Development and validation of a questionnaire to assess satisfaction with hospital emergency care.

OBJECTIVE: To develop and validate a questionnaire to determine satisfaction with the hospital emergency department. DESIGN: Cross-sectional study to validate a telephone questionnaire designed in Spanish by a panel of experts. SETTING: The emergency department of Hospital Gregorio Marañón, a tertiary level hospital of the Spanish national health system. PARTICIPANTS: A sample of 651 emergency department patients completed the questionnaire. MAIN OUTCOME MEASURES: The psychometric properties of the questionnaire were evaluated; namely, construct, criterion validity, predictive validity and internal consistency. RESULTS: Two dimensions--comfortable service and personalised service--were identified from the exploratory factor analysis, and these accounted for 63% of the variance. Both factors showed a positive correlation with the global assessment items 'global satisfaction with the attention received in the emergency ward' and 'Would you recommend this emergency department?' The predictive validity of the questionnaire was assessed by means of discriminant analysis, which showed that 66.7% of patients were correctly classified. Internal consistency measured by Cronbach's alpha resulted in a value greater than 0.80 for both dimensions. CONCLUSIONS: This questionnaire fulfils the necessary psychometric properties to be considered a useful and reliable tool for measuring patient satisfaction with hospital emergency services.

Caídas en el hospital: registro del año 2005 / In-hospital falls: register for 2005

Objetivos: Describir la incidencia de caídas en pacientes ingresados en el Hospital General Universitario Gregorio Marañón durante el año 2005, así como las características de éstos y del contexto en que se producen estas caídas. Material y método: Estudio descriptivo realizado en 2005. Cuando se producía una caída se recogían en una ficha prediseñada las variables referentes al estado físico y mental del paciente y su entorno. Los datos se analizaron calculando frecuencias absolutas, porcentajes, medias, desviaciones típicas, rango y mediana. Resultados: La incidencia de caídas en el año 2005 fue del 0,6%. La edad media fue de 71,4 ± 14,89 años, con más frecuencia en varones (55,4%). El 14,7% de los pacientes presentaba un antecedente de caídas en el último mes. El 65,9% se produjo en la habitación; el 69,2%, en días laborables, y el 47%, en el turno de noche. Destaca que los pacientes presentaban más frecuentemente limitaciones de la movilidad y alteración de los sentidos, y tomaban varios fármacos. El timbre inalcanzable, el calzado inadecuado y la escasa iluminación fueron las características del entorno más registradas. Conclusiones: Es importante intensificar el registro de caídas para conocer las circunstancias en que éstas se producen y así poder instaurar estrategias de prevención

Objective: To describe the incidence of falls in patients admitted to the Hospital General Universitario Gregorio Marañón in 2005 and to identify the clinical characteristics and context of these falls. Material and method: A descriptive study was carried out during 2005. When a fall was reported, variables related to the patient's physical and mental status and to the context in which the fall was produced were recorded on a predesigned sheet. Data were analyzed using absolute frequencies, proportions, means, standard deviations, median, and range. Results: The incidence of falls in 2005 was 0.6%.The mean age was 71.4 (14.89) years. Falls were more frequent among males (55.4%). Of patients who fell, 14.7% had suffered a fall in the previous month. A total of 65.9% of falls occurred inside the patient's room, 69.2% on work days and 47% in the night shift. Gait impairment, sensory defects and use of several drugs were more frequent among patients who fell. The most frequently reported environmental characteristics were an unreachable bell, unsuitable footwear, and insufficient lighting. Conclusions: Recording of falls should be increased to identify their causes and to design new prevention strategies