Reception with leather chairs near a wall

If you work in healthcare it will come as no surprise to you that patients are no longer simply patients, they are consumers too. Even when patients rush to the nearest emergency room (ER) to save life and limb, they will evaluate their care by the cleanliness of your waiting room and how they were treated by staff. Stopping the bleeding or saving a life is no longer enough. The powerful movement of patient satisfaction is one of the leading reasons why HCAHPS are now tied to reimbursements, Press Ganey patient satisfaction surveys impact budget strategies, and CMS includes patient satisfaction as a quality measurement.

However, here’s the problem; the drive to improve patient satisfaction runs headlong into the basic premise of emergency room care. How exactly are you supposed to triage life-threatening conditions, without creating patient dissatisfaction over ER wait times? If every touch point is an opportunity for a successful or failed experience during the patient journey, what is to be done in light of ER waits?

It’s not easy. Successfully reducing ER wait times is tantamount to changing organizational culture. Not only is the ER the door to the hospital, the fingers of the ER reach deep into the arteries of hospital operations and change at that level is extensive- and expensive.

Look at Stroger Hospital in Illinois. They faced extraordinary ER wait times; 110,000 patient visits a year, 2+ hours for non-emergency conditions and a full 10% of patients left without being seen (talk about revenue hemmoragh). Determined to turn the situation around, hospital leaders virtually eliminated the ER waiting room. They instituted “immediate bedding” where patients were led to an available bed immediately upon arrival at the ER and triaged there. A physician had to quickly evaluate non-urgent cases and appropriately discharge them. At the same time the hospital had to reduce diagnostic imaging and lab time by purchasing additional equipment.

Obviously, not every hospital can afford the Stroger approach to change. But you can reduce ER waits with some simple, effective strategies that can improve patient satisfaction too.

Talk to your patients. It’s that simple. Walk into the ER waiting room regularly. Tell patients they have not been forgotten. If a mass casualty accident is filling your ER, tell them that too. People’s empathy makes them more understanding while waiting.

Concierge: Hiring a concierge to liaison between the ER waiting room and treatment rooms increases patient satisfaction. They update patients on wait times and give crayons and coloring books to children. A happy child is a happy parent.

Community awareness of wait times: This is a tricky proposition. Some hospitals purchase space on digital billboards to post ER wait times. Others allow patients to schedule ER appointments online for non-life threatening conditions. The simplest solution is perhaps the best; have the ER receptionist give callers the current ER wait time.

Security: If you are an urban trauma center, you already have ER security built into operations. If you are in a suburb, train hospital security to regularly scan the ER waiting room. Your patients don’t want to watch a divorced couple argue or a drunk rampage. Make sure security is vigilant about keeping the ER calm.

It’s safe to say that the challenges of the ER are not going to go away any time soon but it doesn’t have to prevent you from increasing patient satisfaction. When a patient has the opportunity to tell you how they feel about their care, before they leave the ER, they feel empowered, and acknowledged. This can increase patient satisfaction and as a result, your ROI. That closes the all important loop of ER care, patient satisfaction and reimbursement. HCXP is the creator of a five point, 5 Star rating system for all in house satisfaction questionnaires and one comparison/benchmark reporting system. To learn more about our technology and to talk about improving the patient experience in your medical facility, contact us right now at 707.654.HCXP (4297)

  1. January 25, 2017

    Great article, in my last role as healthcare administrator, we saw about 10% of the population you describe by volume; as an ASC, we did not have critical patients so that was a part of the factor that allowed us to keep pace. Regardless, front facing staff were made responsible to periodically ensure the waiting area was free of refuse, and information racks were orderly. I transited between offices regularly, so often had time to stop and check in with patients. It took me 4 years to build a patients first mentality in front staff, breaking down resistance barriers by modeling desired behaviors, hiring more customer focused staff and using both positive and negative survey results to drive training! Keep these kinds of articles coming.

  2. January 25, 2017

    Great article. As you mentioned, one of the most import things for improving not only the quality of care, but also patient satisfaction is a good communication with patients. Since they arrive into the ER is fundamental to ensure you can handle a good communication with them. In my experience as a Doctor and Medical Chief in ER at Bogotá, Colombia in 2007, we implemented a pre-triage process leading by skilled nursing staff in the waiting room. So, they were able to 1)evaluates non-urgent cases and appropriately discharge them to a primary care services ; 2) identify serious health emergencies and handle the situation and 3) talk to patients who are at the waiting room. Patients who arrived in the ER instantly felt cared by health professionals and not by administrative staff. As a result after the pre-triage process implementation, we improved patient satisfaction indicator of emergency room care and waiting times on average decreased from 4 to 2 hours.

  3. January 25, 2017

    we addressed this issue in the 90’s. check out our article in nursing management. we develooed that moved patients out of the ED as soon as the decision to admit was made. By doing this

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