stated that 73.1% were necessary.
Implications: With the increased trend of associating quality of care to patient satisfaction scores, much focus has been placed on the patient perception of care. Although this is an easily measurable proxy for quality, it may not be the most accurate. As we can see, patient’s perception of the care they receive (i.e. interruptions) may not be representative of the actual care they receive. Patient satisfaction and perception of care should remain a component of judging care quality as long as more accurate measure of care are considered.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Triage Interruptions, Patient Satisfaction, Quality of Care
Recommended Citation
Johnson, Kimberly D., "Triage interruptions: How do they impact patient perceptions of care?" (2020). General Submissions: Presenations (Oral and Poster). 130.
https://www.sigmarepository.org/gen_sub_presentations/2019/posters/130
Conference Name
Emergency Nursing 2019
Conference Host
Emergency Nurses Association
Conference Location
Austin, Texas, USA
Conference Year
2019
Rights Holder
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Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Triage interruptions: How do they impact patient perceptions of care?
Austin, Texas, USA
Poster presentation
Session E presented Tuesday, October 1, 10:00-11:00 am
Purpose: Triage interruptions have been shown to significantly delay treatment and are perceived by healthcare workers to negatively impact care quality. However, it is unknown whether patients perceive that interruptions negatively affect their care or satisfaction. The purpose of this study was to test whether there is a difference between how patients perceive interruptions and the number of observed interruptions; whether there is a relationship between the number of interruptions and the quality of care; and whether interruption length impacts patients perceptions of the interruptions.
Design: Prospective, observational, time-and-motion cohort study.
Setting: This study was conducted in an adult 728 bed academic Level 1 trauma center with 55 ED beds seeing 75,000 patients per year.
Participants/Subjects: The participants included ED nurses, physicians, and mid-level providers and patients seeking emergency treatment. Patients were excluded if they were prisoners, under 18 years old, non-english speaking, extremely high acuity (Emergency Severity Index of 1), or combative.
Methods: Triage observations were conducted for both nurse triage interviews and initial physician assessments. Observational data was collected using the Triage Interruption Assessment Tool. ED patients were approached after the triage interview and initial physician assessment were complete and completed patient satisfaction and perceptions of care survey.
Results/Outcomes:Observations were completed on 105 providers caring for 122 patients. 103 surveys were completed on the nursing triage process and 90 on the physician assessments. Of the 193 interactions between patients and providers, 119 (61.7%) were interrupted with a total of 205 interruptions. Patients reported interruption 84 times (43.5%) with 120 interruptions. The difference between the observed and perceived interruptions was significantly different (X2 = 6.893, p=0.011). Patients perceived that nurses and physicians were interrupted with similar frequency at 55.8% and 57%, respectively. However, we observed a significant difference (X2 = 7.298, p=0.007). Nurse triage was interrupted 70% of the time while physicians were interrupted 51.6%. T-tests were conducted to determine if the number or duration of interruptions differed if an interruptions was perceived. There was a significant difference in the number of times triage was interrupted between the perceived vs no interruption perceived groups (t=3.500, p=0.001). Interruption duration did not impact the perception of interruptions between these 2 groups (t=-1.162, p=0.248). Paired sample t-test were done to compare observed and perceived interruption length. Interruptions lasted a mean of 2.75 minutes (SD= 3.683). Patients perceived interruptions to last less time (mean 1.58 minutes (SD=2.55). However, there was a relationship between the two variables (t= 3.377, p=0.002). Of the interrupted interactions, patients stated that 73.1% were necessary.
Implications: With the increased trend of associating quality of care to patient satisfaction scores, much focus has been placed on the patient perception of care. Although this is an easily measurable proxy for quality, it may not be the most accurate. As we can see, patient’s perception of the care they receive (i.e. interruptions) may not be representative of the actual care they receive. Patient satisfaction and perception of care should remain a component of judging care quality as long as more accurate measure of care are considered.