Improving ED patient satisfaction when triage nurses routinely communicate with patients as to reasons for waits: one rural hospital's experience.

336 W ith hospitals closing and the number of ED patient visits increasing dramatically, patients’ waits are a growing problem. We are now learning that lack of communication from the ED staff during these waits can sometimes be a greater source of patient dissatisfaction than the actual waits themselves. At our rural hospital, we received ED patient complaints several times every month. The complaints generally centered on having to wait for services. The Chief Executive Officer asked me, as the Director of Behavioral Health, primarily involved in employee assistance programs but having experience in organizational improvement, to assist the Director of Nursing to see if we could make a positive impact in the department. Our initiative involved the ED waiting room of Hillsdale Community Health Center, a small, rural 40-bed hospital in Hillsdale, Michigan, which treats approximately 25,000 patients annually. The waiting room is approximately 27 27 feet in size with comfortable seating and a television. The emergency department is equipped with 8 beds. The staffing level for each shift is 1 physician, 1 part-time mid-level provider, and 2 registered nurses. The emergency department has 6 ED triage nurses who cover all shifts, 7 days a week. Each triage nurse is responsible for assessing incoming patients, assigning appropriate triage acuity, and monitoring patients’ conditions as they await ED admission.