As the demand on the Emergency Department (ED) continues to grow, so does the need for bigger and better ED facilities. Everywhere we look, Emergency Departments are expanding in order to keep pace with rising patient volumes and the heightened focus on patient experience.
In fact, 50 percent of the EDs currently working with Studer Group’s Emergency Services Team are tackling some sort of renovation or even construction of an entirely new facility. Projects range from reducing the size of waiting rooms to add more care space to large-scale expansions.
No matter the size of the project, every renovation impacts throughput, patient experience, and employee engagement - often for the simple reason that every day during a renovation a space can look different to patients and staff than it did the day before.
Those undergoing or anticipating a renovation for any department should be prepared for some variability in patient experience during this time period. A renovation should not, however, be an excuse for poor employee engagement or unhappy patients. Frequent, consistent, and effective communication is the best way to support patients and staff through change so that you have a smooth renovation transition and a positive final outcome.
Here are three strategies to increase communication and decrease the potential negative impact of a renovation on your patients, staff, and physicians.
Communication with Every Patient, Every Time
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I cannot over emphasize the importance of the use of AIDET® during a renovation. AIDET®, which stands for Acknowledge, Introduce, Duration, Explanation and Thank You, is a communication framework popular with healthcare facilities for its use in incorporating vital information into every patient interaction.
AIDET® is a simple tool, but it takes engaged training and practice to get it “hardwired”, or to make it a permanent behavior for staff. Using skills labs accelerates staff’s comfort level with AIDET®, allows for on-the-spot coaching, and, most importantly, validates skills competency.
Here’s an example of how the AIDET® framework might come together during a patient encounter. “Hello Mrs. Evans. My name is Angela and I will be checking you in to get your care started. What brings you in today? Thank you so much for your patience as we are undergoing renovations. We are so excited about the future of our hospital and the increased capacity to serve our patients. Please excuse the dust and noise that you may experience today. You may also recognize that you are being moved to many different areas, and that is so we can continue to expedite your care with us.”
Words Matter
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Building on AIDET®, organizations will find using Key Words at Key Times is critical to managing patients’ concerns about the ED environment during renovations. Staff should be sure to explain the “why” behind the current environment and how the new ED will benefit patients. Every interaction should include a “thank you” to patients for their patience.
For example, if a patient or family says, “This place is a mess. What is going on?” Using key words, you might respond, “Thank you for your patience. We know the construction isn’t ideal, but we feel fortunate to be able to stay open during renovations so we can continue to serve our patients. When construction is done, we’ll be able to reduce the time you spend in the waiting room.”
Staff shouldn’t have to do all the work either. Support your staff by providing ample internal signage about the renovation all the way through their ED visit. Make your staff aware of the signage, and make sure they can speak to the messaging on the signs.
I recently worked with a Level I Trauma Center undergoing a large-scale three-year renovation. Patient experience metrics for the organization took a drastic dip to a single-digit percentile rank. We realized quickly that we had not done enough staff training on using key words with patients about the renovation. And while signage was present, it wasn’t placed correctly near the ED entrance, and it didn’t include a visual of the new ED.
After implementing skills labs with staff, including security, registration, and other ancillary staff, and adding signage that included renderings of the completed ED, that same organization’s patient experience scores climbed more than 40 points during the remaining stages of renovations.
Studer Group partners can access the Skills Lab Toolkit on the Learning Lab for resources needed to run a skills lab at your organization or ask your Studer Group Coach for more on best practices.
A Day in the Life
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Flow simulations should be conducted regularly throughout the renovation. The goal is to walk through a day in the life of patients. This gives staff a better understanding of what each patient experiences. The experiential learning helps them appreciate the changes to their work pattern so they feel comfortable and know where things are located.
The more comfortable your staff feels during the renovation, the better they will be at presenting an authentic and positive message to patients. As with all training during a renovation, it’s critical to be inclusive of all staff – nurses, physicians, transport, registration desk staff, and so on.
Increasing communication during a renovation takes persistence and commitment from leadership. Because so much is going on, there will be a temptation to back off or even ignore the practice of tactics such as AIDET® or nurse leader rounding. The opposite should happen. Leaders should significantly increase their communication with staff and patients and conduct intentional and focused training for staff to help them communicate better with patents.
Angie Esbenshade, RN, MSN has more than 17 years of clinical nursing and administrative experience in emergency, trauma, and critical care. Angie is currently the Leader of Emergency Department Services at Studer Group.
Additional Resources:
For a deeper dive into tactics that improve patient experience in the ED and across the continuum of care, view the curriculum tracks available at Studer Conferences.
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