Document Type : Original Article


1 Department of Emergency Medicine, Ayatollah Kashani Hospital, Tehran, Iran

2 Department of Emergency Medicine, Nekoee-Hedayati Hospital, Qom University of Medical Sciences, Qom, Iran

3 Department of Emergency Medicine, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran


Objective: Patient satisfaction (PS) is a major quality assessment index for the emergency department (ED) which affects patient safety, litigation, reimbursements, and consumer satisfaction. In this study we aimed to recognize the factors affecting PS in our center.
Method: Random shifts during a week were selected and all patients disposed from the ED were asked to fill out a revised and validated Persian version of the Press-Ganey questionnaire with the help of a research assistant. Results were analyzed using a linear regression model by SPSS software version 21.
Results: Findings reaffirmed some of the factors previously described. These included longer door to treatment area times having a negative effect on satisfaction (P < 0.001), and providing vivid discharge information improving PS (P < 0.001). Other important factors were also found that had not previously been focused on, namely cleanliness of the area (P < 0.0001) and courtesy of the staff in charge of patient transfer (P = 0.03). We also found that men had a more satisfying ED experience (P = 0.002).
Conclusion: Cultural expectations may have an important effect on PS. Thus, every institution should determine and alter the expectations most relevant to them.


Main Subjects

1. Boudreaux ED, O’Hea EL. Patient satisfaction in the Emergency Department: a review of the literature and implications for practice. J Emerg Med 2004; 26(1): 13-26.doi: 10.1016/j.jemermed.2003.04.003.
2. Fenton JJ, Jerant AF, Bertakis KD, Franks P. The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med 2012; 172(5): 405-11. doi: 10.1001/archinternmed.2011.1662.
3. Friedberg MW, Gelb Safran D, Schneider EC. Satisfied to death: a spurious result? Arch Intern Med 2012; 172(14): 1112-3. doi: 10.1001/archinternmed.2012.2060.
4. Welch SJ. Twenty years of patient satisfaction research applied to the emergency department: a qualitative review. Am J Med Qual 2010; 25(1): 64-72. doi: 10.1177/1062860609352536.
5. Johansen ML. Conflicting priorities: emergency nurses perceived disconnect between patient satisfaction and the delivery of quality patient care. J Emerg Nurs 2014; 40(1): 13-9. doi: 10.1016/j.jen.2012.04.013.
6. Soleimanpour H, Gholipouri C, Salarilak S, Raoufi P, Vahidi RG, Rouhi AJ, et al. Emergency department patient satisfaction survey in Imam Reza Hospital, Tabriz, Iran. Int J Emerg Med 2011; 4: 2. doi: 10.1186/1865-1380-1-2.
7. Arab M, Movahed Kor E, Mahmoodi M. The effect of time-to-provider, left-without-treatment and length-of stay on patient satisfaction in training hospitals’ emergency department, Iran. Iran J Public Health 2015; 44(10): 1411-7.
8. Atari M, Atari M. Brief Emergency Department Patient Satisfaction Scale (BEPSS); development of a new practical instrument. Emerg (Tehran) 2015; 3(3): 103-8.
9. Reihani H, Pishbin E, Abbasi Shaye Z, Ebrahimi M, Bolvardi E, Talebi Delooi M, et al. Patient satisfaction analysis in emergency department in Imam Reza hospital of Mashhad. Patient Saf Qual Improv 2015; 3(1): 179-83.
10. Taghizadeh H, Taghizadeh F. The comparing of health cares’s satisfaction in main and satellite villages of Qom province, Iran. Adv in Biol Res 2013; 7(6): 305-9. doi: 10.5829/idosi.abr.2013.7.6.11191.
11. Zohrevandi B, Tajik H. A survey of patients’ satisfaction in emergency department of Rasht Poursina hospital. Emerg (Tehran) 2014; 2(4): 162-5.
