Case Study #3: Emergency Department Customer Service

EMERGENCY DEPARTMENT SETTING:

PROBLEM:

Abysmal patient satisfaction scores
Daily complaints about service in the Emergency Department
Physician staffing difficulties with troubled staff morale
Other QI indicators moving in a negative direction (increase in left without being seen, ED stays over 4 hours)

APPROACH:

Hospital board and CEO demanded significant change in Emergency Department
New ED physician group selected (Emergency Service Partners)
ED and hospital leaders developed “patient satisfaction improvement” committee sanctioned and supported by highest levels of administration
Committee facilitator appointed from quality department
Representatives from ED medicine, ED nursing, ED registration, inpatient nursing, ancillary departments, information systems. QC, including staff members and managers
Monthly meetings with homework every meeting
Mandatory attendance
Data-driven: average length of visit, Press-Ganey, % LWBS

INITIATIVES:

Facility improvements with new triage station
Bedside registration
Marked improvement in physician staff credentials
Implementation of 12-hour Express Care unit with dedicated staff
Customer service education
Investigation of electronic medical record system (pending)
Construction of improved Emergency Department with improved flow pattern (approved and pending)

RESULTS:

1. Reduction in number of patients who left without being seen (LWBS) from a high of 3.75% to a low of 0.6%:

2. A dramatic decrease in length of stay (LOS) from a high of 151 minutes to a low of 114 minutes:

3. An increase in the patient satisfaction scores for the Emergency Department from the 25th percentile to the 90th percentile:

Case Studies