10 Easy Ways to Improve Customer Service in the Emergency Department

We emergency physicians don’t always think about customer service while we’re getting beat up in the ED, but that’s exactly the time we should think about it the most.

Why? When you go to a hotel or restaurant, and it’s exceptionally busy, a staff that treats you with respect and attention stands out in your mind. The same holds true for our ER patients. If they’ve been waiting for a long while to see you--and then you run in, ask a few questions, run out and never return, letting the nurse give them the test results and diagnosis--you better believe they will remember their experience.

Try to remember that, while customer service (aka emergency department patient satisfaction) is something we should work very hard at all the time, it is most important when the emergency department is busy. I have seen from my own experience and those providers with whom I work that you can make a very bad experience excellent just by connecting with the patient in a non-medical way. How?

1. See your patient as quickly as possible. Remember that for a patient a positive customer experience starts with seeing the provider very quickly. We need to set the expectation for ourselves that we want to be the fastest provider in the room. Take pride in being present when the nurse first starts his or her assessment (or arriving even before he or she begins). Trust me, the nurse will notice.

2. Introduce yourself. Over the years I’ve answered numerous complaints from patients who said that, in the mix of providers and other staff they’d encountered during their visit, they had never been told who their doctor was. Make sure that you introduce yourself clearly. If you take a second to write your name on the white board in the room, that’s even better.

3. If there is a wait, apologize for it. “Hi, I am Dr. Richter. Sorry you had to wait--it’s been a busy day. What can I do for you?” is a great start. Even if there isn’t much of a wait, consider starting every conversation with an introduction and apology; it prompts patients to feel that you’ve set a high standard for yourself.

4. Sit down. Several studies show that when a provider sits, rather than stands, at the bedside while discussing a patient’s history, the patient perceives the provider has spent significantly more time with him or her. Sitting down also offers a spatial benefit, putting you and the patient on the same level and allowing you to have a conversation without being overbearing.

5. Acknowledge everyone. Acknowledge any family or friends that are in the room, and make a point to introduce yourself to them. It only takes a second but goes a long way. I have answered many patient complaints about providers who “didn’t even look” at their patients’ family/wife/husband.

6. Listen and make eye contact. Let your patients speak; don’t interrupt or anticipate answers unless they need to be redirected. Sometimes we’re so busy that we let our impatience show through. They will feel your impatience and resent it--a sure knock to their patient satisfaction perception.

7. Don’t skip the exam. Make sure that even if you’re doing a focused exam, you do a brief complete exam too. Patients feel better cared for when you listen to their heart and lungs even if they have a leg injury. In the age of tests for everything, we often forget the power of laying hands on the patient.

8. Make yourself available to your patients. Stop in your patients’ rooms periodically when you pass by on your way to something else--just to see if they need anything. Ask how they’re feeling, introduce yourself to any new family members. It only takes a second but is one of the most impactful things you can do to make them feel cared for.

9. Continually explain your thoughts. During your first encounter, at the end of the history and physical, let them know what you’re thinking. Let them in on your differential diagnosis, what you think is likely and unlikely, and how you plan to narrow that list down. Let them know if you’re anticipating admission or discharge so they can begin to plan for this. For example: “Well, your chest pain could be any number of things, but we’re going to try to narrow it down. You might have a problem with your heart or lungs, so we’re going to do a chest X-ray and some blood tests. These will take a few hours. It also might be a problem with your stomach or esophagus, such as heartburn. To be safe, I think you’ll need to be admitted. Do you have any questions at this point?”

10. Explain the test results. When your labs and tests are back, and you have made a decision, discuss it with the patient and his or her family. Make sure that you return to the room to let them know why you have decided to admit or discharge them. Explain the test results. Again, make sure to sit down and answer any questions from them before you stand up. It is always best to finish your time with them by asking if they have any questions. After you have answered these questions, ask if they have any more questions. Do this until they run out of questions. Finally, stand up, thank them for their patience, and ask if there is anything you could have done better to make their experience more positive.

Using these 10 tips will improve your patient satisfaction scores. This customer service approach will further us on the path toward being the best emergency room physicians that we can be.