Athens-Limestone Hospital ER Survey - Athens, Alabama

Situation
How to increase the number of patient satisfaction survey responses in an emergency room without spending a lot of money or staff time doing it?

Due to high volumes in Emergency Rooms, many hospitals are faced with the question: How do we go beyond statistical reliability and probability of error, to believability with a high number of responses based on that volume? The typical return rate on written instruments in an Emergency Room is below 10%. Calling patients at home can cost a facility anywhere from $14-$18 per completed call.


Action
Gina Hanserd, Marketing Director, and her staff at Athens-Limestone Hospital in Athens, Alabama believed there had to be a way to get increased patient responses without increasing staff or budget.

In November 2002, Athens-Limestone Hospital answered the dilemma of affordable patient satisfaction surveying by using the Patient Entry Terminal for Satisfaction (PETS) to survey patients in their Emergency Room. The PETS system is a self-entry device that allows patients to read a question on a LCD monitor and then answer by pressing a corresponding number.


Results
There was some doubt initially, because this system was brand new to the facility. Would they get the number of patient responses they were hoping for? Would a system that asks patients to complete a survey BEFORE they leave really work?

The subject line of the email after the first month of surveying said it all: WOW! At the end of the first month of surveying in the Emergency Department at Athens-Limestone Hospital (a 101 bed facility in Northern Alabama), 425 patients had taken the survey. Since the first month, Athens-Limestone has averaged 539 responses with a high of 850 completed surveys

Their process is simple: When patients get ready to leave the ER, they are handed a 3x5 card asking them to stop at the business office desk and complete the survey. While business office staff complete paperwork, patients are asked to complete a short eleven-question survey. This serves two purposes. It not only gets people to take the survey, it has also improved their accounts payable system.


Outcomes and usage of data
We had an opportunity to celebrate their success by hosting a pizza party for the ER staff on March 21st. While celebrating we had a chance to ask how this new patient satisfaction system has impacted customer service in the ER.

According to Jan Perkins, Director of Nursing, she has noticed an improvement in scores over the short four-month period. Due to the rapid return of reports (10 days after the end of the report period) provided by PETS, she has been able to give immediate feedback to the staff of the ER. Additionally, the flexibility of the PETS allows them to track feedback by name for each of the nurses and ER physicians. Patient satisfaction is a key measure of the ER physician contract. By tracking scores by nurse, Jan is able to give individual feedback to nurses and has set up a quarterly reward program for the nurse with the best scores. By the way, individual scores are shared among the group by assigning discreet numbers to each nurse and show that number instead of names.

After just completing their fourth month of surveying, the ER will be reviewing data for improvement opportunities. Awareness alone has already begun to improve scores and reduce patient complaints. A quick review of the four-month report shows a positive trend among all items on the survey. Scores to the item about discharge instructions have improved over two points in just the four-month period. For Jan, one of the greatest impacts has been the noticeable reduction of patient complaints. She remembers getting a thick stack of complaints about the ER from the CEO each month. Now, she says there may be 2 - 3 complaints each month. To her, that shows the survey feedback is raising awareness among the nursing staff about their interaction with patients.


Future of the system
The ER survey has been so successful, Jan chose The Jackson Group's PETS system to begin conducting patient surveying for their Ambulatory Surgery Department beginning in April, and expects the same success there as they have achieved in the ER.

Within the emergency room, they are going to increase their response rate by surveying the patients that do not go to the business office. A volunteer will take the PETS device into the patient.

Can a 101-bed hospital get 1,000 responses from discharged ER patients in one month? We think they can.

For more information on patient satisfaction surveying through The Jackson Group, please contact us at 828.328.8968 or though email at info@thejacksongroup.com.