Communication, pre-op visits reduce complaints

"Why am I waiting so long?" It’s one comment that staff members always can expect to hear from patients and family members, say experts interviewed by Same-Day Surgery.

"Long waits always show up on patient satisfaction surveys as complaints," says Jackie Scott, RN, CAPA, performance improvement coordinator for surgical services at Gwinnett Hospital System in Lawrenceville, GA. "We’ve cut down on our wait times by scheduling same-day surgery patients for pre-op interviews, at which time we perform any lab work or X-rays that are needed."

To make sure they can handle the pre-op interview schedule, additional staff was added to conduct the interviews, draw blood, and perform EKGs within the same-day surgery area, she says.

"Adding the extra staff eliminated the need for patients to go into the main hospital departments for these tests and gives us more control over scheduling," she explains. "We don’t routinely order X-rays, so very few of our patients must have them done."

Although not all patients can make it to a pre-op interview prior to their surgery day, 70% to 80% of all same-day surgery patients at the hospital-based and freestanding center at Gwinnett Hospital System do come in for pre-op interview and testing, says Mary Nash, RN, CNOR, director of the surgical services line at Gwinnett Hospital System.

Freestanding centers have a special challenge when it comes to addressing wait times for ancillary services, says Vicki Axsom-Brown, a same-day surgery consultant with Practice Resources in Anderson, SC. "Most freestanding centers don’t have X-ray, lab, or EKG in their building, so patients have to go to another location for pre-procedure tests," she says.

Even if you send patients elsewhere, don’t think that you won’t have to deal with complaints about these areas, she cautions. A same-day surgery manager can’t pass the buck and tell the patient that because diagnostic services are offered elsewhere, there’s nothing that can be done to improve service, she says.

A same-day surgery center should address the process of handling patient complaints in its agreement with the ancillary service partner, says Axsom-Brown. "Keep the lines of communication open between yourself and your partners and suggest ways you can expedite the solution to any fixable problem," she says. "For example, if patients complain about long waits, call your partner and ask if there are certain times of the day that are busier for them and offer to schedule your patients at a different time."

The only employee group that shows up in the South Bend, IN-based Press Ganey Associates’ priority index as an area for improvement is courtesy of X-ray technicians. "Handle complaints about employee courtesy the same way you handle complaints about waiting times," Axsom-Brown suggests. Contact the partner or department providing the service and pass along the patient comments, she says. "Also, ask your partner to pass along any comments about your service or employees that your patients may make while at the ancillary service provider," she adds.

Patients may make comments to someone outside your surgery program that they may not feel comfortable making directly to your own employees, she explains. Having the communication about patient complaints go both ways helps both your same-day surgery program and the ancillary service provider, Axsom-Brown adds.

If possible, make the lab, EKG, or X-ray tech a part of your staff to ensure patients see a friendly, courteous person, suggests Nash. Not only do the ancillary staff members receive the same customer service-focused orientation to the department, but they feel more accountable because they are part of the department, she says. "Since we don’t routinely order X-rays, we don’t have an X-ray tech on staff, but the lab and EKG personnel are a part of the same-day surgery staff," she says.

Nash looks for people with "the right personality" to provide good customer service. "Sometimes, we hire the right personality for the job and teach the skills they need," she says.