How to improve patient satisfaction in the ER [Interview]

Patient satisfaction typically isn't the most important issue for emergency room doctors when dealing with life-and-death cases and a waiting room packed full of sick patients. But it must become a higher priority, especially when the ER is busier than usual.

In addition to the fact that hospitals receive a portion of their Medicare reimbursement on patient satisfaction scores via the Hospital Consumer Assessment of Healthcare Providers and Systems, ER docs are under greater pressure to boost scores because consumers now can turn to Yelp to find out about emergency department wait times and how patients rate them on communication.

"Patient satisfaction has to be a big deal to us," Catherine Polera, M.D., chief medical officer for Sheridan Healthcare's emergency medicine division, tells FierceHealthcare in an exclusive interview. Sheridan is a national hospital-based, multispecialty practice management company.

"It's important to have a good relationship with patients in the ER," Polera says. "The problem is, how do you do it when you have critically-ill patients, a surge in patient volume and not-so-sick patients?"

ER docs are mainly concerned with providing timely, high-quality care to the sickest patients first, Polera (pictured) says. But the challenge is meeting the demands of all patients, who all want to be seen immediately and receive treatment in a manner that she describes as a "Walt Disney customer-service mentality."

 "The perception of the job versus the reality of the job can be a mismatch," she says. "Everyone who arrives at the ER is important, but since the patients don't triage, they don't know what's going on."

The other problem is that physicians have never received training on customer service in medical school or their residencies. But, hospitals expect them to embrace the patient experience when they join the staff. "So it's a challenge," Polera says. "How do you help doctors become customer service-friendly when they have no experience with it?"

Sheridan now incorporates the need to consider the patient experience as part of its ER doctor orientation and ongoing education, according to Polera. "It's important that the docs understand the concept," she says. "When they are oriented to the site, we explain ways in which patients want to be talked to."

Polera says that when she first finished her residency, she didn't do well on patient satisfaction scores. The surveys showed that she was providing patients with too much "scientific" information and indicated that she needed to talk to patients in a simpler way; to treat them as she would her own family members.

"That's the concept we talk about with doctors," Polera says. "It's not enough to know the medicine. You have to be a well-rounded provider. The expectation is that we do more than get [diagnosis and treatment] right. We are doing it in a timely manner and with a smile on our face."

The main strategy for hospitals, she says, is to help doctors understand that the environment used to be designed based on the comfort level of staff. In today's patient-centered environment, healthcare must make it comfortable for the patient.

"This is not just important to hospitals because it basically affects the bottom line," Polera says. "It's important because patient satisfaction will lead to better outcomes. If patients trust the doctor and the doctor gets the information they need from the patient, there is better communication. And it's more than just getting a high survey number. It's a patient safety issue so this is a good thing."

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