Consistent Communication Increases ER Patients' Satisfaction

Anyone who has ever spent any time in the ER knows that emergency departments can be volatile places.

For one thing, it can’t be predicted how many patients will come through the door in a given day, but they most likely won’t arrive in an easily managed steady stream. For another, patients show up at the ER feeling anxious—they’re ill, injured and/or in pain. Nerves are frayed, tempers can flare and it seems no one is happy.

So, what would make ER patients feel better? Immediate treatment? No. Pain control? No. Although those two things are hovering near the top of the list, a recent survey of 1.5 million patients in over 1,600 ERs revealed that the most important factor in making the ER visit more tolerable for patients is that they be kept informed about how long they can expect to wait.

In 2007, the average emergency room visit was four hours and five minutes—which, I’m sure, feels like an eternity when the patient is in pain or simply feels too poorly to sit upright for that length of time.

Even though patient satisfaction decreased as the wait grew longer, the survey results showed that the ER staff’s consistent updates regarding delays gave the patients the sense they were cared about as a person and that they had not become invisible.

Here I go, climbing up on the Communication Bandwagon again. Communication is such a simple, common sense sort of thing that I find it puzzling that there are so many failures along that line.

I will draw the analogy of an ER to a restaurant. Recently a friend and I went to lunch at a new, moderately upscale place in town. It is small, perhaps only 12 tables and when we arrived only three tables were occupied. We were seated and the server, a woman in her fifties, entered the room carrying plates of food that she placed at one table. Then, she turned, walked right past us and left the room. She was gone for awhile, returned with more food for another table and left again to fetch a condiment from the kitchen that was requested by someone at that table. She had passed by our table four times without even acknowledging that we were there. Just a simple, "Be right with you," would’ve sufficed. We truly did feel invisible and it was annoying. We were just waiting for menus, not medical care, and the only pain we were feeling was due to mild hunger. Clearly, the annoyance we felt in a social setting would be greatly magnified in an ER waiting room.

It is easy to understand, then, that patients' agitation would be reduced by knowing that someone knows and cares that they are waiting (haven’t we all wondered, when waits drag on and we have no idea why, if our charts have been lost or misplaced?), that they have not become invisible and that there is a projected end to their wait. It doesn’t have to be a nurse, although that would be ideal, but someone needs to maintain communication with the patient. Communication solves or eases a plethora of problems.

Is your emergency department doing anything special to increase patient satisfaction? A fast-track system that separates patients with less serious injuries and illnesses from those who require more medical attention, perhaps? Please comment as to what is being done and how effectively it is working.