The Influence of Prior Ambulance Transport on Reported Perceptions of Patient Satisfaction During Subsequent Ambulance Transports in a High-Volume EMS System

Introduction—Tracking patient satisfaction data can help an EMS system pursue targeted improvements by adapting to meet the predisposed patient expectations.

Objective—To explore and describe any extraneous influence of prior ambulance transport on perceived patient satisfaction during subsequent ambulance transport.

Methods—This quality improvement study involved the planned secondary analysis of prospectively collected data from a systemwide patient satisfaction initiative. A third-party vendor conducted telephone surveys aimed at obtaining 500 complete responses per month using a random sample from 130,000 local 9-1-1-initiated incidents resulting in ambulance transport. Incomplete responses and nonemergency calls were excluded. The instrument contained six questions intended to measure various aspects of patient satisfaction using a four-point ordinal scale (strongly disagree to strongly agree) along with a net promoter item. A single additional question was temporarily added to determine if a respondent had previously been transported by an ambulance before the current incident. This distinction was then used as a basis of comparison against reported patient satisfaction in each category.

Results—Over the three-month study period, 1,508 complete patient responses were obtained. Most patients (74%) indicated they had been transported in an ambulance on at least one occasion before the incident for which they were being surveyed. Patients who had been transported previously reported higher levels of satisfaction in all categories measured. However, the categorical differences were minimal, with only patient perception of 9-1-1 call-taker professionalism demonstrating a statistically significant difference c2 (3, n=1,508)=8.930, p=.03. The top box score (very satisfied) of those having prior transport experience was 45%, compared to 37% for those who had never been transported via ambulance.

Conclusion—Despite potential limitations of homogeneity within our sample, these results still provide a meaningful context for the interpretation of our patient satisfaction data. These results also contribute to a void in the literature specific to patient satisfaction in the context of value-related characteristics of EMS.