Document Type: Original Article


1 Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran


Objective: This study was conducted to investigate the role of an emergency nurse coordinator (ENC) in improving patient satisfaction at the emergency department (ED) in Tehran, Iran.
Methods: This was an interventional study in the field of ED management. This study was undertaken in the ED of Sina hospital in Tehran, Iran, during March 2018 until April 2019. An ENC was assigned to the ED on even days and during the next week. Also, the presence of the ENC was switched to odd days and so on. Patient satisfaction was evaluated by a questionnaire. In order to analyze data, independent T-test was used to assess the mean difference in satisfaction scores. In addition, analysis of covariance (ANCOVA) test was utilized to assess the difference in satisfaction scores after considering age, sex and triage level as confounding variables.
Results: Finally, 315 and 291 patients were allocated to the intervention (patients with ENC) and control groups (patients without ENC), respectively. The total satisfaction rate in the intervention and control groups was 63.9% and 59.3%, respectively. The mean score of total satisfaction in the intervention group was significantly higher than the control group [115.1 (SD = 20.0) vs 106.8 (SD = 22.3); P < 0.001]. The ANCOVA analysis showed that age, sex and triage level were not confounding factors affecting the satisfaction score.
Conclusion: This study showed that the presence of the ENC in the ED can increase patient satisfaction, especially in domains related to “diagnostic and therapeutic services”, “cleanliness”, “cost and discharge information”, “ethical and privacy issues”, “admission, discharge and management services”.


Main Subjects

1. Baummer-Carr A, Nicolau DP. The challenges of patient satisfaction: influencing factors and the patient - provider relationship in the United States. Expert Rev Anti Infect Ther 2017; 15(10): 955-62. doi: 10.1080/14787210.2017.1378097.
2. Naidu A. Factors affecting patient satisfaction and healthcare quality. Int J Health Care Qual Assur 2009;
22(4): 366-81. doi: 10.1108/09526860910964834.
3. Talebpour M, Payandemehr P, Kalhor P, Abbasi N, Baratloo A. One-year analysis of the emergency department input and output; a case study of Sina hospital, Iran. Journal of Police Medicine 2019; 8(2): 87-92.
4. Momeni M, Vahidi E, Seyedhosseini J, Jarchi A, Naderpour Z, Saeedi M. Emergency overcrowding impact on the quality of care of patients presenting with acute stroke. Adv J Emerg Med 2018; 2(1): e3. doi: 10.22114/ajem.v2i1.25.
5. Nayeem A, Hinchcliffe M, Gumbs K. ED assembly: introducing a simple method of bringing emergency
department staff together to facilitate improvement; a report of a real experience. Adv J Emerg Med. 2019; 3(4):e36. doi: 10.22114/ajem.v3i4.212.
6. Valizadeh L, Zamanzadeh V, Ghahramanian A, Aghajari P, Foronda C. Factors influencing nurse-to-parent
communication in culturally sensitive pediatric care: a qualitative study. Contemp Nurse 2017; 53(4): 474-88. doi:10.1080/10376178.2017.1409644.
7. Lamiani G, Furey A. Teaching nurses how to teach: an evaluation of a workshop on patient education. Patient Educ Couns 2009; 75(2): 270-3. doi: 10.1016/j.pec.2008.09.022.
8. Kashani P, Mirbaha S, Forouzanfar MM, Meschi F, Baratloo A. The prevalence of personality disorders among emergency nurses based on MMPI-2 questionnaire; a cross-sectional study. Emerg (Tehran) 2017; 5(1): e17.
9. Shahriari M, Mohammadi E, Abbaszadeh A, Bahrami M, Fooladi MM. Perceived ethical values by Iranian nurses. Nurs Ethics 2012; 19(1): 30-44. doi: 10.1177/0969733011408169.
10. Morowati Sharifabad MA, Rafati Fard M, Fattahi Ardakani M, Dehghani Ahmadabad A, Sotudeh A. Determinants of effective nurse-patient communication based on the health action process approach in Yazd hospitals. Horm Mol Biol Clin Investig 2019; 40(3). doi: 10.1515/hmbci-2019-0026.
11. Mirbaha S, Kashani P, Arhami Dolatabadi A, Amini A, Meschi F, Baratloo A. The prevalence of personality disorders in nurses: role of the workplace environment. J Emerg Pract Trauma 2017; 3(2): 59-63. doi: 10.15171/jept.2017.22.
12. Esmaeili R, Aghili SM, Sedaghat M, Afzalimoghaddam M. Causes of prolonged emergency department stay; a crosssectional action research. Adv J Emerg Med 2018; 2(2): e18. doi: 10.22114/ajem.v0i0.58.
13. Williams G, Hughes V, Timms J, Raftery C. Emergency nurse as hospital clinical team coordinator--shining a light into the night. Australas Emerg Nurs J 2012; 15(4): 245-51.doi: 10.1016/j.aenj.2012.08.001.
14. Arhami Dolatabadi A, Maleki M, Memary E, Kariman H, Shojaee M, Baratloo A. The use of emergency department services for non-emergency conditions. HealthMED 2017;11(1): 3-9.
15. Seyedhosseini-Davarani S, Hesari E, Afzalimoghadam M, Tavakoli N, Seyedhosseini J, Hossein-Nejed H, et al.Validity of triage performed by nurses educated by train-oftrainer workshop participants; a cross-sectional study for assessment of cascade training system. Adv J Emerg Med2020; 4(1): e2. doi: 10.22114/ajem.v0i0.127.

