For most hospitals, a patient’s first touch point with the organization is the Emergency Department.
On average one-third of those entering the ED doors are admitted to the hospital, which comprises more than 50% of total hospital admissions. Current ED operations at most health care systems are plagued by opportunities for waits and delays and missteps and miscues, the main ingredients for a less than satisfactory patient experience. How can hospitals devise a purposefully satisfying journey for patients and their families, one that will mitigate and eliminate flawed processes while creating loyal patients?
Thom Mayer, MD, Executive Vice President with EmCare, and author of Leadership for Great Customer Service, Hardwiring Flow and The Patient Flow Advantage says four strategies are key to helping hospitals improve the patient experience. “Waiting-particularly waiting without adequate information- correlates directly with dissatisfaction,” he explains. “The typical journey through the ED treats ‘uniformed waiting’ as acceptable-but it is no longer tolerable to patients. Waiting to be triaged. Waiting to be registered and taken to a bed. Waiting to see a physician. Waiting on test results. Waiting to get a bed in the hospital, if the patient is admitted. The list goes on and on.”
Eliminate waiting by improving patient flow. How does a hospital diffuse the volatile waiting phenomenon? Focusing on two areas for improvement has paid big returns for many leading health care organizations: improving flow within the system of care and improving communication with patients and families. Using LEAN methodologies and hardwiring flow, hospital leaders are identifying opportunities to eliminate rework, redundancy and waste. Partnering with experts in patient flow, like EmCare, enables hospitals to cut wait times by increasing productivity and reducing bottlenecks both within the ED and throughout the hospital. EmCare’s Door to Discharge™ approach integrates process improvement with a communication system to improve hand-offs at every stage of care. RAP&GO™ uses technology to facilitate communication between emergency medicine physicians and hospital medicine physicians, enabling faster throughput and smoother transitions across the organization, which drives improved metrics and higher HCAHPS scores.
All roads lead to communication. “The biggest disconnect in healthcare is the providers’ feeling that they are keeping the patient informed, while the patient feels they are not informed nearly as much or as well as they want. But this is a huge opportunity was well,” says Dr. Mayer. “Physicians and nurses are the ‘Chief Story Tellers’ of healthcare. They should be taught that one of their most important roles is to tell the story of the healthcare journey in ways the patient can understand.” Tools such as active listening, use of white boards, scripts as “evidence-based language,” and managing service transitions are all disciplines that most healthcare systems have underemphasized. As Dr. Mayer notes, “It’s not just how much time you spend, it’s how you spend the time.” Each test should be explained, as well as the reasons for doing them and how long the test would take. The problem is that most clinicians think they are already doing that, but patients still feel under informed. EmCare provides mandatory communications training to its staff to fill that gap. “The key to motivating staff for better communication is showing them that this is a discipline which not only improves the patient experience, it also makes their jobs easier,’ says Dr. Mayer.
Real-time results. External partners with expertise in the patient experience have developed tools and techniques to capture patient satisfaction in real time. “For example,” Dr. Mayer explains, “one expert consulting firm with whom we contract has developed real-time point-of-care surveys that can administered at the patient bedside, captured on a tablet, saved to a patient satisfaction data warehouse and accessed immediately to create dashboards and reports. This is a giant leap forward in patient satisfaction measurement and gives the hospital immediate insight into what they are doing right and what needs to be improved. Imagine having the ability to provide service recovery before the patient leaves the property!”
Safe, quality care. Finally, patients come to the hospital expecting high-quality, safe care. They expect to receive the right treatment at the right time provided in the right way by the right people so that they can recover with the confidence of having excellent care. . When a hospital event jeopardizes their wellbeing and recovery, their optimism quickly changes to criticism and dissatisfaction. Hospitals and outside experts have devoted considerable time and resources to assuring patient safety. A proven approach like EmCare’s Risk Free ED™ is an evidence-based approach to the 30 highest risk ED presentations, which improves safety and has reduced risk by over 70% in our emergency departments.
Happy, highly satisfied patients are those that feel they are well informed, being cared for safely, in an environment where waits are the exception rather than the rule and where their concerns are heard and addressed immediately. As Dr. Mayer notes, “These aren’t just ideas-they are disciplines which form the foundation of our practice and the experience the patient takes from it.”
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