Emergency Department Patients and Emergency Department Clinicians Perceptions of Acuity: How Do They Differ?

The differences between emergency department (ED) patients and clinicians perception of patients' acuity have not been evaluated since studies published in 1980 and 1995. This study prospectively compared ED patient and clinicians perceptions of patient acuity.

The 5- point acuity scale used to survey patients and clinicians was level 1 critical: immediate care required, level 2 emergent: care required within 15 minutes, level 3 urgent: care required within 15- 60 minutes, level 4 semiurgent: care required within 2- 24 hours, level 5 nonurgent: care required within several days. Socio- economic variables were collected from patients electronic medical records (EMR). Comparisons were made between patients and clinicians.

Of the 387 patients surveyed, 60.7% were female, 60.3% African- American, 39.7% White, 48.2% single, 32.8% married , 47.4% public vs. 35.3% private insurance, 17.4% uninsured, 56.1% employed or receiving benefits, 74.4% had a primary care physician (PCP), 53.5% discharged vs.43.2% admitted vs.3.4% transferred. Mean (±SD) acuity score was 3.40 (±2.40) for patients vs. clinicians 2.02 (±1.13) (p=0.0001). Patient vs. Clinicians ratings acuity levels were level 1:45.2% vs. 4.5% (p <0.001), level 2: 22.0% vs. 12.3% (p <0.001), level 3: 23.0% vs. 34.0% (p <0.001), level 4: 5.8% vs. 37.0% (p <0.001), level 5: 4.0% vs. 12.3% (p < 0.001)

Patients and clinicians perceptions of acuity are significantly different. Patients consider themselves to be more acutely ill/injured and in need of immediate care than clinicians. Clinicians most often perceived patients required semiurgent or urgent care, patients perceived they most often required immediate medical care.

Learning Areas:

Advocacy for health and health education
Provision of health care to the public
Public health or related education
Public health or related research

Learning Objectives:
Evaluate differences between emergency department patients and clinicians perceptions of patients' medical acuity.

Keyword(s): Health Care Access, Health Promotion and Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am responsible for all preliminary research, methods proposal, materials development, data collection and analysis and result conclusions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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