Why Am I Here? A Survey of Patent Knowledge on their Care in the E.D.
Objective: We observed that admitted patients in the ED were often inadequately informed about the care they were receiving and their admission diagnosis. Our search of the medical literature revealed no study evaluating patients' knowledge of their admission diagnosis. This is the first reported study evaluating patients' knowledge of their admission diagnosis.
Methods: A convenience sample was taken, which surveyed all admitted patients in the ED at shift change, twice a day, over a five month period in the ED (N = 579). The survey asked if the patients knew why they were admitted, to name any doctor involved in their care, and predict their length of stay. Univariate and bivariate analysis was performed with SPSS. Categorical variables were analyzed using chi-sq. Length of stay was analyzed using independent sample t-tests and correlations. P values were 2 sided.
Results: 579 patients were surveyed. 366 (63.4%) were cognizant of their admission diagnosis. 403 (69.6%) could not recall the name of any physician who provided treatment during their ED visit. Patients who knew their diagnosis expected to stay in the hospital longer than patients who did not. 2.1 days compared to 1.6 days (P=.037) respectively. Patients who knew their diagnosis and knew their doctor expected to stay even longer 2.5 days compared to 1.6 days (P=.015). Patients (5/6; P=.027) admitted for CVAs significantly differed to patients with other admitting diagnoses as to not knowing why they were being admitted. There was no correlation between expected length of stay and actual length of stay (σ=.08; P=.401). Expected length of stay was 1.8 days actual length 5.1 days.Conclusion: As was suspected a 1/3 of patients admitted from the ED did not know their diagnosis. In addition greater than 2/3 of the patients could not name a single doctor involved in their care. Patients who knew their diagnosis and physician had a more accurate expectation of their length of stay. Patients diagnosed with CVAs were less aware of their condition. Our next step in this study is to determine if there is a correlation between patient knowledge and expectation of their lengths of stay and patent satisfaction. More importantly, this study reveals that there is a gap between patient expectation of their lengths of stay and the reality. This chasm, we suspect, is a source of lower patient satisfaction with their medical care.