I have been an ER nurse for 22 years now and this has to be one of the hardest parts of my job, customer satisfaction and Press Ganey. I work in an ED that sees 135 patients daily with the highest volumne during my shift 7p-7a. The problem I am having as well as many of my co-workers is that the hospital has decided for the last two years to use the Press Ganey survey company to evaluate our hospital. That in its self isn't much of a problem but when they start staying on us to the point it is interfering with our jobs it gets to be quite a head ache.
We as an ER have an average wait time of 2 hours or so. I think that is very good considing there are only 5 nurses on each shift . We have 2 doctors during peak times with a fast track open on weekends for even higher volumne.
My question is if anyone else has similiar problems keeping patients happy while still covering the TRUE emergencies. Even when I have a great day and don't let anyone fluster me I still can't seem to make the majority of patients happy. They get mad about the wait time, the lab wait time, the doctor attitude and the list goes on. Has any one out there got any ideas that I can take back to my ED customer satisfaction comittee to improve our scores. This is getting so old and it definitely takes the little bit of fun out of a very demanding job.
We use pG and our raises are 100% dependent upon them :angryfire Mind you, we are a level 1 trauma center which upsets the wait time with every multicar MVA. Administration put their money where there mouth was to make changes, herein lies the big difference... a RN cannot change PG scores with an understaffed ER, with an overfilled hospital. PERIOD.
-patient rep. (you must have one to diffuse volitile situations to getting that second pillow)
-opened up a 30 bed observation unit (23 hrs. work'em up, admit or bye bye)
-minor treatment center (10 beds with a three hr. turn around time). Did this by having all labs in the er in yellow bags, all yellow bags are a lab priority, must have results in 45 min. admin. follows the times bet your bottom $$.
-20 bed fast track unit, 7 are ped's beds (this is one level above minor treatment).
-chest pain center 10 beds, door to treatment 15 minutes if vss, , many of these guys do camp out until am if bed not needed to have stress test, then admit or d/c. , standing RN orders for labs and EKG's.
-hired two PA's for all shifts who cover all of the above
-this cost $4mil. took 2 years.
-patient transportation team, so ER resources stay in the ER. A transport RN, one is available 24/7 for all ACLS patients leaving ER to a step down or unit, also will take inpatients for tests, the ER is the priority.
-coffee and snack station for family, plus seperate wait room for family who's patients have ER bed.
-ED designated CT scanner and Rad tech. right in the ER
-county sheriff, positioned in the waiting room, need I say more.
All this facilitated quick access to ER services, did not in itself improve the wait time for an inpatient bed, yet the house supervisor would goto units and the step down's and call the docs requesting a "change in status" to make a bed.
Hope this helps, but again, as an RN, can you adjust the budget to accomodate this? The patient satifsfaction goal must trickle down with administration making it possible for you to give GOOD PATIENT CARE AND GOOD COUSTOMER SERVICE, then the rest is up to you. :rotfl:
Staff was happier, scores improved. again this was a two year process and when multi-trauma's roll in... all bet's are off.
We use pG and our raises are 100% dependent upon them :angryfire Mind you, we are a level 1 trauma center which upsets the wait time with every multicar MVA. Administration put their money where there mouth was to make changes, herein lies the big difference... a RN cannot change PG scores with an understaffed ER, with an overfilled hospital. PERIOD.
-patient rep. (you must have one to diffuse volitile situations to getting that second pillow)
-opened up a 30 bed observation unit (23 hrs. work'em up, admit or bye bye)
-minor treatment center (10 beds with a three hr. turn around time). Did this by having all labs in the er in yellow bags, all yellow bags are a lab priority, must have results in 45 min. admin. follows the times bet your bottom $$.
-20 bed fast track unit, 7 are ped's beds (this is one level above minor treatment).
-chest pain center 10 beds, door to treatment 15 minutes if vss, , many of these guys do camp out until am if bed not needed to have stress test, then admit or d/c. , standing RN orders for labs and EKG's.
-hired two PA's for all shifts who cover all of the above
-this cost $4mil. took 2 years.
-patient transportation team, so ER resources stay in the ER. A transport RN, one is available 24/7 for all ACLS patients leaving ER to a step down or unit, also will take inpatients for tests, the ER is the priority.
-coffee and snack station for family, plus seperate wait room for family who's patients have ER bed.
-ED designated CT scanner and Rad tech. right in the ER
-county sheriff, positioned in the waiting room, need I say more.
All this facilitated quick access to ER services, did not in itself improve the wait time for an inpatient bed, yet the house supervisor would goto units and the step down's and call the docs requesting a "change in status" to make a bed.
Hope this helps, but again, as an RN, can you adjust the budget to accomodate this? The patient satifsfaction goal must trickle down with administration making it possible for you to give GOOD PATIENT CARE AND GOOD COUSTOMER SERVICE, then the rest is up to you. :rotfl:
Staff was happier, scores improved. again this was a two year process and when multi-trauma's roll in... all bet's are off.
