At Ochsner Medical Center, Monica James-Harper, patient access manager for the ED, recently reviewed comments about the department from a Press Ganey survey. Many patients expressed concerns about these two issues: confidentiality and timely evaluation. For both issues, registrars needed just a little bit more information to solve the problem. This information was added in the “comments” section of the EMR:

What the patient is wearing today. One thing the survey respondents really disliked was “cattle calling” (hearing their name called out loudly in public). “Many patients complained it was a breach of confidentiality,” James-Harper says.

Registrars came up with a way to avoid this annoyance. When checking in a patient, the registrar adds a brief description of the patient’s clothing, such as “red shirt, blue hat, sitting in a wheelchair.” This way, registrars can walk right up to the person they are looking for and greet him or her. This makes the first contact not only more discreet but also much more personal.

A brief description of what brought the person to the ED. “This allows triage nurses to identify medically urgent patients sooner,” James-Harper says.

As a result, some patients are brought back sooner. But in turn, this raises another issue: Patients left behind do not understand why others are allowed to “jump the line.” The ED waiting area encompasses many different areas, including pediatric offices, patients waiting for test results, the main lobby, and the “super track” where less urgent patients are seen. Patients and family members are upset when they see others called first -— especially if those patients who were just called arrived after the patients who were left to wait. “Where is that person going?”

When someone voices this complaint, the registrar always starts with an apology. Next, the registrar calmly explains the many reasons another person might have been called first.

“Patients are upset and afraid of the unknown,” James-Harper notes. “Once you explain the ‘why’ behind the event, they usually calm down.”