Driving improvements in emergency department care

At William Osler Health System, innovative forms of technology have touched virtually every aspect of patient care delivery in recent years. From pharmacy to food services to cardiac procedures and critical care, technology has played a significant role in helping the hospital improve patient care processes, find efficiencies and enhance communications between staff and patients.

With almost 600 patients treated in Osler emergency departments (ED) daily, as well as the busiest emergency department in the province (Brampton Civic Hospital), enhancing the patient experience in the ED is one of the top priorities for the organization. Recently, with the help of technology, Osler has taken its commitment to patient satisfaction one step further with the introduction of a ground-breaking ED survey that collects real-time feedback from patients and brings immediate results to staff – all from the touch of an iPad screen.

This unique initiative – the first of its kind in Ontario – was created in response to the need for better and more timely information about a patient’s experience in Osler’s two emergency departments. Armed with an iPad, trained staff conduct the surveys between 7:30 a.m. and 11:30 p.m., five to seven days a week. The survey is comprised of eight simple questions that range from “How well did staff keep you updated about the wait times?” to “Would you recommend Osler to friends and family?” Responses are collated immediately and deposited into a database so Managers have quick access to the latest information. Managers can then share results with front-line providers and if required, adjust processes to better meet patient needs.

“With this initiative, we are connecting to patients in a way that we never have before”, says Dr. Naveed Mohammad, VP Medical Affairs, William Osler Health System. “Our ED surveys are allowing us to use patient feedback to improve and enhance the services we provide, and ensure that we continue to deliver quality care that respects the traditions, religion, and culture of our patients and their families.”

Prior to the iPad surveying, hard copy feedback forms were handed to patients as they were discharged from the ED, though response rates were low. Osler also relies on the survey results from NRC Picker but has found that with its longer turn-around times, it is able to implement change more quickly and effectively through the iPad surveying. The iPad surveys also allow staff to more easily validate results through the NRC Picker surveys.

The idea for an iPad survey was inspired by a trip to the grand opening of a large department store, where an Osler staff member noticed shoppers being surveyed about their experience – from an iPad – as they were leaving the store. Recognizing the value of real-time information when the experience is still fresh, this individual believed the approach might work well in the hospital’s emergency departments and within just a short time, the iPad survey was up and running.

“Patient care delivery without good data is like driving a car without a dashboard – it is critical to understanding what’s working and what needs a tune-up,” says Kiki Ferrari, Executive Director, Patient Services, William Osler Health System. “With this real-time information at our fingertips, we are able to more easily track and trend our results, and then address situations immediately if needed – ultimately improving the experience for the patient, and our staff and physicians who work in the ED.”

With the introduction of the ED iPad survey along with some other organization-wide patient satisfaction initiatives, Osler recognized that it needed a means of feeding information back to the front-lines where it could be used immediately to influence behaviours and improvement strategies. As a result, Osler implemented daily ‘performance huddles’ across all clinical areas in the hospital in early 2012. These huddles are short, 10-minute sessions where managers and front-line staff come together to discuss their performance against four key metrics.

Osler has already begun to see positive shifts in the opinions of patients, particularly around the question of, “How well did the doctors and nurses explain things to you?” The latest results show that over the past year, there has been a 24 per cent improvement in ED staff communications skills when it comes to explaining to patients about their care. In addition, compliments are up over 100 per cent, which is also helping to contribute to staff satisfaction and morale.

For more information about William Osler Health System, go to www.williamoslerhs.on.ca.