Impact of Patient and Family Communication in a Pediatric Emergency Department on Likelihood to Recommend

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Identify the specific patient experience variables that most strongly predict satisfaction as measured by the likelihood to recommend rating.


We performed a retrospective analysis of a patient satisfaction survey distributed to patients during their visit to an academic children’s hospital emergency department (ED) during a 3-month period. Any incomplete or incorrectly completed surveys were excluded. The associations between staff communication variables and “likelihood to recommend” were assessed while controlling for daily ED flow data.


A total of 3135 surveys were completed with 825 (26%) excluded for incomplete or incorrect entry. After controlling for daily census, median daily wait time and median daily length of stay, the communication question that asks if the nurse or physician kept them informed while in the examination room had the strongest association (odds ratio, 12.2; 95% confidence interval, 9.3–16.1; P < 0.001), with the response of “always” likely to recommend this ED.


This study demonstrates that keeping patients and their families informed has a more positive effect on patient satisfaction than any other variable studied even in the setting of increased census and wait times.

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