What do patients say about emergency departments in online reviews? A qualitative study

• Published in: BMJ quality & safety Vol. 25; no. 1; pp. 14 - 24
• Main Authors: Kilaru, Austin S, Meisel, Zachary F, Paciotti, Breah, Ha, Yoonhee P, Smith, Robert J, Ranard, Benjamin L, Merchant, Raina M
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.01.2016
• Subjects: Communication; Efficiency, Organizational; Emergency medical services; Emergency Service, Hospital - organization & administration; Health administration; Health care; Hospitals; Humans; Internet; Medical personnel; Pain Management - methods; Patient Satisfaction; Qualitative analysis; Qualitative Research; Quality of Health Care - organization & administration; Waiting Lists; United States > US; Qualitative research; Emergency department; Patient satisfaction; Patient-centred care; Quality measurement
• ISSN: 2044-5415; 2044-5423
• DOI: 10.1136/bmjqs-2015-004035

BackgroundPatients have adopted web-based tools to report on the quality of their healthcare experiences. We seek to examine online reviews for US emergency departments (EDs) posted on Yelp, a popular consumer ratings website.MethodsWe conducted a qualitative analysis of unstructured, publicly accessible reviews for hospitals available on http://www.yelp.com. We collected all reviews describing experiences of ED care for a stratified random sample of 100 US hospitals. We analysed the content of the reviews using themes derived from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) inpatient care survey. We also used modified grounded theory to iteratively code the text of the reviews, identifying additional themes specific to emergency care. The data were double-coded, and discrepancies were evaluated to ensure consensus.ResultsOf the 1736 total reviews, 573 (33%) described patient experiences involving the ED. The reviews contained several themes assessed by the HCAHPS survey, including communication with nurses, communication with doctors, and pain control. The reviews also contained key themes specific to emergency care: waiting and efficiency; decisions to seek care in the ED; and events following discharge, including administrative difficulties.ConclusionsThese exploratory findings suggest that online reviews for EDs contain similar themes to survey-based assessments of inpatient hospital care as well as themes specific to emergency care. Consumer rating websites allow patients to provide rapid and public feedback on their experience of medical care. Web-based platforms may offer a novel strategy for assessing patient-centred quality in emergency care.