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| PetrackConsulting.com | ||
 Summer, 2008 Volume 6, Issue 3
New: Dr. Petrack quoted in recent CNN article.
For free articles, abstracts, Emergency Care Briefs, and more, visit our Resource Center at PetrackConsulting.com...
New, revised CalmerKids Training Module! Get a new low price, plus become CalmerKids Certified when training is complete. Show me... |
Consultant's Corner Emory Petrack, MD, FAAP, FACEP
A quick welcome and "thanks!" to our new subscribers from the recent Urgent Care Association of America meeting in New Orleans: we had some wonderful conversations at our booth, and some great questions and discussion during my lecture, "Focus on pediatric procedures: improving the experience for children and providers alike." And a special "thanks!" goes out to those of you who invested in the CalmerKids Training Module to upgrade pediatric and family-centered care for your centers. I trust that CalmerKids will serve you, your patients and your facilities well.
Feature Article Pain Management, Patient Satisfaction, Rotten Data
We recently received "data" on how individual physicians in the pediatric emergency department are doing with respect to addressing pain and patient satisfaction. It looks like we're not doing very well. In fact, our scores were lower than those of our colleagues in the adult emergency department. Given my passion for reducing pain in children whenever possible, I was surprised and disappointed to see this.
Then one of our staff physicians called me, very distressed. She had scored only 50% for the question "percent of patients who stated pain management was excellent." Our hospital administration, like many, focuses not on averages, but on "percent excellent" responses. Frankly, I think this is appropriate, as we all need a high benchmark.
This particular physician has excellent communication skills. She's also highly attuned to concerns around reducing pain. After calming her down, I told her that I'd look further into the raw data and get back to her.
It did not take me long to discover the problem: we had received rotten data.
Her scores in this category were based on an "n" of two (2)! That's right - of two families surveyed (two!), one responded "excellent" while the other responded only "good." Clearly, this data should never have been reported. It does not take a statistician to figure out that this simply is not a valid sample.
The point is this: if we're going to ask physicians, nurses or other staff to change behaviors or improve care, they deserve specific, clear feedback as to what the concern is and how they can do better. And not only must the feedback be specific - it must also be legitimate and valid. Anything less, and not only will the desired change NOT happen, but we also potentially demoralize the very people we are trying to help improve.
In the News
Quote of the Month
New Articles/Abstracts
Brief summary of recent new articles and abstracts from http://www.PetrackConsulting.com/articles.html
Singer, A. J., Viccellio, P., Thode, H. C. J., et al.
It is well known that ED length of stay (LOS) is a major determinant of patient satisfaction, and laboratory delays are a frequent cause of increased LOS. These authors looked at LOS in their ED for a one month period, before and after installation of a stat lab in the central laboratory. Implementation of the stat lab resulted in reduction of median LOS from 466 minutes to 402 minutes for admitted patients. The effects of the stat lab on LOS of discharged patients was less marked, although there were significant increases in the percentages of laboratory tests with test turnaround time within 30 minutes.
We frequently hear from patients about attempts to see their primary provider that were unsuccessful. In this study, research assistants called a random sample of 603 ambulatory clinics, posing as patients, to get a follow up appointment from their ED visit. Only 242 of 603 (40%) pseudopatient scenarios resulted in a follow up appointment within 1 week of ED visit. Multiple barriers were identified and discussed, including busy signals, clinic closures, voicemail or personnel too busy to take the call. If clinic personnel were reached, 55% were put on hold, with average hold time of 2.43 minutes. On average, it required 1.7 calls to reach appointment staff. Total telephone time averaged 11.1 minutes for successful appointments. This study documents the many barriers to obtaining timely follow up care for ED visits.
Upcoming Meetings
Sept 24-27, 2008, Emergency Nurses Association, Annual Meeting, Minneapolis, MN
Oct 11-14, 2008, American Academy of Pediatrics, Annual Meeting, Boston, MA
Oct 27-30, 2008, American College of Emergency Physicians, Annual Meeting, Chicago, IL 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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