Let me just say WOW!
It is quite impressive you got your admin to buy in...
Is anyone else sending representatives to this conference in Washington DC next week? It's supposed to be a conference to talk about ways to improve customer and employee satisfaction. Our manager is giving three nurses here an all expense paid trip to this conference (none of which have ever done anything to help improve satisfaction for anyone-sorry, 'nuther story)
Just wondering if anyone thinks this kind of thing will help.
Is anyone else sending representatives to this conference in Washington DC next week? It's supposed to be a conference to talk about ways to improve customer and employee satisfaction. Our manager is giving three nurses here an all expense paid trip to this conference (none of which have ever done anything to help improve satisfaction for anyone-sorry, 'nuther story)
Just wondering if anyone thinks this kind of thing will help.
Pam
we dont have anyone going, and we are only 90 minutes from DC! I hope the trip is worth while for your hospital
Is anyone else sending representatives to this conference in Washington DC next week? It's supposed to be a conference to talk about ways to improve customer and employee satisfaction. Our manager is giving three nurses here an all expense paid trip to this conference (none of which have ever done anything to help improve satisfaction for anyone-sorry, 'nuther story)
Just wondering if anyone thinks this kind of thing will help.
Pam
Actually, I am going with one of my managers.
We'll see...
I personally think that "Customer Satisfaction in the ED" is an oxymoron.
Is anyone else sending representatives to this conference in Washington DC next week? It's supposed to be a conference to talk about ways to improve customer and employee satisfaction. Our manager is giving three nurses here an all expense paid trip to this conference (none of which have ever done anything to help improve satisfaction for anyone-sorry, 'nuther story)
Just wondering if anyone thinks this kind of thing will help.
I personally think that "Customer Satisfaction in the ED" is an oxymoron.
I'm with you there about the oxymoron. Let me know if YOU thought it was worth the trip. I know I won't get the real story from anyone from our ER that went. I'm sure they will come back full of ideas for all of us to implement; we'll see if the ideas work.
Or are there times when you could really give a rip how "satisfied" the "customer" was with his/her visit? :angryfire
I had a women bring her dd into the ER at nearly 11:30 pm one night because she had a lac to the upper part of her mouth. Now this in of itself wouldn't bother me; what did bother the snot out of me was that the kid was happy and smiling, had already been seen in the morning of that same day at another hospital and was told to follow up with an oral surgeon, and had been sent to our ER that late at night by an "Ask a Nurse" R/t continued bleeding from the mouth (which was not evident when she brought this happy, smiling child in at a time that the poor child should have been in bed.)
Did I care if I didn't act like I was just thrilled that she was gracing OUR ER with her presence and her medicaid card? NOPE! I really didn't. Guess it had been the end of a very long week and I had already worked 8 hours earlier in the day (7-3, then back in 11p-3a). I know that is no excuse but sometimes.........you just want to scream at these people! We have a new manager now that follows up on every complaint she gets (which is good, don't get me wrong) so if this bimbo idiot complains then I am going to get called on the carpet for not acting like I was thrilled and happy that she was there. I wasn't all out rude, but I wasn't friendly either. As I said, I'm glad that our manager is concientious, but sometimes I think the "powers that be" should look hard at the chart and consider the source of the complaint before fussing at someone. I guess that sounds stupid. Sorry.
I'm not a bad person, but we have had a horrendous week with so many people coming in that don't need to be there. It almost got to the point of being funny at one point. I was working triage and generally sucking as I must have turned on the free beer and pizza sign inadvertently. Anyway, it got so backed up that everytime someone walked up and said that they wanted/needed to see a doctor, I wanted to laugh in their face and tell them "yeah, you and the other 12 people ahead of you! :chuckle ) I didn't, but that is the kind of week we have had.
I get so tired of seeing stupid patients take ambulances out of service to give them a taxi ride to the ER and the worst patients walk in the front door! That has been the big contraversary in our county; do we need to increase the number of ambulances or not? One of our ER docs wrote a very good response to that and basically stated that if people would use common sense when calling an ambulance then there would be no need for any additional ambulances. Course, it seems like the ambulance loads haven't gotten worse since that letter came out.
