Good Press Ganey for ER. Possible??

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Specializes in ICU/CVICU now ER RN.

I work in a small ER that sees a large number of frequent fliers. The patient satisfaction scores are pretty low. How do you increase the satisfaction level of a public that feels "their needs are met" when they receive narcotics as fast as possible? Any ideas? What do you do in your ER's?

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

We built a new one. The patients feel like you're taking care of them when they are inside an ER "pod" and there is TV..and a phone.

They don't care that they are waiting for HOURS...

Yep, so easily amused the children.....

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Specializes in ICU/CVICU now ER RN.

My hospital is doing a remodel--slowly. Maybe it will work. Another local hospital has TV's in every ER room (except Trauma) and the minds are numbed and the satisfaction is up 60%!!! Opiate for the masses? :lol2:

How does your ER keep the pts informed an the status of their stay? Lots of our staff just don't bother....makes the

people write bad things on surveys.

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Specializes in Emergency.

We do a miniclinic run by midlevels. One sits in triage and puts orders in on every pt triaged as they are being triaged to atleast get basic labs, IVs, etc initiated on pts waiting for main ED beds. It makes them less likely to LWPA plus it decreases the wait because labs can be back by the time they get a main ED room and are seen by the MD. In the clinic we just send low triage priority pts and a midlevel runs it with an LPN. They see toothaches, minior lacs, colds, med refills, fxs, etc. It has really helped with satisfaction scores because our wait times have dropped. We still get knocked though because no one is ever satisfied with their pain management. Why do people c/o hand tingling/numbness want narcs for pain????

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Specializes in ICU/CVICU now ER RN.

Thanks ThrowEDNurse! We see a lot of clinic pts, for sure. Your process sounds good and I can see how it would help with wait times. We do triage with ESI and bring them back based on that. Hard to decide when the wr is full of dental pain and nausea (that's the person eating tacos!) and chronic back pain who can't keep her eyes open but wants more oxy ir!!!

Somehow I don't think they will give good scores!!

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Specializes in ER.

I don't think good Press Gainey scores are possible. We have everything you can think of- food, TV's, phones, mid-levels, less than 1 hr wait times, etc. and scores are still low. And we also get low scores of pain management and comfort of your blood draw. A blood draw is supposed to hurt at least a little bit...why are we asking people these questions?? I could go on but I won't!

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Specializes in ICU/CVICU now ER RN.

Thanks PAERRN20,

I agree, wonder why senior leadership does not agree?? Seems so obvious.

How big is your ER?

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Specializes in ER.

My ER is smaller- 25 beds.

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Specializes in ICU/CVICU now ER RN.

Ours is only 8 beds!! The only other hospital in town has a 26 bed ER and is a Level 2 Trauma Center. It is big and impersonal. Ours is the one "everyone" likes because of the care and the personal attention you can give on the units.

The ER is a whole new ball game. The whole world has this entitlement attitude.

The motto seems to be "Its not my fault I am a drug addict and you must give me narcotics!"

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Specializes in Emergency Nursing.

I think there is only so much you can do to improve satisfaction scores in the ER but in the ER I work in we have really improved scores (especially over the past 6 months) and here is what I have noticed (keep in mind this is an All Peds. ER so it is somewhat different than adults.)

  • Every patient care room has a television. This allows patients to watch TV and try to relax while they are waiting to be seen.
  • During the busiest hours we have a dedicated staff member called a "Family Assistant" who circulates the ER offering to get coffee or drinks for the family members of the patients, provide them with information in terms of wait times and to attend to the family needs in any way they can. In smaller ERs I've heard of this position being a volunteer position for ERs who could not afford the cost to have this be a paid staff position, this is a great opportunity for high school students looking for community service hours or students who are potentially interested in health care.
  • The ER has taken steps to try to improve the wait times, this includes: from when a patient first walks into the ER to when they are placed in a room, when they are seen by a nurse, when they receive pain medication and finally to when they are seen by a licensed independent practitioner.
  • We have worked on providing better "customer service" by trying to improve the interactions between patients and care providers at every level of the ER. Starting in the Triage area. I've actually found as an adult patient who has gone to a few different emergency rooms that one of the worst parts of the experience is the interactions that take place with some of the care providers, especially in the Triage area. Many triage nurses don't realize that they can come off as judgmental, uncaring and cold during their assessments and this is something that can be prevented. We need to make sure that we are empathetic and respectful to patients even if we do not believe they should be in the ER and we need to make sure that our personal opinions and judgments are not being passed on to our patients in a way that damages the patient-care provider relationship.
  • We have a "fast-track" clinic in the evenings to handle lower acuity cases and to improve weight times in the ER overall. This is usually with one physician, one nurse and one tech. but on busier nights we may have two physicians, two nurses and a tech. to handle all the lower acuity patients. Patients really seem to respond to this and the LIPs like how it keeps the main ER from getting too overfilled with lower acuity patients.

While patient scores aren't perfect they are definitely on the rise in our ER and I think a lot of the changes we have made are improvements that are being implemented in ERs around the country.

!Chris :specs:

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Specializes in ICU,OR,PACU,ER.

What ever happened to the good old days when you could say...."We're here to save your a_ _, not kiss it!"

Yes, I know they are long gone. The former "patient" is now the "customer" and patient satisfaction fulfills the "bottom line" and, as with any business, the "customer" is always right. I do draw the line at "Do you want fries with that"....Seriously now, this is what we did.

The ER I work in is in a seasonal summer vacation area and is an 8 bed unit. Our population goes from 16-18,000 to 110,000 in the summer. To lessen wait times a few years ago for the peak periods, we added a 2 bed 10a-10p Fast Track area for ESI 4 & 5 level patients. We also added a patient beeper system that gave the waiting patients a little flexibility to move around and it also preserved their privacy when called for treatment. Our small waiting room was equipped with a TV and patients had access to picnic tables just outside the WR, in view of triage. Triage protocols allowed some initial lab & X-ray to be ordered by the triage RN and this helped expedite treatment. These adjustments brought us 2 Summit Awards from the Press Ganey folks.

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Specializes in ICU/CVICU now ER RN.

Thanks Rickbos! We a looking at a fast-track process but need to finish an expansion project to create the rooms. A lot of our "clients" expect instant service, as their issue is the "most urgent"; it is easy to see that the dysuria they have had for 2 years is much more important than the evolving MI in the next room!!! So who will be most likely to respond to the survey? Yes, indeed, it will be that poor soul with dysuria.

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