Patient expectations of minor injury care: a cross-sectional survey

Background and objective: Little is known about the expectations of patients attending the emergency department (ED) with minor injuries. Failure to address expectations may lead to dissatisfaction and poor compliance. We aimed to describe patient expectations of minor injury care and explore the association between unmet expectations and patient satisfaction.

Methods: We undertook a cross-sectional questionnaire survey of 300 patients attending the ED with minor injuries on weekdays between 9:00 and 17:00. Participants completed a questionnaire asking which tests and treatments they expected, which they consequently received, whether explanations were given for tests and treatments, and how they rated satisfaction with care.

Results: The most frequently expected interventions were x-ray, analgesia and bandage/strapping. In each case the proportion expecting intervention was significantly higher than the proportion receiving intervention: x-ray (58% vs 47%, p<0.001); analgesia (40% vs 20%, p<0.001); bandage/strapping (39% vs 22%, p<0.001). There were no significant differences between the proportions expecting and receiving other interventions. At least one unmet expectation was reported by 208/300 patients (69%) but an explanation was received in 151/208 cases (73%). Conversely, 106 (35%) received an unexpected intervention, of whom 79/106 (74%) received an explanation. Patients with unmet expectations tended to rate the satisfaction lower, but the difference was not statistically significant (p=0.187).

Conclusions: Patients often expect interventions for minor injuries that they do not receive, but in most cases an explanation was given. We were unable to demonstrate an association between unmet expectations and reduced satisfaction with care.