Introduction
Patient satisfaction is a double-edged sword. While we aim for our patients to be satisfied with the care we provide, leading to better health outcomes, we are often unfairly judged by administration based on patient satisfaction scores. These scores can be influenced by factors outside of our control, causing emergency physicians to perform unnecessary tests and prescribe medications merely to maintain high satisfaction levels.
The benefits of POCUS in diagnosing and treating ED patients are well-documented. However, its impact on patient satisfaction is less discussed. Despite limited research, both qualitative and quantitative studies support a positive association between POCUS and patient satisfaction. Known factors contributing to patient satisfaction can be linked to POCUS, suggesting it does enhance patient satisfaction.
POCUS and Patient Satisfaction
Let’s examine how POCUS can be integrated into known factors affecting patient outcomes.
Communication
Individuals have different learning styles with which they learn best: auditory, visual, reading/writing, and kinesthetic. In the ED, we primarily use auditory communication, explaining diagnoses, test results, and management verbally. We add reading when discharging patients, discussing return instructions and expectations.
POCUS introduces a visual and possibly kinesthetic component through probe movement. Understanding requires effective communication. Using POCUS to demonstrate the organ system involved, as well as normal or abnormal findings related to the patient’s condition, makes it more likely that the patient will better comprehend their treating physician’s explanations. This improved understanding can lead the patient to perceive the physician as a better communicator when recalling their ED visit.
Wait Times
Patients spend most of their ED visit waiting. Extended wait times correlate with lower patient satisfaction. Efficient POCUS use can expedite care in certain scenarios. For instance, if a patient presents with unilateral leg swelling or pain, a POCUS can quickly rule in or out a DVT during the initial evaluation, leading to faster disposition and shorter length of stay. Streamlined workflow with imaging archival and reporting is essential in such cases.
Perceived Physician Competence
Patient perception of physician competence and actual competence aren’t always correlated. Factors increasing perceived competence include longer contact time and the use of technology. POCUS extends perceived contact time as the physician is “examining” the patient for a higher percentage of the encounter. Additionally, using advanced technology like ultrasound can boost the perception of competence. Certainly, having a machine that allows patients to see inside their own body in real-time qualifies as enhancing this perception.
Sonoanxiolysis
Sonoanxiolysis, or therapeutic sonography, is when a patient feels better knowing their POCUS is normal. This placebo-like effect can improve symptoms, including pain. For example, a patient with chest pain determined to be anxiety-related can be reassured more effectively by showing a normal cardiac POCUS than by simply stating the results are normal.
Conclusion
POCUS is a powerful diagnostic tool in emergency medicine. While we cannot control many factors affecting patient satisfaction, we can leverage POCUS to enhance it. Despite our aversion to Press Ganey scores, improved patient satisfaction correlates with better health outcomes.
As emergency physicians, our goal is to improve patient outcomes. Incorporating POCUS into our workflow can achieve this beyond its diagnostic and procedural benefits. Establishing a robust POCUS program with streamlined workflows, optimized archiving, and documentation will increase POCUS utilization and patient satisfaction.
