Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions.

How to Get Patients to Fiercely Love Your ED — and Say So

1/4/2017 5:55:49 PM | 4 comments

Satisfying ED patients has become a do or die mission for hospitals. Unfortunately, EDs are not naturally satisfying places. Long waits, rushed communications, and multitasking staff tend to be the norm.
 
But that doesn't mean ED care can't satisfy . . . and even delight. And in the digital age, a little goodwill can spread at the speed of light.
 
Perspectives recently sat down with Charmaine Mislang, 22, of Redlands, Calif. Her Facebook post about the great care she received at the Redlands Community Hospital ED went viral. Today, she shares her tips on how EDs can connect with patients and cultivate positive social proof.
 
Perspectives: Tell us a little about what brought you to the emergency room.
 
Mislang: I'd been sick for a couple days, but I really didn’t want to go to the hospital. I’m pretty scared of hospitals and doctors, to be honest. But that evening, I started getting worse, and I didn’t think I could make it until morning without seeing someone.
 
My parents drove me to one urgent care center, then another one. The first had stopped taking patients because it was an hour from closing. The second had their doors locked even though the schedule posted on their door indicated they were still open; the staff was pretty much ignoring me and the few others who were also trying to receive care. They refused to acknowledge us.
 
Next, we headed over to a hospital near the first urgent care we'd driven to. When we got there, the parking lot was a mess, and there was a line stretching out the door to get into the emergency room. So we decided to switch directions and head to the ER at Redlands Community Hospital (RCH), which was actually closer to our home. That whole time I was trying to avoid the ER due to previous negative experiences. But that night, I was left with no choice but to take the risk.
 
When we got to RCH, their ER was super packed too. The waiting room was full, and five patients were waiting to check in in front of me. But the moment I got to the desk, the people at registration were so, so nice. Even though it was busy, for that moment they made me feel like I was the only one in the room.
 
  • Takeaway: The first person the patient meets when they walk into your department sets the tone for the entire visit. Greet everyone quickly and with genuine warmth and kindness.

 

Perspectives: So it was a busy night. Did you wait long?
 
Mislang: Actually, no. They had a great system they used to move the patients through quickly. I liked it, because I could see that things kept moving from step to step. The wait wasn’t long in between.
 
They also gave me a checklist of all the tests and things they were going to do, which helped me relax a bit.
 
After triage, I went back to the waiting room until another nurse called me back to collect a urine sample. Then it was back to waiting for maybe five to 10 more minutes.  Before I knew it, they were calling me in to see the doctor, or in this case, the physician assistant. That was about 30 minutes after I arrived.
 
What I liked about their system was that every person had a specific job to do, and it allowed them to execute it really well. Everything felt very smooth — not rushed or confused like I've seen at other emergency rooms. They were so organized that it seemed to give them freedom to focus on the patient rather than the task.
 
  • Takeaway: Have a process to expedite the care of less acute patients. In this case, the CEP team used Rapid Medical Evaluation® to keep care flowing.
 

 

Perspectives: Next you saw PA Brian Stinnett. How did that go?
 
Mislang: Brian and his scribe were very professional, very courteous. And they listened.
 
I've had experiences before where doctors or nurses got impatient or cut me off. It seems like in healthcare, people sometimes get so focused on tasks that they forget that the individual in front of them is a person, not just “patient number four."
 
But Brian — really all the people at RCH — showed me that they were mindful of me as a person. They were high-spirited and seemed to enjoy their jobs. I was impressed, because I know it’s a very stressful field — especially when the emergency room is crowded and short-staffed.
 
  • Takeaway: Listening, empathy, and effective communication all make a huge difference to patients. They're watching how we treat them — and how we treat one another.
 
Perspectives: Afterward, you went back to the waiting room?
 
Mislang: Actually, they had a smaller room set up for people who'd finished all their tests. There was a TV in there and a comfortable recliner.
 
Another nurse was in charge of that room. She gave me some medicine, the kind that numbs your throat and mouth. I was glad I didn’t have to deal with that in the crowded waiting room. Also around this time, a friend came by to see me. The nurse was really welcoming and brought her right back.
 
After about 20 minutes, Brian came in. I thought he was calling me into the room, but instead he just sat down. Then he went through every single one of my lab results and explained it in layman's terms. He really welcomed my questions and concerns, which was nice, because I felt like I was involved. I wasn’t just being told what to do or what was going on with my body. He made sure I understood, and I truly appreciated that.
 
