Online Reviews Spotlight ER and Urgent Care Center Patient Experience

Online reviews reveal opportunities to improve patient experience at emergency departments and urgent care centers.

Studying online review platforms such as Yelp can help healthcare organizations understand and improve the patient experience at emergency departments and urgent care centers, new research shows.

In most areas of the country, urgent care centers have become an alternative to emergency rooms for acute medical needs. Both nonprofit healthcare organizations and private companies have opened freestanding urgent care centers in pharmacies, grocery stores, and other retail locations.

Yelp and other online review platforms are a golden opportunity for healthcare organizations to assess patient experience at emergency departments and urgent care centers, according to the new research published in Annals of Emergency Medicine.

"Studying differences in the patient experience between the ED and urgent care centers can provide insight into patients' needs and perceptions of these services. Furthermore, understanding differences in the patient experience may help health systems improve the allocation of, and investment in, alternative acute care settings," the researchers wrote.

Yelp data for emergency departments and urgent care centers
 

The Annals of Emergency Medicine research examined more than 100,000 Yelp reviews: 16,447 ED reviews and 84,502 urgent care center reviews. Yelp users pick ratings ranging from 1 star for the lowest rating to 5 stars for the highest rating.

The researchers' analysis of Yelp reviews of emergency departments and urgent care centers generated several key data points:

• Ratings of urgent care centers were generally higher than ED ratings. More than 60% of ED reviews were 3 stars or fewer, and 60% of urgent care reviews were 4 stars or more.
   
• There were five primary similar themes in 5-star reviews for EDs and urgent care centers—comfort and overall experience, professionalism, clean facilities, pediatric care, and friendly staff interactions.
   
• There were six primary similar themes in 1-star reviews for EDs and urgent care centers—poor communication, telephone or reception experience, excessive wait times, billing or insurance problems, pain management, and diagnostic testing.
   
• Unique themes in 5-star ED reviews included bedside manner, care for family members, and nighttime and weekend care access.
   
• Unique themes in 5-star urgent care center reviews included pharmacy refills and prescriptions.
   
• Unique themes in 1-star ED reviews included overall service and speed of care.
   
• Unique themes in 1-star urgent care center reviews included lack of confidence in care and reception experience.

"Although in general strengths in ED and urgent care center reviews suggest patients perceive better clinical care in EDs and service in urgent care centers, the deficiencies in these reviews suggest [patients] expect both elements from both settings. Lessons learned from patient reviews in these clinical settings may help improve care delivery and the patient experience as the acute care markets emerge, grow, and change," the researchers wrote.

'Improving negative experiences and reinforcing positive ones'
 

The lead author of the research told HealthLeaders that patients posting Yelp reviews have differing drivers that set apart low and high ratings for EDs and urgent care centers.

"This suggests that people may seek different types of care from the two settings and that the expectations may be different. Additionally, there are components of urgent care centers that approach the patient experience in a much different way as compared to ERs," said Anish Agarwal, MD, MPH, a national clinician scholars fellow in the Department of Emergency Medicine at Penn Medicine in Philadelphia.

Although the researchers did not examine why patients are more likely to post reviews for urgent care centers than for EDs, Agarwal said he believes there are two reasons. "One, there are many more urgent care centers, and, two, a 'better' experience likely leads to a higher likelihood for an individual to post a review," he said.

A crucial lesson learned from the research is that healthcare organizations should pay attention to online reviews, Agarwal said.

"Patients and their families are using online platforms to rate, review, and research healthcare. These reviews are organic and free-form, so they can offer a lot of insights as compared to structured surveys that are randomly sent out. Obviously, these reviews come with selection bias and multiple other forms of bias, but the themes that emerge from them can provide important areas to focus on for both improving negative experiences and reinforcing positive ones."