16. Haroutunian P, Alsabri M, Kerdiles FJ, Adel Ahmed Abdullah H, Bellou A. Analysis of factors and medical
errors involved in patient complaints in a European emergency department. Adv J Emerg Med 2018; 2(1): e4. doi: 10.22114/AJEM.v0i0.34.
17. Hajzargarbashi E, Rashedi R, Pourafzali S, Esmailian M. Waiting time for specialist consultation and visit requested in the emergency department; a cross-sectional study. Adv J Emerg Med 2019; 3(2): e15. doi: 10.22114/ajem.v3i2.136.
18. Henderson DP. Role of “nurse coordinator for pediatric emergency care”: important part of new consensus guidelines. J Emerg Nurs 2002; 28(1): 73-7. doi: 10.1067/men.2002.121838.
19. Frank C, Elmqvist C. Staff strategies for dealing with care situations at an emergency department. Scand J Caring Sci 2019. doi: 10.1111/scs.12812.
20. Bourdolle É, Mitha N, Guillem P, Zerhouni N, Gavazzi G. [Role of the nurse coordinator in geriatric oncology].Rev Infirm 2019; 68(249): 25-6. doi: 10.1016/j.revinf.2019.02.007.
21. Al-Kaiyat MO. Precision coordination: the growing role of the nurse coordinator in the Era of personalized medicine. Clin J Oncol Nurs 2018; 22(1): 113-5. doi: 10.1188/18.cjon.113-115.
22. Nutt M, Hungerford C. Nurse care coordinators: definitions and scope of practice. Contemp Nurse 2010; 36(1-2): 71-81.doi: 10.5172/conu.2010.36.1-2.071.
23. Kardanmoghadam V, Movahednia N, Movahednia M, Nekoei-Moghadam M, Amiresmaili M, Moosazadeh M,et al. Determining patients’ satisfaction level with hospital emergency rooms in Iran: a meta-analysis. Glob J Health Sci 2015; 7(4): 260-9. doi: 10.5539/gjhs.v7n4p260.
24. Forster AJ, Clark HD, Menard A, Dupuis N, Chernish R, Chandok N, et al. Effect of a nurse team coordinator on outcomes for hospitalized medicine patients. Am J Med 2005; 118(10): 1148-53. doi: 10.1016/j.amjmed.2005.04.019.
25. Asha SE, Ajami A. Improvement in emergency department length of stay using a nurse-led ‘emergency journey coordinator’: a before/after study. Emerg Med Australas 2014; 26(2): 158-63. doi: 10.1111/1742-6723.12201.
26. Karagun O, Yesilagac H, Gulalp B, Gokel Y. What can we do to improve patient satisfactıon in the emergency department? a prospective study in a Turkish university hospital. Adv J Emerg Med 2018; 2(4): e41. doi: 10.22114/AJEM.v0i0.94.
27. Mohammadi-Sardo MR, Salehi S. Emergency department patient satisfaction assessment using modified servqual model; a cross-sectional study. Adv J Emerg Med 2019; 3(1): e3. doi: 10.22114/AJEM.v0i0.107.
28. Moher D, Weinberg A, Hanlon R, Runnalls K. Effects of a medical team coordinator on length of hospital stay. Cmaj 1992; 146(4): 511-5.
29. Preethy S, Xavier T, Reghunathan N, Robin M, Agrawal D. Impact of an emergency nurse coordinator on work flow optimization in an emergency department in Delhi, India. Stud Health Technol Inform 2016; 225: 875-6.
30. Taylor C, Benger JR. Patient satisfaction in emergency medicine. Emerg Med J 2004; 21(5): 528-32. doi: 10.1136/emj.2002.003723.