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The disconfirmation paradigm: throughput times and emergency department patient satisfaction.
J Emerg Med. 2007 Jan; 32(1):7-13.JE

Abstract

This study examined the relationship between throughput times, expectations, and patient satisfaction using the Disconfirmation Paradigm (DP), which proposes that dissatisfaction arises when service expectations are not met. Before discharge or admission, adult emergency department (ED) patients estimated how long they waited for three intervals (Perceived Times): triage to patient care area, patient care area placement to physician evaluation, and physician evaluation to disposition. Acceptable waiting times and satisfaction for the same intervals were then provided by the subject (Acceptable Times and Throughput Time Satisfaction, respectively). Perceived Times were subtracted from Acceptable Times to yield an index of Expectancy Disconfirmation. There were 1118 (72%) of 1550 eligible patients interviewed. Throughput Time Satisfaction predicted overall satisfaction (r = 0.56 to 0.62, p < 0.001). In turn, Expectancy Disconfirmation predicted Wait Time Satisfaction (r = 0.42 to 0.64, p < 0.001). Consistent with the DP, when throughput times exceeded expectations, dissatisfaction with those throughput times arose, leading to general dissatisfaction with the ED visit.

Authors+Show Affiliations

Department of Emergency Medicine, Cooper University Hospital and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School at Camden, New Jersey 08103, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17239726

Citation

Cassidy-Smith, Tara N., et al. "The Disconfirmation Paradigm: Throughput Times and Emergency Department Patient Satisfaction." The Journal of Emergency Medicine, vol. 32, no. 1, 2007, pp. 7-13.
Cassidy-Smith TN, Baumann BM, Boudreaux ED. The disconfirmation paradigm: throughput times and emergency department patient satisfaction. J Emerg Med. 2007;32(1):7-13.
Cassidy-Smith, T. N., Baumann, B. M., & Boudreaux, E. D. (2007). The disconfirmation paradigm: throughput times and emergency department patient satisfaction. The Journal of Emergency Medicine, 32(1), 7-13.
Cassidy-Smith TN, Baumann BM, Boudreaux ED. The Disconfirmation Paradigm: Throughput Times and Emergency Department Patient Satisfaction. J Emerg Med. 2007;32(1):7-13. PubMed PMID: 17239726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The disconfirmation paradigm: throughput times and emergency department patient satisfaction. AU - Cassidy-Smith,Tara N, AU - Baumann,Brigitte M, AU - Boudreaux,Edwin D, PY - 2005/07/11/received PY - 2006/04/04/revised PY - 2006/05/17/accepted PY - 2007/1/24/pubmed PY - 2007/4/4/medline PY - 2007/1/24/entrez SP - 7 EP - 13 JF - The Journal of emergency medicine JO - J Emerg Med VL - 32 IS - 1 N2 - This study examined the relationship between throughput times, expectations, and patient satisfaction using the Disconfirmation Paradigm (DP), which proposes that dissatisfaction arises when service expectations are not met. Before discharge or admission, adult emergency department (ED) patients estimated how long they waited for three intervals (Perceived Times): triage to patient care area, patient care area placement to physician evaluation, and physician evaluation to disposition. Acceptable waiting times and satisfaction for the same intervals were then provided by the subject (Acceptable Times and Throughput Time Satisfaction, respectively). Perceived Times were subtracted from Acceptable Times to yield an index of Expectancy Disconfirmation. There were 1118 (72%) of 1550 eligible patients interviewed. Throughput Time Satisfaction predicted overall satisfaction (r = 0.56 to 0.62, p < 0.001). In turn, Expectancy Disconfirmation predicted Wait Time Satisfaction (r = 0.42 to 0.64, p < 0.001). Consistent with the DP, when throughput times exceeded expectations, dissatisfaction with those throughput times arose, leading to general dissatisfaction with the ED visit. SN - 0736-4679 UR - https://www.unboundmedicine.com/medline/citation/17239726/The_disconfirmation_paradigm:_throughput_times_and_emergency_department_patient_satisfaction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0736-4679(06)00629-9 DB - PRIME DP - Unbound Medicine ER -