Does the presence of a patient advocate in the emergency department influence outpatient satisfaction? A quality improvement initiative

Study objectives: The Patient Advocate Project used nonclinical assistance to serve as a liaison between clinicians, patients, and their families. These duties included making rounds in the waiting room, distributing informational packets, and helping patients or visitors. The project was implemented 24 hours a day, 7 days a week, for a 5-week period in our emergency department (ED) as a quality improvement initiative. We determine the impact of the patient advocate on outpatient satisfaction survey scores as measured by an independent contracted commercial health care survey vendor. Methods: This was an institutional review board–approved, retrospective, observational survey study conducted at a university teaching hospital ED with an annual census of 60,000. We compared the survey data 5 weeks before implementation, 5 weeks during the program, and 5 weeks after the program. We also collected data of patient advocate interventions, such as provision of general hospital information, comforting activities, aided with ED policy, transportation assistance, and relayed information. The Mann-Whitney U test and the χ2 test were used to analyze the data, with a P value less than .05 considered significant. Results: Of the 1,837 interventions recorded, 16.8% were general hospital information, 40.1% comforting activities, 10.1% aided with ED policy, 2.4% transportation assistance, and 30.6% relayed information. Compared with the pooled pre- and postprovider intervals of results from an outside patient satisfaction survey, the Patient Advocate Project–provided interval exhibited a significantly higher level of approval (mean 85.6% versus mean 81.2%; Mann-Whitney χ2=4.34; P=.04). Conclusion: Outpatient satisfaction survey data from pre-, peri-, and postprovider (patient advocate) periods were compared. The data obtained demonstrated that the implementation of a Patient Advocate Project improved overall satisfaction scores in the ED during the peri-intervention period.