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How to boost satisfaction rates: A tale of two EDs
If you want to please patients, timing is everything
In 1997, the ED at Parkview Hospital in Fort Wayne, IN, was in the 45th percentile in South Bend, IN-based Press Ganey Associates satisfaction rankings. That same year, Southern Ohio Medical Center in Portsmouth, languished in the ninth percentile.
Since 1998, however, Parkview has consistently been between the 90th and 99th percentiles almost every quarter, and Southern Ohio has also gotten its Press Ganey numbers into the 90s.
What were the keys to such dramatic turnarounds? "Our hospital made the decision in 1997 that we wanted to become known for service," says Mary Kate Dilts-Skaggs, RN, MSN, CAN, director of nursing for emergency and outpatient services at Southern Ohio. "We had to use what the public was saying about us to really improve processes." And what did the customer surveys say? "The No. 1 complaint was time," she explains.
Parkview saw the same overriding issue. "The No. 1 goal we always have is to get the patient to the doctor [quickly]," adds Deb Richey, MPA, director of emergency services. "They come to the ED to see the physicians, so any opportunity you have to streamline processes will benefit satisfaction."
Richey says it’s important to take a broad-brush approach. "Obstacles can be in the parking lot, in triage, in registration," she says. "There is a variety of things that can impede access."
One step at a time
With such a long way to go, Dilts-Skaggs says that success did not happen overnight. "It took slow but sure increments of improvement," she adds.
One of the keys at the starting point was an interdisciplinary team. "If you want to make changes, you need all the stakeholders at the table," Dilts-Skaggs says. Have all the departments interface with the ED so they know what the goals are, she suggests. "For example, it’s hard for the laboratory to understand that all work in the ED is STAT unless they are at the table and hear it, because the [intensive care unit] and everyone else all want their attention," Dilts-Skaggs says.
The team, which included physicians, nursing, unit clerks, patient representatives, ED technicians, registration, medical imaging, the laboratory, and human resources began meeting monthly. Here are some of the key changes they implemented that have reduced process times:
In addition, several initiatives were adopted that directly addressed patients and their families:
Training, then action
Outside consultants were brought to Parkview to train staff in customer service to get patient satisfaction efforts started, Richey recalls. The combination of lectures and role-playing helped increase awareness of the need to serve customers. Then, several timesaving measures were instituted:
This produced immediate positive feedback from patients and reduced turnaround time by 40 minutes.
"If there is a bed available and you can look at a patient and see what kind of bed [he or she] needs, it’s not critical to do vitals or a huge history in the triage area," Richey explains.
"This creates white noise and helps pass the time," Richey notes.
Interestingly, both Parkview and Southern Ohio adopted the "FISH philosophy of customer service." The approach draws its name from a series of books based on the successful customer service approach in Seattle’s Pike Place Fish Market. "They include a number of simple principles that help make your team passionate about customer service," says Dilts-Skaggs. "It makes it fun." (To learn more about the FISH philosophy, see resource box below.)
Richey adds, "We’ve really gotten a lot of mileage out of it. We’ve repeated the program each year and presented new customer service goals for each year."
Drawing on the FISH philosophy, Dilts-Skaggs says she celebrates the successes of staff. "For example, the first time monthly bedside registration hit 800, we had ribs and chicken," she relates. "Happy employees make happy customer. It all plays into patient satisfaction."
For more information on improving patient satisfaction, contact:
To access books and video products about the FISH philosophy of customer service, contact: