Relationships between patient flow problems, health care services, and patient satisfaction : an empirical investigation of the emergency department

Purpose The purpose of this study is to establish empirical relationships between patient flow problems, healthcare service quality and patient satisfaction with emergency department (ED) service factors from the patient perspective. Design/methodology/approach In the overall study, of which the current investigation is a part, a mixed-method research approach was to achieve the research objectives. The results reported in this paper are based on a comprehensive questionnaire survey where a well-designed and reliable questionnaire was used to survey ED patients. This study conducted partial least squares structural equation modelling (PLS-SEM) by using Smart PLS software. Findings Results show that the respondents mostly agreed with the proposed concept of quality in ED and patients were less satisfied with ED services in general and with the internal and external environments in ED in particular. It was found that relationships between nine identified scales of patient flow problems, healthcare service quality, and patient satisfaction are significant. The findings reveal that the relationship between patient flow problems and patient satisfaction is positively mediated through healthcare service quality, which shows the predictive capability of the model, indicating high predictive relevance. Research limitations/implications This research involves a relatively small sample from a single case study. The positive relationship between patient flow problems and patient satisfaction indicate practical significance of the model for guiding to improve overall patient satisfaction. Originality/value This research, through the involvement of both hospital staff and the patient, brings out a holistic approach in terms of operational excellence in a critical unit such as the ED. The empirically established relationships form the benchmarking and guide for developing guidelines for designing policies for service improvements of ED practices.