Date of Award


Degree Name

Doctor of Philosophy


Public Affairs and Administration


As the cost of providing healthcare services continues to rise, hospitals and other healthcare provider organizations adopt businesslike approaches to increase efficiency and productivity. The satisfaction level of the individual patient may, however, be determined by how care is delivered rather than what services are provided.

In order to enhance patient satisfaction and prevent the consequences of dissatisfaction, many healthcare institutions have utilized the role of the patient representative. The primary function of the patient representative is to act as a liaison between the patients, their families, and the healthcare providers and staff.

The purpose of this study was to examine the relationship between the role of the patient representative and the patient's and family's satisfaction. Five emergency departments were studied. Three emergency departments had the services of the patient representative available and two emergency departments did not. A questionnaire was given to each patient, family member or friend in order to measure satisfaction levels. The questionnaire was designed to measure five components of satisfaction as determined by the literature: communication, access to care, humaness of care, waiting time and the physical environment of the department.

The response rate for the study was low, averaging 7%. The data was examined in terms of individual emergency departments, combined totals for all participating departments, and departments with patient representatives compared to those without patient representatives. The hypothesis that a patient representative may impact satisfaction levels positively was not supported. Although results are not generalizable because of the low response rate, significant scores were found several satisfaction categories. Humanness as a predictor of satisfaction among independent, demographic variables was significant at the .03 level and may impact satisfaction regardless of a patient representation. A Chi-Square test also produced significant results of satisfaction variables among demographic categories. "Communication" by "gender" was significant (.03) as was "humanness" by "age" (.01) and "education" (.02). Although waiting time scores were not significant, they had the lowest mean score of all satisfaction categories, in all departments. It also had the lowest mean scores for all demographic categories and urgency of care.

The findings of this study did support the many studies that demonstrate the patient's expectations of humanness and communication as they seek medical attention. It also stresses the importance of caring, concerned health care providers in meeting the patient's needs.

Access Setting

Dissertation-Open Access