A system-wide approach to creating an exceptional Emergency Department patient experience

Helping to improve patient satisfaction in healthcare across a four hospital health system


By Beth Fuller, Consulting Manager, Ricky McCraw, Principal, and Misty Milling, Consultant, Philips Blue Jay Consulting
 

Emergency Departments are in a new age where quality care must be provided with an excellent patient experience. In 2016, the Centers for Medicare and Medicaid Services will fully implement the Emergency Department Patient Experience of Care (EDPEC) as a standardized method of gathering and publically reporting emergency department patients’ experience across the nation.1
 

Seeing this as an opportunity to create a culture of excellence in patient experience for their ED, a four-hospital system in Texas contracted with Philips Blue Jay Consulting to identify and deliver process improvement initiatives to achieve their patient experience goals. 

After three successful twenty-six week engagements featuring dedicated training, observation and validation, this hospital system was able to successfully enhance the emergency department experience provided to their patients. The hospital systems overall Press Ganey® standard score increased by 27 percentile points. The system adopted methodologies, training program, and process improvement initiatives that will support sustainable success and will continue to foster a culture of excellence.

Our Approach

The Philips collaboration with the health system began with a twenty-six week consulting engagement. During this time the consultants worked on site with the system to redesign front end processes, initiate and complete several triage training programs, and develop a system-wide ED metric dashboard.


The initial engagement was so successful that the health system contracted with Philips Blue Jay Consulting for two additional twenty-six week consulting engagements with a particular focus on improving patient experience within their Emergency Departments.

 

The following engagements focused on the clinical staff and then the medical staff. The goals of these engagements were to create a consistent patient experience education and training program, to enhance the patient perception of care through refined workflow processes, and to improve patient experience across all emergency departments in the system.

 

Philips facilitated the following initiatives to achieve these goals:

 

  • Definition of 5 new patient experience standards: use of positive language, hourly rounds on patients, leader rounding on patients, waiting area rounding, and bedside shift reports.
  • Creation of a didactic patient experience presentation used to educate and promote discussion among staff.
  • The teaching of 20 courses on the topic of patient care versus patient experience.
  • 40 hours of skills labs conducted at each hospital over a two week period, role playing patient care scenarios and the 5 patient experience standards.
  • In-department live observations of staff-patient interactions.

Results


Through dedicated training, observation, and validation, this hospital system was able to successfully enhance the emergency department experience provided to their patients. The Press Ganey® standard overall score increased by 27 percentile points. The staff has developed a culture of caring and a realization that patient experience and quality of care are synonymous. 

All four hospitals had substantial increases in their Press Ganey overall standard rating, nurse rating, doctor rating, overall rating of ED care, and likelihood to recommend. Improvements include: 

 

  • All hospitals increased their Press Ganey standard overall nursing scores.
  • Scores regarding “Nurses took time to listen” and “Nurses’ attention to your needs” increased (50 and 53 percentile points in 2 cases).
  • All facilities recognized an increase in their Press Ganey overall doctor scores, ranging from 9 to 54 percentile points.
  • Increases in all hospitals for “Overall ER Care” and “Likeliness to Recommend”.
 
The system adopted the methodologies, training program, and process improvement initiatives that support sustainable success and will continue to foster a culture of excellence. This will help to further improve patient experience scores and position continued increases in scores as the culture becomes one of service and quality patient care.

 
Weinich, R., Becker, K., Parast, L., Stucky, B., Elliott, M., Mathews, M., Chan, C., and Kotzias, V. (2014). Emergency department patient experience of care survey: Development and field test. Santa Monica, California: RAND Corporation.
 

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*Results from case studies are not predictive of results in other cases. Results in other cases may vary.