Key factors influencing patient satisfaction in the emergency department of a tertiary hospital in Saudi Arabia: a cross-sectional study

Background Patient satisfaction is a key indicator of healthcare quality and an essential measure of emergency department (ED) performance. In high-demand ED environments, satisfaction reflects not only clinical outcomes, but also communication, waiting time, clarity of processes, and the overall patient experience. The aim of this study was to identify clinical and non-clinical factors that influence patient satisfaction in the ED of a tertiary healthcare center in Saudi Arabia. Methods This analytical cross-sectional study included Arabic or English speaking adult patients (≥ 18 years) attending the ED of a tertiary care center in Saudi Arabia after triage and clinical stabilization. Patients triaged as levels I–II, arriving by ambulance, medically unstable, or having impaired cognitive or mental status were excluded. The target sample size was estimated using a 95% confidence level, 5% margin of error, and 50% response distribution, which yielded an approximate target range of 280–380 participants for a large ED population; 298 complete questionnaires were included. A structured questionnaire covering demographics, 21 satisfaction factors, and three global satisfaction items was administered. Descriptive statistics, Spearman correlation, and multivariable linear regression were used; significance was set at p < 0.05. Results A total of 298 patients were included, and the response rate was 75.06% of eligible participants (298/397). Most participants reported generally positive experiences across satisfaction domains. Nearly all factors showed significant positive correlations with overall satisfaction, and the strongest associations were observed for communication with physicians ( ρ = 0.46), communication with nurses ( ρ = 0.40), explanation of the treatment provided ( ρ = 0.38), and waiting time during stay ( ρ = 0.41). In the multivariable model ( R ² = 0.50), four factors remained significant predictors: communication with physicians, communication with nurses, explanation of the treatment provided, and waiting time during stay. Environmental and facility-related factors were less influential after adjustment. Conclusions Communication and timely care play central roles in shaping patient satisfaction in the ED. These findings highlight the value of improving communication skills among healthcare providers and workflow processes to reduce waiting times. Future studies should incorporate length of stay and examine how different clinical presentations influence satisfaction within the ED environment.