Medical Directors Speak Out on Patient Satisfaction

Whether your ED is a high volume Level 1 trauma center or a small hospital, you can deliver on patient satisfaction. Here, two medical directors, Dr. Corey Slovis and Dr. J. Greg Oakley, share their perspectives.

1. What was your biggest barrier to embracing the value of service in the ED?
CS: "An expansion in focus. I felt service was not my job. My job was to beat death…treat the critically ill. The challenge is to expand the focus of physician training so they understand that quality emergency medicine is not based on the dosage of a drug. It is based on how the patient perceives you are treating them. By training physicians how to introduce themselves and teaching them to sit down and make emotional contact, physicians gain control over how patients perceive them. Additionally, when you give physicians their patient satisfaction data as compared to colleagues, they are empowered to improve it."

JGO: "There's always a core group of traditionalists with the 'that's the way it's always worked' mentality who create a barrier for change. At Pekin, there was a confluence of factors that forced us to confront real change. We were at the brink of financial disaster ...months from being sold. Administration's focus on the ED's poor patient satisfaction scores also offered opportunity for real improvement. And an influx of new ED staff were open to change. As a result, we fundamentally changed the way we looked at patient care."

2. How has improved service impacted quality?
CS: "I think in any scientific endeavor, if you pay attention to one variable—or one disease—it spills over into other areas. Just as our ability to deliver an antibiotic faster provides better clinical care, it also makes the patient feel we care more about them. When a patient comes to the ED and antibiotics are administered within 90 minutes instead of several hours, patient satisfaction improves because patients feel definitively cared for and at the same time, we are delivering quality care."

3. What tactic has worked especially well to get results?
JGO: "Physician leaders and key nurse leaders must lead by example. Otherwise, no one will embrace service. It doesn't happen by magic or osmosis."

CS: "Two things: First, teach and review specific practices that improve patient satisfaction ratings. Secondly, ensure every ED physician knows his or her score and those (anonymously) of colleagues. The people on the bottom don't want to be there and the people at the top want to stay there. That moves scores."

4. Has improvement in service impacted your personal enjoyment or fulfillment in your role as an ED physician?
CS: "Our ED clinicians and staff feel prouder than ever. The ED is the only place where everyone upstairs reviews your sickest cases and the decisions you made. Plus, the ED's the only place in the hospital where patients wait to get a bed, so it's easy to be a target of criticism. Our high patient satisfaction scores are an excellent way to advertise that we do great work in spite of those limitations. If it can be achieved in the ED, it can be achieved anywhere."

JGO: "Absolutely. When I decided to come back to my hometown to practice medicine in a small hospital, I accepted some good-natured ribbing from instructors and nurses at my residency program. I'm viewed differently now that Pekin has gained a huge measure of respect throughout the region. It's very gratifying to feel I've made a difference in my community."