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June 2, 2011

Establishing Your ED’s Reputation to Ensure Patient Satisfaction

Hospitals typically see greater than 50 percent of their admission rates from patients first seen in the Emergency Department, making it the unofficial "front door" of the hospital.  The impression you give at your front door is critical in establishing your reputation in the community and ensuring that you continue to attract patients.

Length of stay is the biggest indicator of not only your department's efficiency, but also patient perception of your hospital.  Patients are asking themselves how long it takes to get seen, get treated, and get out.  In the offering of Off the Shelf we present you with a series of ways to improve your length of stay and patient satisfaction in the ED.

How Are We Doing?
Better Length of Stay in 5 Steps
Ensuring Patient Satisfaction

How Are We Doing?

Breaking down the overall length of stay within an ED into timestamps will aid in discovering the root cause for increases in length of stay and help answer the how am I doing question.  The key time stamps to track are:

• door to triage;
• triage to bed (without immediate bedding in place);
• door to physician;
• bed to physician;
• bed to nurse;
• bed to decision; and
• door to admission/discharge/transfer.

Tracking these time stamps is critical in reducing length of stay, which will affect patient satisfaction.  Once you know where you stand, it's time to look at ways to improve your length of stay.  (Review real results from Soyring's ED Operational Improvements case study)

Better Length of Stay in 5 Steps
Better Length of Stay in 5 Steps

1. Better Bedding

The sooner patients feel that they are being seen by ED personnel, the higher the satisfaction they will perceive.  Thus, once the critical points are identified within the length of stay continuum, leadership within the ED can address these issues.

Two processes to help improve the door-to-bed time include immediate bedding and the use of a separate area for low acuity patients.  Immediate bedding allows for triage to occur at the bedside, as opposed to a specific area.  Triage is a process, not a place.

2. Scheduling

With scheduling, the key is to evaluate your volume trends and mirror your staffing to those trends by day/time/season to prevent labor shortages.  Another consideration is ensuring that staff assignments are effective in relation to the care needed by patients, which plays a pivotal role in reducing length of stay.

3. Diagnostic Testing

Test results are a key factor in improving the time from bed to decision.  Utilizing standard protocols for clinical care pathways will help get speedy results by standardizing tests for common complaints.  Also, having a strong working relationship with Ancillary departments that provide these tests is critical for timely delivery.

4. Notification

So the Diagnostic testing is being processed quickly and efficiently.  Now what?  Updates between nursing and physicians are critical in length of stay.  The use of communication devices to keep key team members in the loop enables staff to know immediately when results have been received and whether follow-up is needed.

5. Troubleshooting

To improve bed-to-admission/transfer/discharge, case management can play a positive role in the appropriate decision for each patient.  Get case management involved early and often when patients fall outside of your normal length of stay and require better coordination between other departments.

Ensuring Patient Satisfaction

Communication is the most important "X factor" in the ED to have a positive effect on patient satisfaction and care.  Beyond the obvious need for communication among caregivers and interfacing departments of the organization, patients and their families also need information, which will impact overall patient satisfaction.  (Take a look at Soyring's case study for real world results from improving patient flow)

The use of rounding gives patients the perception of progress and keeps then updates.  Prior to a patients leaving the department, a crutical step is to answer any outstanding questions the patient or family may have related to the visit.

Using these ideas will positively affect patient satisfaction and the general perception of the healthcare organization within the community.  Even if you have a highly efficient department, without a strong culture of patient communication, your satisfaction ratings will nosedive.

Soyring's Solution

Contact Soyring Consulting for a free consultation to learn how we can satisfy your needs and assure measurable and sustainable results for your Emergency Department..

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