Take tip from restaurants to ease waits, ED advises

As EDs look for any solution that will help ease the problems of overcrowding and long wait times, one is finding that a technique already used in the restaurant industry can work in a health care setting as well.

Restaurants have found they can manage waiting patrons much better if they hand out pagers instead of just screaming the next party’s name, so the ED at St. Joseph’s Hospital in Savannah, GA, is trying the same approach.

So far, the results are impressive: Patients and staff are happier, and the ED is reaping some of its highest patient satisfaction scores ever — the 90th percentile. As an added bonus, the benefits come at relatively low cost.

The idea came about because the administration was looking for new and creative ways to address the perennial challenges of overcrowding and long waits in the ED, says Judy Peterman, RN, MSN, director of critical care and emergency services. The ED sees about 47,000 patients a year.

"We’re accustomed to the idea that there’s no perfect overall solution to the problem of overcrowding," she says. "All you can do is sort of nibble away at it and try to make a positive impact in different little niches throughout the problem. This is one of those."

Same beepers used in restaurants

The hospital decided to try using the same devices that are found in many restaurants. Though most people call them "beepers," they don’t actually beep. They’re flat, square devices about 5 inches by 5 inches; and when activated, they vibrate and red lights flash. Peterman says they’re exactly the same as the devices used in some popular restaurants.

The hospital invested about $3,000 for a docking system to charge the devices and 20 hand-held units. The system was purchased from JTECH Communications in Boca Raton, FL.

Each pager has a number on it that is recorded in the triage record. The hospital had the devices programmed so they would allow the patient to go all the way to the other side of the hospital — to the cafeteria, for instance — or for a walk outside.

The triage nurse has the pagers and docking station at her desk and hands them out when assessing the patient. The units are completely sealed plastic, so infection control only requires wiping them down like any other surface. The pagers are used only for low-acuity patients who probably will wait for a while. If the ED is not busy at the moment and no long wait is expected, the nurse doesn’t bother handing out the devices.

The system has been in place in for about four months. Though there was some initial concern that the system might seem unprofessional in a medical setting, Peterman says she understands now that patients expect this kind of technology as a part of customer service.

"Patients’ expectations of us are more and more like their expectations of customer service at the rental car outlet, the hotel, and the restaurant," she says. "We’re at a disadvantage from the start because people come to the ED and just expect to wait a while. We don’t get off on a good relationship with them from the beginning. Innovative ideas like this put a positive spark back into the experience."

The pagers lower the overall anxiety level of the ED because patients don’t worry that they will be bumped to the end of the line if they step outside for a minute and miss their names being called.

Staff also appreciate the way the pagers decrease the stress level in the ED, Peterman says. Patients feel like they have been treated better while waiting, she says, and that makes them more pleasant when the staff treat them.

"They also don’t have to go out screaming for the patient, and then go back a few minutes later and scream for them again," she adds. "That creates rework for the staff."

Because there is no need to call out patient’s names, the pagers also help the ED comply with the privacy protections of the Health Insurance Portability and Accountability Act, she explains.

Peterman and ED staff knew patients responded favorably to the pager system, but she says she was surprised when she found out just how much. The ED’s patient satisfaction scores, as measured by an outside company, Omaha, NE-based Professional Research Corp., always reflected patients’ frustration with waiting so long for treatment, she says. The hospital strives to be in the 75th percentile for ED patient satisfaction.

In the past, the ED has struggled to meet that 75th percentile goal, Peterman says. In the first quarterly report after introducing the pager system, the ED’s patient satisfaction score jumped to the 90th percentile.

"That’s a real morale booster for the staff," she notes. "They know the patients are out there saying something positive about them, and it encourages them to take a look at all of their processes. What are some other ways to revise processes and tweak what we’re doing? When you see happy customers, you want to do everything possible to keep them that way."

Sources

For more information, contact:

  • Judy Peterman, RN, MSN, Director of Critical Care and Emergency Services, St. Joseph’s/Candler, 5353 Reynolds St., Savannah, GA 31405. Phone: (912) 692-6000.
  • JTECH Communications, 6413 Congress Ave., Suite 150, Boca Raton, FL 33487. Phone: (800) 321-6221. Web: www.jtech.com.