Professionalism & Excelling in the Patient Experience

One of the critical skills in your future career in which you may not have formalized teaching during your training is excelling in patient satisfaction which is one aspect of the ACGME competency of professionalism.  With the increasing transparency of our healthcare system comes the reality that consumers of healthcare now have the opportunity to grade healthcare professionals on their professionalism & skills.  At the institutional level this impacts patient loyalty and may eventually be tied to institutional reimbursements from CMS.  Institutions have thus made excelling in this area a priority in recent years and tied patient satisfaction to doctors salaries and incentive bonuses as well.  This is very likely to remain the case upon your graduation and thus knowledge and excellence in patient satisfaction will be viewed as an asset to your future employer.

The emergency department is a particularly challenging environment to master this skill as one has to quickly build rapport with a patient to earn their trust and confidence.  There are certain techniques one can use to attain this trust and confidence.  One acronym to summarize these skills is AIDET.

ACKNOWLEDGE – this is the easy part.. smile and make eye contact with the patient and family as you enter the room.

INTRODUCE – be certain you introduce yourself and your role on the healthcare team.  Patients have many people come in and out of their room throughout their time in the ED so it can often be confusing which one is the nurse, PCT, resident, transport or attending.

DURATION – try to provide an estimate of time we will be waiting for a given study or treatment.  In general I over-estimate as often by the time we have results, interpret them and return to the patients room to explain the results it will be a bit longer than predicted.  Be sure to use the white communication boards in each room for this purpose.

EXPLANATION – be sure to explain exactly what you are thinking, studies or labs you are planning to obtain to the patient so she/he is on-board with the plan.  This is also a good opportunity to ask the patient what further questions they have as you may circumvent delays at time of discharge or admission by addressing concerns early in the treatment course.

THANK – at the end of the encounter it is courteous and memorable to patients if one thanks them for allowing you to partake in their care.  This part can feel admittedly difficult and awkward at first but I have found many patients appreciate it.

Finally, please take a moment to watch this very short video produced by Cathy Johnson our Patient Experience expert.  It includes two of the ED attendings with whom you may work during your rotation:  Dr Ward and Dr Patwari.

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