March 24, 2006

Satisfaction rates on rise in adult ED

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Satisfaction rates on rise in adult ED

Brent Lemonds, M.S., administrative director of Emergency Services, John Paul Rohde, M.D., and Elizabeth Reeves, R.N., a charge nurse in the Emergency Department, discuss strategies to recognize employees who adopt elevate credo behaviors.
Photo by Dana Johnson

Brent Lemonds, M.S., administrative director of Emergency Services, John Paul Rohde, M.D., and Elizabeth Reeves, R.N., a charge nurse in the Emergency Department, discuss strategies to recognize employees who adopt elevate credo behaviors.
Photo by Dana Johnson

A concerted effort by Vanderbilt's Emergency Department to improve communications with patients is paying dividends in the form of rising satisfaction scores.

Corey Slovis, M.D., chair of Emergency Medicine, said physicians and nursing staff have been concentrating on five vital communication pieces as part of a formal, elevate-inspired plan to improve customer satisfaction.

The plan is working. According to national benchmarking data, the ED is ranked in the top 3 percent to 5 percent of emergency departments across the country in terms of patient satisfaction.

“Our goal is to be the best,” Slovis said.

When a patient arrives in the ED, the following elevate steps have been put into place:

• The physician's goal is to be in the patient room within ten minutes.

• The physician introduces him/her self and the role he/she is playing in the patient's care.

• The physician closes the door and tells the patient that the door is being closed for the patient’s privacy.

• The physician sits down to listen to the patient's complaint and take a history.

• The physician asks if the patient has any questions and explains the potential treatment plan.

“We've gotten excellent results,” Slovis said.

Now that a formalized system has been established, Slovis said the department would be working to establish two additional procedures — having a physician return within one hour of the initial visit to explain how things are progressing, and setting clear expectations about the amount of time patients may expect to be in the ED.

“Many times getting test results back may take awhile,” Slovis said. “It's all about managing the patients’ expectations and minimizing their anxiety.”

And those are just a few of the initiatives the ED has implemented as part of elevate. Brent Lemonds, administrative director of the adult ED, said his area has quickly taken to the principles of the institution-wide improvement effort known as elevate.

“We have a ton of initiatives,” he said. “We have been early adopters in rounding and the use of key words.”

Lemonds added that the ED was “doing groundbreaking work in provider-specific accountability in multiple areas.”

That work has laid the foundation for potential research funding on nursing report cards.

Among initiatives the ED is working toward to further improve patient satisfaction are:

• Cleanliness of Vanderbilt University Hospital.

• Raising physicians' ability to listen and answer questions.

• Overall teamwork between doctors, nurses, and other staff.

• Overall quality of care.

Another ED elevate initiative was the implementation of “I Saw What You Did.” This form page on the ED's intranet Web site allows employees to praise other employees when they see them performing credo behaviors or elevate principles.

“We're proud of the accomplishments of the ED team members,” Lemonds said.

“We are committed to creating an environment that is a great place for staff to work, a great place for our physicians to practice medicine and a place that our patients and their families receive the highest quality of care.”