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Simultaneously, diversions removed cold turkey’
In response to emergency department (ED) overcrowding, Baptist Memorial Health Care in Memphis, TN, is launching an educational campaign focused on area EDs. A Tennessee Hospital Association study released last December found that ED visits in the state had increased 31% over three years, or twice the national rate.
The health system’s three-pronged campaign includes a series of local public service announcements cosponsored by the Tennessee Hospital Association, Mississippi Hospital Association, and county health department to educate the public about the problem and encourage patients to seek more appropriate care settings for non-emergent conditions. It also includes efforts to improve communication with patients in the ED and to recruit volunteers to serve as ED patient liaisons and advocates.
"Our efforts to improve patient care and patient satisfaction form the context of the entire campaign," says Beverly Jordan, RN, vice president and chief nursing officer at Baptist Memorial. "Overcrowding can have an impact on satisfaction because it affects flow, resource allocation, and wait time."
She says the system’s regular focus groups and opinion surveys showed the public was adamant that waiting times are a key indicator of satisfaction. "They are sure they will have competent care and adequate diagnostics — what they want to know is when they will be seen, when they will go to their room, and when they will get home."
Laying the foundation
The Memphis health care community, and EDs in particular, had been discussing ED diversion for a number of years, Jordan notes. "In 2002, the hospitals got together and agreed to stop ED diversions cold turkey. This was in the winter, the time of the highest volume crunch. We stopped at midnight, Dec. 10, and said we’d revisit the issue in 90 days. We haven’t had a diversion since; we were convinced this was the right thing to do."
Of course, ending diversions meant the hospitals would get whatever patients came to their EDs. "So, we made a commitment to the state that we would educate the public," she explains.
First, a special, targeted survey was conducted with random public community members that specifically addressed the ED.
"This was part of the research that led up to the campaign; it established a baseline and let us know the expectations of the public," she says. Then a team comprising people in the corporate communications department and directors of EDs in the metro Memphis area got to work, networking in turn with physicians in the facilities. "It was very much an integrated approach."
Three key components
The campaign has three major components: public education, patient communication, and the creation of a new ED volunteer corps. The public education effort involves print, radio, and television public service announcements and other tactics that address proper use of EDs, urgent vs. emergent care issues, health care options, and information about flu and the national ED situation in general.
Baptist’s partners in the ED public service campaign include the Tennessee Hospital Association, the Mississippi Hospital Association, and the Memphis and Shelby County Health Department. Baptist also will coordinate free public events, such as a flu shot day.
The second component of the campaign will focus on enhancing patient and family communication in Baptist’s metro-Memphis EDs, located inside Baptist Memphis, Baptist Memorial Hospital-Collierville, and Baptist Memorial Hospital-DeSoto. The hospitals will use posters, a newly developed ED magazine, a video, and employee-focused tactics to achieve these goals.
"The magazine will continue the public education efforts," Jordan adds. "It will talk about the roles of the triage nurse, physician, PA, what to expect from diagnostics, how the pediatric ED is different from the general ED, and so on. Today, we are shooting a video in Nashville that will run in all the waiting rooms. The public told us the No. 1 feeling they have is anxiety, and one way to reduce anxiety is education. Also, we want to re-educate the staff about their job in reducing anxiety, like making them aware of wait times."
The final component of the campaign is the development of a strong ED volunteer corps. While all of Baptist’s hospitals already have well-established volunteer programs in place, this new team of volunteers will work exclusively in the EDs, where they will serve as patient liaisons and advocates.
Duties will include making patients and their loved ones more comfortable in the ED, communicating with families, and answering patient questions during their visits. To create the corps, Baptist will launch aggressive recruitment efforts across the mid-South to attract a number of nontraditional volunteers — many of whom most likely will be area college students or graduates interested in pursuing health care careers.
"We benchmarked this issue across the country," Jordan says. "One of the things we found was that some systems were targeting Gen-X and Gen-Y individuals looking for opportunities in health care. We know they have altruistic beliefs and are trying to find areas in which to put those beliefs to work."
Potential volunteers are being targeted through fliers. The opportunity to work nights and weekends may make the volunteer positions even more attractive, Jordan suggests.
"Volunteering may also help them decide if they want a career in health care," she adds. "This is a win-win for both parties."
On ongoing effort
While the campaign will run for a full year, many of the campaign’s programs and tactics will become permanent parts of hospital operations.
For example, the patient-focused aspects, such as the volunteer corps, ED magazine, and video, will continue to be offered at Baptist’s metro facilities. Once the educational campaign has proven successful in the metro area, Baptist will roll it out to its 11 regional hospitals, which are located in the tri-state (Tennessee, Arkansas, and Mississippi) area.
"We will measure the success of the campaign, first of all, on how it impacts patient satisfaction, then by the number of folks we are able to recruit into our volunteer corps," Jordan points out.
"Also, we will continue to routinely conduct community opinion surveys," she says.
Is Jordan also looking for a drop in ED visits?
"That’s really not a goal we’ve set, because we want to provide care to anyone who decides they want to visit us, but we think the campaign has a huge potential to impact the hospitals and the community as well," she concludes.
Need More Information?
For more information, contact:
• Baptist Memorial Health Care, Communications Department, Memphis, TN. Phone: (901) 227-3509.