Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Run your emergency department like a restaurant

Patsy McNeil, MD
Physician
November 17, 2014
188 Shares
Share
Tweet
Share

Imagine you walk into a restaurant named Luigi’s. From the décor and the smell of pasta sauce coming from the kitchen, you assume that this restaurant serves Italian food. You walk forward, your name is taken and you are then told to sit off to the side and wait until your name is called so that you can get a table. Time goes by, and no one gives you any eye contact or tells you what’s going on but you’re quite hungry and so you wait. Other people go get seated ahead of you and you don’t know why.

You finally get escorted back to a table and the host says “a waiter will be with you,” but no one arrives. Eventually, a waiter arrives and sets menus before you but this menu is written in Italian with no descriptors of the food. The waiter takes your order but you have no real idea what to expect and this particular waiter doesn’t ask if you need help, is irritated when you ask questions and gives completely unclear explanations when questions are asked.

You finally get your food. The quality may be phenomenal, but the waiter has been completely absent during most of your meal, only to appear as you are getting up to leave with a bill for $1,700.

Patients often have a similar experience when they visit the emergency department, but instead of Italian food, the confusion is about their ongoing health plan and ED experience. The medical care may be great, but no explanations of what to expect are given. An occasional staff member may be abrupt, and delays are frequent and unexplained. In addition, their visit looks nothing like it was supposed to according the shows they’ve seen on TV.

It is exceedingly important that appropriate expectations are set when patients arrive at the emergency departments and it is extremely important that patients are kept updated regarding delays. Study after study has shown that when increased wait times and decreased throughput occur, patient satisfaction scores can be maintained and a positive impression made if patients are kept informed and have appropriate expectations set from the very beginning.

If you’re an ER doctor, how often have you been working an incredibly busy shift and had several patients to see when all of a sudden you hear a nurse say, “The doctor will be in within just a few minutes?” How often have you told the patient that their labs should be back within the next hour or so and yet at the almost two hour mark those labs have still not resulted? As frustrating as these moments are for you as a provider, they are even more frustrating for a patient when some of the very first crucial information they receive from the care team is incorrect.

Several steps can be taken to help clarify expectations and keep patients appropriately informed.

  1. Encourage triage nursing staff to have general explanations ready for what patients should expect from their time in the Emergency Room as they triage patients. Even a pamphlet would be useful in informing them.
  2. Communicate with your nursing staff when the ED is particularly busy. Make a quick call to triage to tell the nurse to start setting realistic expectations.
  3. During busy times, tell your staff who place patients in the rooms to inform them that it may take time for the doctor to come in but that he/she is aware of their illness and will see them as soon as possible.
  4. Briefly touch base with waiting patients when they are in rooms to say when you believe you will be in to see them.
  5. When there is a delay at any level of ED care, inform the patient of the delay immediately.
  6. Keep patients up-to-date about their results. When passing rooms step fully into the room to give a 30 second update on their status and then continue to deliver care to others.
  7. Inform your nursing staff of the plan and of de- lays so that when the patients ask questions of the nursing staff, it is clear to the patient that the entire ED care team is cooperating and clear regarding their care.

These steps take less than a full minute each to implement, but will impact the patient satisfaction scores on your emergency department and raise your patient’s view of you as a physician tremendously. Emergency physicians should aim to improve the patient experience for every patient at every encounter. Delivering clarity as to what to expect and then frequently supplying clear information about the patient’s ongoing care is a sure way to continue make sure patients stay appropriately informed.

Patsy McNeil is an emergency physician who blogs at The Shift.

Prev

Ebola is yesterday's news, but should the media move on?

November 17, 2014 Kevin 7
…
Next

Meaningful use: The independent majority can stop the madness

November 17, 2014 Kevin 21
…

Tagged as: Emergency Medicine

Post navigation

< Previous Post
Ebola is yesterday's news, but should the media move on?
Next Post >
Meaningful use: The independent majority can stop the madness

More in Physician

  • It’s time for C-suite to contract directly with physicians for part-time work

    Aaron Morgenstein, MD & Corinne Sundar Rao, MD
  • From rural communities to underserved populations: How telemedicine is bridging health care gaps

    Harvey Castro, MD, MBA
  • From solidarity to co-liberation: Understanding the journey towards ending oppression

    Maiysha Clairborne, MD
  • Finding peace through surrender: a personal exploration

    Dympna Weil, MD
  • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

    Katrina Gipson, MD, MPH
  • Beyond the disease: the power of empathy in health care

    Nana Dadzie Ghansah, MD
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • From rural communities to underserved populations: How telemedicine is bridging health care gaps

      Harvey Castro, MD, MBA | Physician
    • 5 essential tips to help men prevent prostate cancer

      Kevin Jones, MD | Conditions
    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Senators Press Moderna's CEO to Drop COVID Vaccine Price
  • Senators Press HHS Chief on Alzheimer's Drugs, Opioids at Budget Hearing
  • Despite Abortion Restrictions, Ob/Gyn Remains Competitive Residency

Meeting Coverage

  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Second-Line Sacituzumab Govitecan Promising in Platinum-Ineligible UC
  • Trial of Novel TYK2 Inhibitor Hits Its Endpoint in Plaque Psoriasis
  • Most Popular

  • Past Week

    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • Breaking the cycle of misery in medicine: a practical guide

      Paul R. Ehrmann, DO | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
  • Recent Posts

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • From rural communities to underserved populations: How telemedicine is bridging health care gaps

      Harvey Castro, MD, MBA | Physician
    • 5 essential tips to help men prevent prostate cancer

      Kevin Jones, MD | Conditions
    • Unlock the power of physician compensation data in contract negotiations [PODCAST]

      The Podcast by KevinMD | Podcast
    • From pennies to attending salaries: Why physicians should teach their kids financial literacy

      Michele Cho-Dorado, MD | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Run your emergency department like a restaurant
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...