Inappropriate use of emergency departments (EDs) → congested EDs → over-worked staff members → frustrated staff members → speculation of more non-emergent ED usage → expectation to provide high customer satisfaction scores → decreased actual customer satisfaction → decreased reimbursement → higher costs of ED → budget cuts → decreased staffing → return to beginning. Whose idea was any of this?  None of it makes sense to me.  The idea of providing reimbursement to healthcare agencies based on customer satisfaction scores is ...

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