Georgetown's ED Earns High Marks from Patients

In the last 18 months, Georgetown University Hospital's Emergency Department has increased staffing, revamped processes and added services. The hard work has paid off, as evidenced by two important measures of success-high patient satisfaction and strong relationships with physicians.

The Level I, 18-bed ED offers a full range of emergency services for pediatric and adult patients. As part of its service-excellence initiative, Georgetown has made a hospital-wide effort to assess patient satisfaction, using the PRC Patient Satisfaction Monitoring System. The Georgetown ED now rates among the top 10% nationally for patient satisfaction. "The PRC data clearly demonstrates that patients rate us very highly for ED services," says John DeSimone, MD, clinical chief, Emergency Medicine.

Process, Process, Process
That satisfaction begins with ED registration. When the department began collecting data a year ago, patient satisfaction was in the 30th percentile. Now satisfaction is in the 98th percentile. Similarly, patients rate the ED in the 90th percentile for promptness of evaluation of medical condition on arrival.

The large increase in patient satisfaction is a result of the hard work of everyone in the ED. The staff has worked together to revamp the registration and evaluation process to expedite patient care. First, they changed the type and quantity of information that is required upon registration. Second, registration personnel begin to collect information as soon as patients enter the department.

Depending on patient flow and acuity, registration then is finished at triage or bedside. The result is elimination of a bottleneck. Not surprisingly, total patient time in the ED has been improved as well. Now about 65% of patients leave the ED in three hours or less. This is especially noteworthy since the patient volume has increased significantly, climbing from about 22,000 two years ago annually to 30,000 today.

New Services
The department also has added hazardous materials (hazmat) areas to care for patients in the event of biological or chemical terrorism. There now is a fixed hazmat area within the ED, with expansion into an adjacent area outside the hospital to handle multiple casualties. A new decontamination unit can decontaminate up to 160 people an hour. As part of the hospital-wide Emergency Preparedness Plan, emergency staff members receive inservice training about how to evaluate and treat disaster victims.

Integration
As volume has increased, so has staffing. The ED now has more physician coverage. In addition, the department's medical staff is integrated with its counterpart at Washington Hospital Center.

In a joint initiative between Georgetown's emergency and pediatric departments, two new pediatricians are joining the medical staff in July. They will help care for children in the ED as well as pediatric inpatients, working eight hours a day, seven days a week.

"This demonstrates that we are serious about taking care of kids at Georgetown," Dr. DeSimone says. "The intent is to optimize the care for children throughout the hospital."

Physician Outreach
The department places a strong emphasis on working closely with physicians. "We want to keep clear communication channels with community physicians," Dr. DeSimone adds. "Collaboration improves patient care."

Physicians are encouraged to call the ED when a patient is en route
to discuss the incoming patient with the ED physician. Physicians also can call Physician Access, a Georgetown service that coordinates referrals of acute and non-acute patients from outlying hospitals. The "one call does it all" service can help arrange transportation by a MedStar Transport Services' helicopter or ambulance.