Patient experience is a good area to mine for a QAPI project in an ASC.
“Based on a lot of feedback I see in patient satisfaction surveys, waiting room time is a huge complaint, universally,” says Carolanne Reho, MHA, BSN, RN, CNOR, senior director of clinical services at AmSurg.
Patients often are anxious or nervous before their procedures. Families worry while waiting for their loved ones during surgery. It’s important for ASC staff to be mindful of their feelings and to communicate what’s going on when procedures are delayed, she says.
“In surgery centers, frequent communication is vital,” Reho says.
Someone might let patients know when there’s a delay.
“A physician or nurse or receptionist could go out and give a brief update,” Reho says. “Acknowledging the wait is vital. It shows that you understand that they’ve been sitting there, waiting, and their time is valuable.”
There also should be follow-up. If someone has just told a patient that they’ll be ready to go back in five minutes, but this is delayed, give the patient an update.
“Consistency is important with communication,” Reho says. “Anytime there’s a wrinkle in that process, where communication lapses, that’s when people get upset; they feel their time is disrespected or their concerns are disregarded.”
To identify a patient experience quality improvement project, the ASC could conduct a time study, tracking the time patients and families wait.
“It would be wise to engage the clinical staff about how long people have been waiting, and it’s wise to also talk with the front office staff, looking at the [check-in] process,” she says.
Ask staff these questions:
• Do you know how long someone has been sitting and waiting to be called up?
• Does your area receive a lot of complaints about patients waiting a long time?
“Engage people at the front line of receiving patients, and help them realize that from the moment a patient walks in the door, the patient’s experience at the surgery center begins,” Reho says. “We need to be mindful of their experience.”
It’s also important to emphasize to front office staff that their experience in dealing with patients is just as important as the experience of the people in the back office, Reho notes.
“This validates the importance of their position and their being the face of the surgery center,” she adds.
Technology can help with this process.
“One of my surgery centers is ophthalmology, and most of their surgeries are cataract procedures, which are fast procedures with a lot of patient turnover,” Reho says.
To improve the patient experience and help the center run more efficiently, the ASC maintains an electronic sign-in board. Patients walk in the door of the center, and their time is noted on the board. This electronic sign-in creates a signal to the front door receptionist, and begins a time clock on each patient’s waiting time.
“They can see in real time how long the patient has been in the facility,” Reho says.
The electronic system also gives the pre-op nurse information that the patient is ready to be brought back. If there is any holdup, the staff can communicate with the patient about it.
“It makes them more efficient, in general,” she says. “They’ve seen a decrease in wait times in doing that process because it heightens their awareness.”
Also, patient satisfaction surveys show that patients are happier with this system, although they’re only aware of the sign-in board and not of the system’s communication to other areas of the ASC.
“That one simple motion of their signing in gives the entire team the beginning of a communication pattern, which has helped them a lot,” Reho adds.