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We are having difficulty getting a return on our ED customers' satisfaction surveys and receiving them in a timely manner. Has anyone found a solution to these problems?

Action
We specialize in customer, employee, and physician satisfaction surveying. Historically, the industry has had the most difficulty in obtaining results from ED patients. While we offer the typical methods of patient data collection, we challenged ourselves to develop a method for emergency departments to increase patient response without significantly increasing the cost. We solved this by capturing patient responses before they leave the facility. Through 2 devices, a touch-screen kiosk and a small book sized self-entry device with a numeric keypad.

We place a kiosk (similar to the check-in station used at an airport) in the ED waiting room. Staff are encouraged to become involved in the process and direct discharged patients to the kiosk to provide immediate feedback. (Admitted patients are captured through the inpatient surveying.)

The touch-screen kiosk's audio and video capabilities provide quicker, user-friendly data collection and faster report turnaround. The machine also can be programmed to show video clips, such as a message from the hospital chief executive officer or an advertisement for a special hospital health promotion. We ask that the touch-screen kiosk be plugged into a dedicated phone line so that we can periodically dial into the kiosk and make sure the computer is running properly and retrieve the information for reports.

The Jackson Group also has available smaller self-entry survey units (called Patient Entry Terminal for Satisfaction (PETS) Units) that can sit on a desk with the last person the patient sees before going home. This smaller device does not have audio or video capabilities. This device works especially well if an emergency department has one discharge point. The individual at the desk with the unit will ask the patient to take a survey while they get together the patient's paperwork, and then the survey becomes a natural part of the discharge process. Unlike the touch-screen kiosk, this device requires the emergency department to download the information, a process that takes about 2 minutes.

No matter which methodology our clients choose, we encourage designing an individualized survey. While the percentage of participation varies between institutions, we typically find the emergency departments have a 30% to 55% return response.

-Wade Wolgemuth, the Jackson Group, Hickory, NC, wwolgemuth@thejacksongroup.com

Results
We switched to The Jackson Group's kiosk system when I was the ED director at Huntsville, Alabama. At that time, our own generated survey returns were only around 302 respondents per month at a time when there was a high level of staff and financial expenditure.

We created a discharge desk that obtained co-pays and the kiosk survey at the same time. (We sent volunteers upstairs to capture the inpatients admitted through the emergency department with the handheld device.) Staff (including physicians) were required to mention the need to participate in the survey. I am considering adding "rent cards," like in hotels, in each room to remind patients as well.

The survey included who was the physician, the day of week, and time of day. It became apparent if certain employees were not asking patients to take the survey. We tied the results of the survey into the physician's compensation package.

In less than a year, we had increased to 2102 patient responses per month (around a 50% return rate), which improved my confidence in the results. The total time involvement was a monthly 5-minute download, and the cost was less than 10 cents per response.

Some of the advantages I found from this system included the following:
* An ability to stratify data. This makes it easier to define the problems and monitor for improvement.
* The capability to ask or change specific questions on short notice. When starting a new program or change, it is good to get such "instantaneous feedback."
* A timely turnaround of data. Instead of the typical wait of months, weekly data can be obtained.

We are now instituting the service at my current employer, even though we do not have the discharge desk. Staff is assuming an increased role in directing patients to the kiosk. We also put comment cards for those patient who have more to say or do not like using the computer.

The only drawback is the inability to benchmark with other institutions. We benchmark with ourselves, and for me, 100% "happy" is my goal.

-Barb Pierce, RN, MN, former Division Manager of EDD/Trauma, OB/GYN, Queen's Medical Center, Honolulu, Hawaii, and current Director, Critical Care/ER, Southeast Georgia Medical Center, Brunswick, GA.