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 April 2006 Volume 4, Issue 2  Consultant's Corner
Feature Article
Quote of the Month
New Articles / Abstracts
In the News
Upcoming Meetings
Special Conference:
Dr. Petrack will be speaking at the 2nd International Multidisciplinary Conference on Pediatric Procedural Sedation, to be held May 31- June 1, 2006 in Columbus, OH (see the Upcoming Meetings section for details).
For free articles, abstracts, Emergency Care Briefs, and more, visit our Resource Center at PetrackConsulting.com...
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Consultant's Corner
Lights! Camera! Improved Patient Satisfaction!
by Emory Petrack, MD, FAAP, FACEP
It was really a pleasure to meet so many of you last month at the Emergency Nurses Association Leadership Challenge in Austin. I was fortunate enough to be able to attend Fred Lee's keynote speech. For those of you who may not be familiar with Mr. Lee, he spoke on If Disney Ran Your Hospital (and is the author of a book by the same title). He brings to the table a rather unusual background, serving in the past as both a senior hospital executive, and a member of the Disneyworld cast. Disneyworld, as you likely know, is renowned for their exceptional customer service.
I believe Fred brings some great wisdom to discussions and initiatives about patient satisfaction. While I hesitate to condense his speaking and writing to a couple sentences, he basically suggests that we need to hire and develop people who delight in truly connecting with those who come to us looking for help in healthcare settings. He argues that those staff who exhibit awareness and compassion are the real stars. That we should be expecting staff to "play a role," not just "do a job."
As I listened to and read his words, I find myself in strong agreement much of the time. Many departments have at least some staff who are quite disconnected, who may even be poison to the department's mission. However, I can't help wondering…. Where are these people, these caring, compassionate, connected staff? They are everywhere, but not infrequently, I have found them to be somewhat shy, overpowered by others who seem to lack connection and compassion. Given the current staff shortages everywhere, one might wonder if actually achieving Fred's goals is a pipedream.
This is a classic catch-22. It is critical to hire and then keep those "connected" staff, and to help those who clearly are unhappy find other, perhaps more suitable, lines of work. If leadership works over time to get the right team on board, the customer service issues will, for the most part, take care of themselves.
Define Educational Objectives in Relation to your Business Goals
The Emergency Nurses Association Leadership conference took place last month, in Austin, Tx. I was quite impressed at the number of educational offerings. At the institutional level, many of us work hard to create educational and training meetings that are appropriate for our staff. Hopefully, we focus closely on the curriculum to ensure that the content begins with learning objectives and then has appropriate methods and content for meeting those objectives.
The concern I have with this approach is that it starts in the middle, rather than the beginning. Educational requirements should drive curriculum, which then drives specific educational or training interventions. But where do the educational requirements come from? Often, they come from areas that come up as "topics of interest" to staff. While that may be fine for some areas, leadership needs to step back and become clear about institutional or departmental goals. These business requirements then become the starting point. And these business requirements are then used to drive performance requirements, which are then used to drive educational requirements.
So…. If you have decided that improving customer service is a current important initiative (ie., a business requirement), then consider how that might translate into performance and educational requirements for training. And next time you or the educational coordinator is arranging an inservice on "splinting of different fracture types," you can focus on weaving in the communication challenges, pain relief techniques, and other elements that are critical for enhancing patient satisfaction in this "clinical" topic.
New Articles/Abstracts Brief summary of recent new articles and abstracts from http://www.PetrackConsulting.com/articles.html 2005 National Healthcare Quality Report, U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality This report is a national overview of the quality of healh care in the United States. It reviews four dimensions of quality- effectiveness, patient safety, timeliness, and patient centeredness. Although not focused on emergency departments, the report suggests that while overall quality is improving in many areas, emergency departments are not doing as well. Examples cited include increasing "left without being seen rates" (1.2% in 1997-98 to 1.7% in 2001-02) and longer than desired (and unchanging) "time to initiation of thrombolytic therapy" of about 45 minutes. National Report Card on the State of Emergency Medicine, American College of Emergency Physicians, 2006 The American College of Emergency Physicians has published a report that looks at the support each state provides for emergency care, offering a letter "grade" for each state, with an overall national average of C minus. Measures were broken into 4 broad categories: access to emergency care, quality and patient safety, medical liability issues, and public health and injury prevention. The report highlights the increasing pressure on our emergency care system, with the closing of 15% of EDs over the past decade and continually increasing volume. You can learn more and see information for any state by going to the link provided above. Availability of pediatric services and equipment in emergency departments: United States, 2002-03, Vital and Health Statistics, U.S. Department of Health and Human Services, February 2006. This report provides some detailed data on the availability of pediatric care in U.S. emergency departments. 23% of EDs had 24 hour access to a board-certified pediatric emergency physician. Only 5.5% had all recommended pediatric supplies, although overall, hospitals had 83% of the recommended supplies. This report, a supplement to the large, national NHAMCS database, is worth a look. You don't say: Patient-doctor nonverbal communication says a lot, Medical News Today, February, 2006 This article summarizes and comments on a paper from the January, 2006 issue of the Journal of General Internal Medicine. It highlights the obvious: nonverbal gestures and cues, from both the patient and the physician, can be as important as what is actually said. However, while perhaps obvious, physicians remain frequently unaware of the impact of nonverbal behaviors, which can have a significant impact on both addressing the patient's concerns, and achieving patient satisfaction.
Hunt EA, Hohenhaus SM, Luo X. This prospective, observational study looked at pediatric trauma mock codes at 35 North Carolina EDs, scoring each code on 44 stabilization tasks. While the median number of tasks that needed improvement was 25 (57%), some common critical tasks, such as warming measures, ordering IV fluids and preparing for intraosseous needle insertion, were missed by the vast majority. Their conclusion suggests that mistakes in handling pediatric trauma are very common and that additional training is needed to enhance outcomes for pediatric patients.
Zibners LM, Bonsu BK, Hayes JR et al. This is another study that examines if weather data can be used to predict emergency department volume. Its conclusions are similar to previous studies, suggesting that temperature and precipitation data do not predict how busy the shift the will be.
Upcoming Meetings
April 5-8, Urgent Care Association of America, Annual Conference, Lake Tahoe, NV
April 24-26, American College of Emergency Physicians, Advanced Pediatric Emergency Medicine Assembly, Chicago, IL
May 18-21, Society for Academic Emergency Medicine, Annual Meeting, San Francisco, CA
May 31- June 1, 2nd International Multidisciplinary Conference on Pediatric Procedural Sedation, sponsored by the Pediatric Sedation Research Consortium and Columbus Children's Hospital, Columbus, OH
Sept 13-17, Emergency Nurses Association, Annual Meeting, San Antonio, TX
Oct 15-18, American College of Emergency Physicians, Annual Scientific Assembly, New Orleans, LA About Our Organization
Created in 2003, Petrack Consulting is dedicated to helping physician and hospital
leadership bring excellence to emergency services. We work collaboratively to
fully understand our client’s needs, and then address programmatic initiatives
with measurable outcomes. Our unique background in emergency medicine, administrative
medicine, and organization development allows us to create uniquely effective solutions
for enhancing emergency services.
Website: http://www.PetrackConsulting.com |
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