Happy here in ED? Please push the smiley face

Simple button terminals featuring “emoji” reflecting a range of emotions were remarkably effective in monitoring the feelings of both patients and medical staff during a recent trail in a US hospital emergency department.

Writing in the journal Annals of Emergency Medicine, researchers from University of Pennsylvania School of Medicine report receiving an average of 108 “sentiments” a day from just three terminals across the five-month trial.

“We wanted to see if people would even notice these buttons, which they did. And they pushed them a lot,” says co-author Anish Agarwal. 

Not only was the response rate much higher than for traditional patient post-visit surveys, the real-time feedback allowed administrators to monitor how both patients and staff were feeling and make adjustments, the researchers say.

The terminals were similar to those used to gauge visitor satisfaction in sports arenas and airports.

Each featured four buttons, ranging from very positive (green, with a happy face) to very negative (red, with a frowning face). 

They were set-up near the physician workstations, at nurse workstations, and at the patient exit.

More than half of the responses came from the nursing terminal, and both doctors and nurses expressed some negative sentiments associated with high patient numbers waiting to be seen. 

At the patient exit terminal, positive responses outnumbered negative by about 25% each day.

“This work suggests that we can collect real-time provider and patient feedback that we haven’t previously been able to identify,” says senior author Raina Merchant. “This can allow for support when things are going well and addressing challenges when they occur.”

Agarwal now plans further work to determine why sentiment shifts happen and the best ways to respond to them.

“I would argue that the day-to-day frustrations – and joy – clinicians experience likely contributes to their long-term satisfaction or burnout. So we need to rethink how we engage with providers and patients.”

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