What Does “Patient Satisfaction” Really Mean in the Emergency Room?

In the last several shifts I’ve worked in the ED I’ve had more people stop and compliment me on my care. I’ve heard the usual, “Do you have a private practice?” compliment and, “I’ve been here a lot and you really took the time to hear what I was saying, I appreciate that.”

Kudos are nice. They are what makes a tough shift go by quicker. They remind me why I have decided to dedicate my life to people who find themselves at their worst possible moment of health and well being. The kudos have also caused me to pause and wonder what the heck I was doing differently since I don’t think today I am treating patients any differently than six months ago.

Patient Satisfaction. The mere words strike fear and occasional disdain in the hearts of many medical professionals trying to do the best they can to provide the highest quality care to their patients. I don’t blame them, because I think we are using the wrong terminology to describe the goal we are trying to achieve.

Improving the patient experience is considered one of three main goals of achieving health care’s Triple Aim. And no this doesn’t mean treating patients like they are in a fast food joint or giving every person as much Percocet as they want.

The patient care experience is about more than patient satisfaction. It’s about engagement. By that I mean engagement of the patient in their care to ensure the best possible chance of becoming well.

In healthcare we have to do things to patients that would be considered assault in any other situation. In order to have that be okay, we, as providers, need to demonstrate that we indeed care for that person sitting or lying on that stretcher. What’s the best way to demonstrate this caring?

Most of us have heard about AIDET: Acknowledge, Introduce, Duration, Explanation and Thanks. It’s a good process and helps to remind us to give the same attention and care to every patient and family. That’s good and we should all practice that. More importantly, the Mom Rule applies here: If my Mom (or sister or son) were sitting in that bed how would I like them to be treated.

AIDET and the Mom Rule help to improve the patient experience once they’re out of the waiting room, but what happens before that? With more and more people on social media – Twitter, Facebook, Yelp, Instagram, Snapchat, and others – have we tried to reach out to patients while they are still waiting (because sometimes people have to wait), or even before they arrive at the hospital?

Have we let them know wait times? Have we set up an alternative to ED care (perish the thought)? How about after the 80% of patients have left? Do they all get a call back from the hospital the next day? If not, why the difference in engagement? Too many patients seems like a convenient excuse to me. Especially considering over 60% of all admissions come through the ED on average and the ED will be the single largest touchpoint with your community as a whole.

So, back to what I am doing differently today. First, my twenty years of experience as an ER physician certainly counts for something. I’ve learned a few lessons along the way. I try and connect with a patient or family and ask about or comment on a piece of history. “You’re from PA, oh so am I, what part?” “Married 55 years? What a blessing. Congratulations.”

I write my name on the board and let them know if they need to yell at someone I want them to get my name right. I’ve learned to be kind and firm when I say no (kind of like Mary Poppins) to that MRI or refill of dilaudid. I try and take that extra moment to ask if they have any questions and have started to ask patients to repeat back reasons to return, although I do not do it consistently.

It’s all about engagement and treating someone how I would like my loved one or myself to be treated. Pretty simple and we can do a lot better. That includes me.