But, I digress.........sorry this is long and brought up a long dead topic, but I just needed to vent. Only four shifts this week and then I'm on vacation for a little over two weeks!
since we all are venting about the ed i will add my 2 cents. i am very aware that our country is becoming more and more multicultural by the minute, but please don't be offended or mad because I don't speak spanish. i am not picking on hispanic people, but this is a BIG problem in the ed where i work. example :mother comes into triage with child and sits down. i begin the triage by asking "what brought you to the ed today?" and i just get a blank stare. why? because the patient assumes that i will go fetch someone that speaks spanish. the mother says in the best english she could "you don't speak spanish?" NOOOOOOOOOO I DON'T!!!.( and no i don't look hispanic) so then i have to call the interpreter and make the patient and her daughter sit on the side until the interpreter comes. by then the patient is upset because we don't have spanish nurses. it is very frustrating. when i do get an interpreter i tell the interpreter to tell the patient to please bring someone with them that speaks english (an adult, not a five year old) at all times, because we cannot always guarantee an interpreter. my other pet peeve: if you don't speak english you, we don't need ten other people in the room who also don't speak english because it doesn't help. this problem is increasing every year. i will be taking a spanish class soon that is offered by the hospital so that i can ask simple questions. i understand that learning a second language is not easy, but patients do themselves a big disservice when they expect to be seen right away with a language barrier. thanks for letting me vent. i feel better now :)
I do not think there is an ER Nurse that can not feel your pain. Most of the time the answers to fixing this problem are process related and require administrative intervention. We know how that goes!!! When I managed the ER, I had the joy of talking with each and every complaint that was place on satisfaction surveys. Needless to say, I worked very hard to decrease the amount coming in. What I have found is that honesty is the best answer. I had them begin in the triage area. They were told on triage that there could be an extended wait if things were backed up. My charge nurse and triage nurse were if continual communication so the approximated time would be realistic. I placed a Welcome letter in the ER waiting room to explain the processes.( What we did, How patients were taken back, What would happen when they can back). This was given to each patient as they were triaged. Once in the ER, I began a trial with some of my nurses. Instead of tucking under the desk when patients poked their heads out the door, (At the point of anger, I might add) we decided that consistent communication with the patient might help. We began upon being placed in the bed. We introduced ourself and explained what would probably occur in the next hour. (Labs, xray, md exam, etc...). I had these nurses go in every 30 minutes when possible and tell them what we have back, what is pending , how long approximately it would take). Being informed was the greatest help. Even if they did not like the wait time, the level of satisfaction dramatically increased. The consistant contact made the patients feel that the staff was there and that they were informed. 9 out of 10 patient complaints included the fact they they were uninformed in one way or another. You have to keep your word. If you say 30 minutes be there even if just to poke your head in and let them know there is an emergency and you have not forgotten them. My nurses were reluctant and simply told me they did not have time when I introduced this. Once they tried it and realized it saved them alot of time in the end, they really liked the results. There are always going to be those you can not satisfy. I always told those patients how sorry I was that they dissatisfied. It really did'nt hurt me to say it either. (except for the lip I had to bite first) A sorry ,even though it is not your fault, at least takes the sting out of most. If it makes them feel better to hear it then why not. Nurses who take the things that patients say personal are going to be really unhappy and unnecessarily stressed. Let them vent and always realize the beauty of the ER is they will eventually go away...........................Hope this helps.
heart queen
206 Posts
We use pG and our raises are 100% dependent upon them :angryfire Mind you, we are a level 1 trauma center which upsets the wait time with every multicar MVA. Administration put their money where there mouth was to make changes, herein lies the big difference... a RN cannot change PG scores with an understaffed ER, with an overfilled hospital. PERIOD.
-patient rep. (you must have one to diffuse volitile situations to getting that second pillow)
-opened up a 30 bed observation unit (23 hrs. work'em up, admit or bye bye)
-minor treatment center (10 beds with a three hr. turn around time). Did this by having all labs in the er in yellow bags, all yellow bags are a lab priority, must have results in 45 min. admin. follows the times bet your bottom $$.
-20 bed fast track unit, 7 are ped's beds (this is one level above minor treatment).
-chest pain center 10 beds, door to treatment 15 minutes if vss, , many of these guys do camp out until am if bed not needed to have stress test, then admit or d/c. , standing RN orders for labs and EKG's.
-hired two PA's for all shifts who cover all of the above
-this cost $4mil. took 2 years.
-patient transportation team, so ER resources stay in the ER. A transport RN, one is available 24/7 for all ACLS patients leaving ER to a step down or unit, also will take inpatients for tests, the ER is the priority.
-coffee and snack station for family, plus seperate wait room for family who's patients have ER bed.
-ED designated CT scanner and Rad tech. right in the ER
-county sheriff, positioned in the waiting room, need I say more.
All this facilitated quick access to ER services, did not in itself improve the wait time for an inpatient bed, yet the house supervisor would goto units and the step down's and call the docs requesting a "change in status" to make a bed.
Hope this helps, but again, as an RN, can you adjust the budget to accomodate this? The patient satifsfaction goal must trickle down with administration making it possible for you to give GOOD PATIENT CARE AND GOOD COUSTOMER SERVICE, then the rest is up to you. :rotfl:
Staff was happier, scores improved. again this was a two year process and when multi-trauma's roll in... all bet's are off.