Impact of COVID-19 Surges on Emergency Department and Yelp Review Scores at a Community Health System

The COVID-19 pandemic has posed an unprecedented challenge to healthcare systems worldwide, and EDs have been at the forefront of this challenge [1,2]. EDs have had to adapt rapidly to the changing circumstances and increased demand for their services while ensuring the safety of their patients and staff [3]. This study provides valuable insights into the impact of the pandemic on EDs and patient experiences, and we believe that its findings have significant implications for the future of EDs and healthcare systems more broadly. The study showed that during surging months, a decrease in ED visits and an increase in ED admission rates were observed. Online rating platforms such as Yelp can offer patients & their family to rate the hospitals on a scale of one to five stars and write a review. The score was used to evaluate the degree of satisfaction or dissatisfaction. During surging month (First surging period: June 2020-August 2020; Second surging period: November 2020-January 2021) (Figure 1), Yelp rating scores also decreased from 3.0 or above to 2.5. These findings are concerning, as they suggest that the pandemic has had a significant impact on EDs and has negatively impacted patient experiences (Figure 2)

Figure 1:A community health system’s COVID-19 cases, January 2020-June 2021.

Figure 2:ED visit, ED admission rates & Yelps review scores during 2 COVID-19 surging periods, June 2020- August 2020 and November 2020 - January 2021.

The decrease in ED visits during surging months may be attributed to fear and uncertainty surrounding the pandemic, as well as concerns about the safety of visiting hospitals [4,5]. Patients may be avoiding EDs for fear of exposure to the virus or because they believe that their condition is not severe enough to warrant a visit to the ED [6-8]. This highlights the need for clear communication and education to address these concerns and encourage patients to seek timely and appropriate care. It is crucial to ensure that patients understand the importance of seeking care when they need it and that EDs are safe and accessible places for them to receive that care. The increase in ED admission rates during surging months is a concerning trend, as it suggests that EDs are struggling to cope with the demands of the pandemic and may be at risk of being overwhelmed. This could lead to delays in care, reduced quality of care, and increased risk of adverse outcomes for patients [9-11]. To address this issue, urgent action is needed to provide additional resources and support to EDs and their staff. This could include providing additional staff, increasing bed capacity, and ensuring that EDs have the necessary equipment and supplies to care for patients effectively

Finally, the decrease in Yelp review scores during surging months is a concerning trend, as it suggests that patients’ experiences in EDs are being negatively impacted by the pandemic. This may be due to a range of factors, including longer wait times, reduced availability of resources, and increased stress and workload for ED staff [12,13]. While Yelp review scores can be a useful tool for monitoring patient experiences and identifying areas for improvement, it is important to note that they may not always be representative or accurate and should be interpreted with caution [14]. However, they can be an important indicator of patient satisfaction and can help to identify areas where improvements are needed [15,16].

In conclusion, the study provides valuable insights into the impact of the COVID-19 pandemic on EDs and patient experiences. The findings highlight the urgent need for additional resources and support for EDs and their staff to ensure that patients receive timely and appropriate care during surging periods. Additionally, monitoring patient experiences through Yelp review scores can be a useful tool for identifying areas for improvement and ensuring that patients receive high-quality care. It is essential that we continue to monitor the impact of the pandemic on EDs and healthcare systems more broadly and take the necessary steps to ensure that patients receive the care they need when they need it.

1. Khosrawipour V, Lau H, Khosrawipour T, Kocbach P, Ichii H, et al. (2020) Failure in initial stage containment of global COVID-19 epicenters. Journal of Medical Virology 92(7): 863-867.
2. Tong JY, Wong A, Zhu D, Fastenberg JH, Tham T (2020) The prevalence of gastrointestinal symptoms and fecal viral shedding in patients with coronavirus disease 2019: A systematic review and meta-analysis. American Journal of Gastroenterology 115(7): 1112-1120.
3. Jones CW, Groner KA, Cohen GR (2020) Emergency department response to COVID-19: Priorities for operational alignment. Annals of Emergency Medicine 76(3): 361-366.
4. Bragazzi NL, Mansour M, Bonsignore A, Ciliberti R (2020) The role of hospital and community pharmacists in the management of COVID-19: Towards an expanded definition of the roles, responsibilities and duties of the pharmacist. Pharmacy (Basel) 8(3): 140.
5. Williams C, McGowan B (2021) Reconsidering the emergency department: Unpacking invisible labour and the neoliberal turn. Social Science & Medicine 270: 113662.
6. Heaney C, Garcia A (2020) COVID-19 and emergency department visits for stroke symptoms. Western Journal of Emergency Medicine 21(5): 1177-1180.
7. Lurie N, Carr BG, Theodorou S, Steingrub JS (2020) Alternative hospital sites for critical care in an era of limited resources. New England Journal of Medicine 382(13): 1271-1273.
8. Baig AM, Sanders EC, Yeo DW (2020) Current perspectives on COVID-19 outbreak and its consequences. Journal of Infection and Public Health 13(7): 913-920.
9. Jelinek GA, Weeramanthri TS, Raubenheimer JE (2021) Emergency department performance during the COVID-19 pandemic: A qualitative study. Emergency Medicine Australasia 33(6): 1357-1361.
10. Lammers E, Dinh I, Grimes K (2020) Characteristics of emergency department presentations during the COVID-19 pandemic in New South Wales, Australia. Emergency Medicine Australasia 32(6): 1614-1621.
11. Lipnicki DM, Gomes AV, Silva DDB (2020) Emergency department presentations during the COVID-19 pandemic in Brazil: A cross-sectional analysis. BMC Emergency Medicine 20(1): 177.
12. Czeisler MÉ, Tynan MA, Howard ME (2020) Public attitudes, behaviors and beliefs related to COVID-19, stay-at-home orders, nonessential business closures, and public health guidance-United States, New York City and Los Angeles, May 5-12, 2020. Morbidity and Mortality Weekly Report 69(24): 751-758.
13. Lin C, Karim SA, Peacock WF (2021) Emergency department performance during the COVID-19 pandemic: A multicenter study of 36 US hospitals. Academic Emergency Medicine 28(4): 433-442.
14. Lagu T, Metayer K, Moran M (2016) Publicly reported hospital Yelp scores do not correlate with objective measures of quality or patient outcomes. Journal of Hospital Medicine 11(7): 491-494.
15. Ranard BL, Werner RM, Antanavicius T (2016) Yelp reviews of hospital care can supplement and inform traditional surveys of the patient experience. Health Affairs 35(4): 697-705.
16. Bardach NS, Lyndon A, Asteria-Peñaloza R, Goldman LE, Lin GA, et al. (2016) From the closest observers of patient care: A thematic analysis of online narrative reviews of hospitals. BMJ Quality & Safety 25(11): 889-897.