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If ED physicians and nurses could choose only one strategy for avoiding lawsuits, it should be to keep patient satisfaction levels high, say several experts.

Patient Satisfaction Planner: Patient satisfaction is a best practice

December 1, 2009

Patient Satisfaction Planer

Patient satisfaction is a best practice

'It's hard to hate someone who's been good to you'

If ED physicians and nurses could choose only one strategy for avoiding lawsuits, it should be to keep patient satisfaction levels high, say several experts.

CEP/MedAmerica, an Emeryville, CA-based provider of ED management and staffing solutions, has conducted internal research regarding malpractice risk. "We track patient satisfaction, door-to-provider time, and medical malpractice cases per 20,000 visits," says Martin E. Ogle, MD, regional director for the southern division. "There is a definite correlation between increasing patient satisfaction and decreasing the medical malpractice frequency."

In fact, there is "almost a linear relationship between the highest and lowest levels of satisfaction," he says. "We've seen up to a threefold reduction in the number of claims over a million patient encounters," Ogle reports.

Gregory Henry, MD, FACEP, risk management consultant for Emergency Physicians Medical Group in Ann Arbor, MI, says, "It's hard to hate someone who's been good to you. The smart ED doctor understands you have to get very close to the family, particularly when things are going badly." He reports that as much as 50% of what he does is "schmoozing."

Corey M. Slovis, MD, FACEP, FACP, FAAEM, chair of emergency medicine at Vanderbilt University Medical Center in Nashville, TN, agrees. "For so long, older doctors — me included — thought the measure of our job was how smart we were, how expert we were in emergency care," he says. "I now have begun to appreciate that you have to layer on customer service and both perceived and delivered quality." In short, he says, delivering the right dose of the drug at the right time "does not make you a great ED doc."

Any patient can have a bad outcome, says Tom Syzek, MD, FACEP, MD, FACEP, director of risk management for Dayton, OH-based Premier Health Care Services. "Who gets sued? The doctors and nurses the patient does not like," he says.

The personal approach is no less important for nurses, adds Diana S. Contino, RN, MBA, FAEN, senior manager of health care with Deloitte Consulting in Los Angeles. "One of the best ways to try to prevent complaints is to be very attuned to patients and their perspective," she says. Building personal skills that enable you to relate to patients helps you anticipate and avoid problems, she says. "The best way to do that is to constantly ask yourself why a person might be doing what they're doing and try to understand where the person is coming from," Contino notes.

Ogle says, "For me, it's also the simple stuff like being your optimized self; coming in well rested, focused; not taking calls from your broker; not texting and 'tweeting'; and focusing on your patients' needs. It's not rocket science, but I can't tell you how many times people have personal crises, and there is a real negative impact on their medical practice."

Nursing Best Practices Can Minimize Complaints

  • Acknowledge patients when they walk up to you. (None of us likes to be ignored.)
  • Develop strategies to ensure that you are 100% present. For example, as you enter the ED, remind yourself that no matter what is going on in your life, you must "leave it at the door." The patients and your colleagues need your full attention to keep everyone safe and free from errors.
  • Encourage open communications between all members of the care team. Everyone should be encouraged to speak up if they identify a problem or potential issue.
  • Know the patient's plan. Encourage physicians to communicate the full plan of care, allowing nurses to anticipate any problems and provide early warning about changes in condition.
  • Take care of yourself. Get enough sleep, and eat properly; fatigue causes inattention.
  • Keep patients informed. (None of us likes to be kept waiting without knowing the plan.) Touch base every 30 minutes at a minimum.
  • Be honest about wait times for labs or radiology. This honesty helps manage patient expectations.
  • Show compassion. No matter how frustrated, stressed, or distracted you are, smile, listen, and be respectful. Treat others like they were your children, spouse, parents, or dearest friends.
  • Conduct follow-up calls every shift. Bring patients back if they aren't improving, and show you care.
  • Use thank-you cards or small tokens of appreciation for immediate service recovery. (Some active hospitalwide service recovery programs have a small budget for giving staff access to the gift shop for small purchases.)

Source: Diana S. Contino, Deloitte Consulting, Los Angeles.