With the Patient Protection and Affordable Care Act (ACA) enactment in 2010, patient satisfaction scores, for better or worse, have become a determinant of healthcare. Patient perspectives of treatment were given additional weight in 2012 when the publicly available HCAHPS Survey began to play a role in hospital payments through the Hospital Value-Based Purchasing program. With patient satisfaction playing a more active role in healthcare, EMS and fire agencies are increasingly under pressure to demonstrate their value to their communities. As typically the first point of contact for a patient moving into and through a hospital system, EMS providers are uniquely positioned to set the tone for each visit. Therefore, providers should pay particular care to the growing focus on the patient experience.
#1 Optimize Wait Times
According to a 2017 study, the average wait time for an EMS unit to arrive on the scene from the time of the initial call is around seven minutes, but that time nearly doubles to 14 minutes in rural settings. While seven minutes may sound like a good target for agencies, to a patient in distress, that same seven minutes will feel like an eternity. One of the biggest reasons wait times increase for agency service areas is short staffing paired with an increase in 9-1-1 calls to levels that overwhelm the resources of the responding agency. To reduce patient wait times, consider implementing a telehealth solution at the point of dispatch so those patients who are lower acuity can receive care from a trusted physician and open up EMS teams to return their unit to service quickly. In 2014, the Houston Fire Department initiated its ETHAN telehealth program to do just that. Over the first 12 months, they saw their median time from EMS notification to the unit back in service reduced by 44 minutes compared to units not utilizing the telehealth option. Units using point-of-dispatch telehealth saw a 56% reduction in transport to the emergency department, which was the major contributor to better back-in-service times.
#2 Employ a Customer-Focused Experience
Often, a patient’s only impression of your emergency resource system is when they call in for an emergency. In those situations, patients and bystanders usually hang on to every word said by the responding team. That initial meeting will set the tone for their journey through the healthcare system and their satisfaction with their total care experience. While working toward a shared goal of creating a positive outcome with the patient, using easily understandable words can be incredibly helpful at no cost to the healthcare worker.
- Communicating is collaborating
While healthcare providers do this daily, patients often have a once-in-a-lifetime experience. While the repetition may get boring, explaining actions as they are happening, can put a patient at ease if they know everything is moving according to plan. Something as simple as “We’re going to lift you now” goes a long way to helping the patient feel safe and secure while in your care. Patients who understand what is happening are also more likely to be willing to assist if they are able.
- Simplify the scary to soothe the patient
As the day-to-day experiences of the job takes over, we sometimes forget that words with a simple meaning to healthcare workers could mean something far direr to a patient or their family. For example, “bring in the defib” is a shorthand way to ask for a cardiac monitor, but a layperson who watches evening TV may fear it means that a defibrillator will be needed to shock their heart. Therefore, whenever possible, it’s a good idea to utilize more lay language in the presence of the patient and their family to help them feel as informed as possible in an already confusing situation.
- Dispense differentials delicately
Differential diagnoses are a necessary part of the job. Even so, generalizing them whenever possible is helpful to ensure patients don’t begin to read into your words while you think aloud. Of course, there will be times when specifics are necessarily based on the situation’s specifics. In these instances, if possible, it may be helpful to communicate with the patient or their family beforehand to allow them to understand the situation as it evolves.
Training while using these techniques is a helpful way to work toward keeping patients and their families compliant, comfortable and calm, allowing healthcare workers to tend to their needs directly.
#3 Create Feedback Loops
You can’t know what you don’t measure, and patient experience is an often missed data point within emergency response systems. Consider creating patient experience surveys to understand how patients view their interactions with your team. EMS agencies may one day share the same payment structure as hospitals, which shifted from fee-for-service to value-based reimbursement structures introduced by CMS in 2010. Patient surveys work well as the first step to future-proofing your agency for payer changes coming in the future. Here are a few tips to help create a patient experience survey:
- Decide how you want to deliver your survey
Traditional phone surveys are always reliable, but an online survey sent to patients by email or mobile phone may present a lower cost to the agency with similar results.
- Ask about your top two (or three) issues.
Typically agencies will have two or three focus points for their patient interactions. Examples might be: Treating patients with respect and providing quality healthcare. Ensuring that your questions fit neatly into one of the categories can guard against asking too many questions or running too far off-topic and confusing the patient as they try to answer.
- Ask the “big one”
Don’t forget to ask patients about their overall satisfaction. That question can provide you with a benchmark to provide insight into how training programs or other focused initiatives impact the service you provide to your patients. This question might be as simple as “Overall, how satisfied were you with the care provided by your first responders”?
- Include at least one open-ended question
While most of your questions will use a scale for answers, typically 1-5 or 1-10, you should always include one or two open-ended questions that give the patient a chance to share their thoughts about your numerical scores. “What can we do to improve”? Or “What did you like best about your time with us”? These examples could lead to a deeper understanding of patient interactions and the steps you can take to improve them from the patient perspective.
9-1-1 integrated telemedicine is an emerging technology that can help to improve patient satisfaction by allowing patients to be seen more timely, having their concerns treated more immediately once they are seen, and ensuring they get directed to the right resources for their needs. MD Ally can help your agency add 9-1-1 integrated telemedicine to your protocols to help not only improve patient satisfaction but get care delivered faster.
