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Turning data into doing: Monitoring patient satisfaction in the emergency department

January 22, 2018

 

Southern Ohio Medical Center sought excellent patient satisfaction levels, knowing they needed to improve staff interactions with patients. Through regular reporting with PRC, hospital leadership came to better understand how their patients perceived the emergency department and its care.

As an increasing number Americans rely on the emergency department for primary care, standards for emergency patient satisfaction are on the rise as well. The resulting overcrowding of emergency facilities places a strain on the department’s ability to offer the best possible care. Finding time to restructure or reorganize work presents an undeniable challenge for staff and leadership alike.

Mary Kate Dilts Skaggs, DNP, RN, NE-BC, Director of Nursing for Emergency and Outpatient Services at Southern Ohio Medical Center (SOMC), took her hospital’s patient satisfaction scores from Professional Research Consultants, Inc., (PRC) as a challenge and worked with her team to embrace the opportunity to find excellence in the emergency room environment. Dilts Skaggs carefully tracked changes in scores as they correlated with changes in nursing behavior and published the results in the Journal of Emergency Nursing.

Her efforts paid off, as the results demonstrated that as patients feel that they spend less time in the emergency department, their ratings of the department increase—even if the actual time spent in the hospital did not change. As part of their move toward excellence, nursing and hospital leadership sought to improve staff interactions with patients, relying on PRC for a comprehensive understanding of how their patients perceived the emergency department.

Using data supplied by PRC, SOMC compared patient satisfaction before and after implementing three new procedures:

  • AIDET (acknowledge, introduce, duration, explanation, thank you)
  • Hourly rounding
  • Bedside shift reports

Perhaps most noticeable to the patients was the introduction of AIDET. This entailed acknowledging the patient and family, introducing themselves and their role, discussing the duration of the visit, explaining the process, and thanking the patient. This set clear expectations for the care the patient could expect to receive. PRC data indicated that this change in caregiver behavior caused patients to become 1.5 times more likely to rank their experience in the emergency department as “excellent.”

Further, the emergency department experienced a nearly 12% increase in the number of patients rating their overall care as excellent. This resulted in a 40% increase in overall quality of care, moving SOMC from the 36th percentile to the 85th.

To gain a full understanding of the patient experience, PRC asked patients to review five elements of their emergency department visit at SOMC:

  • Overall quality of care
  • Overall quality of nursing care
  • Nurses’ understanding and caring
  • Nurses’ explanation of treatment and tests
  • Total time spent in the emergency department

As the SOMC team implemented these new procedures, PRC provided them with monthly report updates, allowing the department and leadership to closely monitor patient experience outcomes in real time. Each week, SOMC shared this data with the staff both during huddles and through emails, keeping everyone on task with their goals in sight. Through these continued measures of excellence, SOMC not only improved its scores, but also quantitatively demonstrated the value of listening to patients and delivering satisfaction.

These findings were reported in the January 2018 issue of Journal of Emergency Nursing. For more information or to download the article, visit the Journal of Emergency Nursing.

Dilts Skaggs will also lead a breakout session at the 2018 Excellence in Healthcare Conference, “Tools to Restore and Enhance the Patient/Caregiver Relationship.”