Category: Administration
Keywords: Patient Experience, Patient Satisfaction, CMS Evaluation, ED Evaluation, (PubMed Search)
Posted: 7/22/2025 by Mercedes Torres, MD
(Updated: 7/23/2025)
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Shout out to UMEM alum Diane Kuhn, MD, PhD as the first author of this recent publication…
She and her colleagues examined the factors that contribute to ED patient experience scores, uncovering several which are not considered in the current CMS evaluative framework. See the editor's (our very own Stephen Schenkel, MD, MPP) capsule summary below:
What is already known on this topic? Medicare plans nationally standardized Emergency Department (ED) Patient Experience scores (ED
CAHPS) to allow comparison across sites.
What question this study addressed. Are there clinical and operational ED characteristics for which ED patient experience scores ought to be adjusted?
What this study adds to our knowledge. Based on 58,622 ED visits from one system, patients arriving in pain were less satisfied and those receiving radiologic studies had a positive experience.
How this is relevant to clinical practice. Influences on patient satisfaction are multifactorial and many are outside the control of the ED. Comparing EDs based on patient experience is complex and prone to misinterpretation.
As the authors point out, If patients placed in a hallway bed have a more negative experience simply due to the location in the department, or patients arriving in pain have a more negative experience regardless of ED care, then some EDs will face more challenges than others in achieving optimal patient experiences.
The current CMS evaluative framework may inherently disadvantage certain EDs, including those with limited physical space relative to their patient volumes, such as safety-net hospitals, or those that care for a high proportion of patients experiencing chronic pain. Is this fair? Does it reflect what CMS is trying to evaluate? Are there alternatives?
Kudos to Dr. Kuhn on her insightful publication and Dr. Schenkel for his expert editing!
Kuhn, Diane et al. Use of Hallway Beds, Radiology Studies, and Patients in Pain on Arrival to the Emergency Department Are Associated With Patient Experience, Annals of Emergency Medicine, Volume 86, Issue 2, 150 - 157. https://doi.org/10.1016/j.annemergmed.2024.11.020