12. Sun BC, Adams J, Orav EJ, Rucker DW, Brennan TA, Burstin HR. Determinants of patient satisfaction and willingness to return with emergency care. Ann Emerg Med 2000; 35(5): 426-34. doi:10.1067/mem.2000.104195.
13. Sun BC, Adams JG, Burstin HR. Validating a model of patient satisfaction with emergency care. Ann Emerg Med 2001; 38(5): 527-32. doi: 10.1067/mem.2001.119250.
14. Rhee KJ, Bird J. Perceptions and satisfaction with emergency department care. J Emerg Med 1996; 14(6): 679-83. doi:10.1016/S0736-4679(96)00176-X.
15. Boquiren VM, Hack TF, Beaver K, Williamson S. What do measures of patient satisfaction with the doctor tell us? Patient Educ Couns 2015; 98(12): 1465-73. doi: 10.1016/j.pec.2015.05.020.
16. Taylor C, Benger JR. Patient satisfaction in emergency medicine. Emerg Med J 2004; 21(5): 528-32. doi: 10.1136/emj.2002.003723.
17. Taylor D, Kennedy MP, Virtue E, McDonald G. A multifaceted intervention improves patient satisfaction and perceptions of emergency department care. Int J Qual Health Care 2006; 18(3): 238-45. doi: 10.1093/intqhc/mzl002.
18. Hargraves JL, Wilson IB, Zaslavsky A, James C, Walker JD, Rogers G, et al. Adjusting for patient characteristics when analyzing reports from patients about hospital care. Med Care 2001; 39(6): 635-41.
19. McKinley RK, Stevenson K, Adams S, Manku-Scott TK. Meeting patient expectations of care: the major determinant of satisfaction with out-of-hours primary medical care? Fam Pract 2002; 19(4): 333-8. doi: 10.1093/fampra/19.4.333.
20. Son H, Yom YH. Factors influencing satisfaction with emergency department medical service: patients’ and their companions’ perspectives. Jpn J Nurs Sci 2017; 14(1): 27-37. doi: 10.1111/jjns.12132.
21. Abolfotouh MA, Al-Assiri MH, Alshahrani RT, Almutairi ZM, Hijazi RA, Alaskar AS. Predictors of patient satisfaction in an emergency care centre in central Saudi Arabia: aprospective study. Emerg Med J 2017; 34(1): 27-33. doi:10.1136/emermed-2015-204954
22. Morgan MW, Salzman JG, LeFevere RC, Thomas AJ, Isenberger KM. Demographic, operational, and healthcare utilization factors associated with emergency department patient satisfaction. West J Emerg Med 2015; 16(4): 516-26. doi: 10.5811/westjem.2015.4.25074.
23. Pines JM, Iyer S, Disbot M, Hollander JE, Shofer FS, Datner EM. The effect of emergency department crowding on patient satisfaction for admitted patients. Acad Emerg Med 2008;8;15(9):825-31. doi:10.1111/j.1553-2712.2008.00200.x.
24. Damghi N, Belayachi J, Armel B, Zekraoui A, Madani N, Abidi K, et al. Patient satisfaction in a Moroccan emergency department. Int Arch Med 2013; 6: 20. doi: 10.1186/1755-7682-6-20.
25. Davis BA, Duffy E. Patient satisfaction with nursing care in a rural and an urban emergency department. Aust J Rural Health 1999; 7(2): 97-103. doi: 10.1046/j.1440- 1584.1999.00231.x.
26. Cowan P. Press Ganey scores and patient satisfaction in the emergency department (ED): the patient perspective. Pain Med 2013; 14(7): 969. doi: 10.1111/pme.12170_3.
27. Chandra A, Sieck S, Hocker M, Gerardo CJ, Villani J, Harrison D, et al. An observation unit may help
improve an institution’s Press Ganey satisfaction score. Crit Pathw Cardiol 2011; 10(2): 104-6. doi:10.1097/HPC.0b013e31821c5da8.
28. Zakerimoghadam M, Sadeghi S, Ghiyasvandian S, Kazemnejad A. The effect of trauma intervention on the satisfaction of patients admitted to the emergency department: a clinical trial study. Iran Red Crescent Med J 2016; 18(4): e26452. doi: 10.5812/ircmj.26452.
29. Hwang CE, Lipman GS, Kane M. Effect of an emergency department fast track on Press-Ganey patient satisfaction scores. West J Emerg Med 2015; 16(1): 34-8. doi: 10.5811/westjem.2014.11.21768.