Patients' comprehension of their emergency department encounter: a pilot study using physician observers

Mandi W. Musso, Graduate Medical Education, Emergency Medicine, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA. Electronic address: mmuss1@lsuhsc.edu.
J Nelson Perret, Emergency Medicine Residency Program, LSU Health-Baton Rouge, Baton Rouge, LA.
Taylor Sanders, Emergency Medicine Residency Program, LSU Health-Baton Rouge, Baton Rouge, LA.
Ross Daray, Emergency Medicine Residency Program, LSU Health-Baton Rouge, Baton Rouge, LA.
Kyle Anderson, Emergency Medicine Residency Program, LSU Health-Baton Rouge, Baton Rouge, LA.
Melissa Lancaster, Emergency Medicine Residency Program, LSU Health-Baton Rouge, Baton Rouge, LA.
David Lim, Emergency Medicine Residency Program, LSU Health-Baton Rouge, Baton Rouge, LA.
Glenn N. Jones

Abstract

STUDY OBJECTIVE: The current study examines patients' comprehension of their emergency department (ED) encounter, using physician observers to document both physician communication and details of the encounter. METHODS: Eighty-nine patients were recruited from a convenience sample in an urban ED. To be included in this study, patients had to have low triage levels (4 and 5) and be discharged from the ED. Physician observers were present throughout the encounter, documenting physician communication and procedures performed. Patients were then interviewed by physician observers about their communication with physicians, accuracy in recalling facts about the encounter, and understanding of information provided during the encounter. RESULTS: The majority of patients were black and had a high school education. Physicians typically engaged in behaviors related to building rapport and diagnosing patients. However, physicians informed patients about test results and diagnoses less frequently. In terms of patients' accuracy and understanding of the visit, patients were generally aware of basic facts in regard to their ED encounter (ie, whether they had blood drawn), but 65.9% of patients demonstrated less than "good" understanding in at least 1 area assessed. CONCLUSION: The findings of the current study indicate physicians could improve communication with patients, particularly in regard to care received in the ED. This study also indicates that a large percentage of patients fail to understand information about their ED encounter even when physicians provide it. A primary limitation of the current study is the relatively homogenous physician sample.