How can emergency department (ED) decision makers contribute to increase patient satisfaction rates? This question has been thoroughly investigated in many hospital departments but not so much in the ED, which has led to a number of untested hypotheses. Maximising value-added activities seen from a patient’s perspective has become an essential outcome in health care, meaning that the untested hypotheses are in need of quantitative testing. This study proposes an integrated framework in which four latent constructs reflecting principal aspects of patient care are tested. The four constructs are entitled safety and satisfaction, waiting time, information delivery, and infrastructure accordingly. As an empirical foundation, a recently published comprehensive survey in 11 Danish EDs is analysed in depth using structural equation modeling (SEM). Consulting the proposed framework, ED decision makers are provided with information of where to launch high-impact initiatives to enhance current satisfaction levels.