Right after he finished, somebody brought me my release papers to sign. I didn’t have to find the front desk and wait.
 
As a staff member walked me out of the hospital, I was in disbelief. I asked, "Am I really done?"
 
  • Takeaway: Where feasible, set up an internal waiting room. Patients and their loved ones will appreciate the comfort and privacy. It also makes it easy for providers and staff to come to patients rather than the other way around.
 
Perspectives: And that was it?
 
Mislang: I thought so. But then that following week, Brian called. He asked how I was doing and if I had any questions. He told me that if I had any concerns to just come back and he would check me out.
 
I really, really appreciated that he remembered to do that. Normally if you see a doctor at the hospital, you never hear from them again. Or at least I never have.
 
I'd been happy with the whole experience up to that point. But right then I decided that I wanted to do something publicly to show my thanks and support.
 
  • Takeaway: Patient callbacks are one of the most powerful tools you have for increasing satisfaction. There's no better way to increase loyalty and promote service recovery.

Perspectives: So you wrote the Facebook post.
 
Mislang: Yes. I should probably mention here that it's been a rough year in Redlands. We had a big increase in our homeless population, and it's caused a lot of negativity with people calling others out online, especially on social media. So I thought this would be a way to bring the community together. Because what's more positive than a great community hospital?
 
So I posted on a Facebook group called Redlands Buzz 2.0, which is very popular here. I described my visit and the positive way I'd been treated. And then I wrote about getting Brian's call:
 

I really, really appreciate the fact that one of RCH's [providers] took the time to call and make sure I was feeling better … I've been to 3 other hospitals in the past, and none of their staff members have ever called to make sure I was better after my visit with them. I'm not sure if it's obligatory for them to do this, but either way, it made my evening! This just shows how well they do their job, and how much they value their patients' well-being.


Perspectives: How did others from the community react?
 
Mislang: A few people were skeptical, because I guess that particular emergency room went through a time in the past when the service wasn't as good. But others who had been there more recently said, "Wow, this place did a 360. It’s totally turned around." A few other people had also received callbacks and been impressed by the outreach.
 
  • Takeaway: The best way to promote social proof is to make a personal connection with patients. The callback made a big impression on Mislang, as did the warmth she felt from Stinnett and the department staff.
 
Perspectives: I understand that's not quite the end of the story.
 
Mislang: A few days later, to my surprise, I got a call from the doctor who's in charge of patient satisfaction at CEP America, Edward Pillar, DO. He invited me to speak at one of their staff retreats in the Redlands area. It was really nice to be able to meet with the RCH staff and share more about my experience. I wanted them to know they made a difference.


 
Dr. Pillar also invited me to CEP's annual meeting in San Francisco to speak at a leadership session for providers and nurse leaders. They’re trying to get more of their hospitals to adopt the callback program, so they thought my experience might drive home how valuable it is for patients.
 
Perspectives: What do you want hospitals to know about callbacks?
 
Mislang: I think they're one of the best ways to get feedback on your service. It sounds like a lot of hospitals rely on surveys. I’m not sure if it’s a generational thing, but I have to say, I really hate surveys. At my work, we get a lot of them from HR. And to be honest, we tend to ignore them. It feels very limited, very impersonal. I don’t believe anyone will genuinely reflect on my answers or recommendations. I just don’t think they are as effective as companies hope them to be, although I understand the convenience it brings them.
 
But see, this is why I admire CEP’s approach. They prioritize their patients’ needs and satisfaction; they are going beyond what is expected of them to ensure quality.
   
Perspectives: Any other advice for hospital and ED leaders?
 
Mislang: Really care about the patients, and show it. This is the ED, not a typical checkup. It’s a life-threatening situation for some people. They want to be taken care of in a way that’s personal.
 
Check out this blog post for more tips on starting a patient callback program.


Comments
Do Kim
It's so great that Charmaine shared her story to show how valuable patient-centered care and patient callbacks are. Great job Redlands for implementing a great ED flow system and Patient Experience process!
1/15/2017 4:53:27 PM

Ben Frizner
Great story. Explaining the results in layman terms is huge and waiting for the patient to stop talking before you talk is the best way to show your patient you care.
1/14/2017 5:58:52 PM

Adam Kaszycki
What a fantastic story! A powerful reminder of the importance of treating patients/clients/customers from a human-centric and empathetic POV.
1/12/2017 10:05:20 AM

Jon Brummond
Great job team!!!
1/10/2017 9:00:24 PM