Comparing patients and families perceptions of satisfaction and predictors of overall satisfaction in the emergency department

STUDY OBJECTIVE: The aim of the study was to investigate factors that best predict patient’s satisfaction with their ED visit, as well as examine whether patients and their families perceived the factors related to satisfaction similarly. METHODS: This is a retrospective study where secondary data analysis was done on patient satisfaction data collected over three quarters for quality improvement purposes. Exploratory factor analysis (EFA) was conducted on the data from the first quarter to identify the factor structure, followed by confirmatory factor analysis (CFA) on the rest of the data to confirm the EFA factor structure. A structural equation model (SEM) was fitted where the factors predicted overall satisfaction with the ED visit. Finally, measurement invariance was conducted to examine if patients and families perceived the factors related to ED services alike. RESULTS: Two factors were found to be predictive of satisfaction: clinical team and system processes. The SEM showed that system process was a statistically significant predictor of overall satisfaction, while clinical team predicted overall satisfaction to a smaller extent. Multi-group CFA showed that the factor structure fitted neither family nor patient groups adequately. The instrument did not exhibit partial invariance. CONCLUSION: This study found that system process was the best predictor of overall satisfaction. Furthermore, this study showed that the same instrument might not reliably compare the perceptions of patients and families.