The Emergency Department Patient Experience initiative aims to create an environment that makes patients, carers and their families feel welcomed, safe, cared-for and empowered.
Four emergency departments completed the initial pilot in June 2019 - Blacktown, Lismore, Liverpool and Nepean. Due to the early success of the pilot, the project was expanded to an additional 17 emergency departments. In light of the COVID-19 crisis, additional funding has been allocated to include all A, B and C1 Emergency Departments and COVID-19 clinics.
The aims of the project are to make sure people:
- know where to go when they arrive
- are communicated with in a caring manner
- know what to expect during their time in the emergency department
- have access to water, refreshments and free wi-fi
- can keep key communication devices charged while waiting
- are provided with information regarding emergency department processes
- have information in their language
- are updated on when they are likely to be seen, the status of test results and any delays.
The pilot supports the implementation of the NSW Health Emergency Department Patients Awaiting Care policy.
The pilot program includes four strategies that were chosen after completing a system and local audit of patient experience activities, identifying existing policies and guidelines, reviewing Bureau of Health Information survey data and examining the Incident Information Management System (IIMS) and patient complaints in relation to patient experience.
The Emergency Department Patient Experience initiative involves four key strategies:
- patient experience officers
- information technology
- waiting room enhancements
- staff support and development.
Patient experience officers
The patient experience officer role is a non-clinical role that works principally during the peak demand times however can also work a range of shifts to understand the challenges across the day and support staff development. During the initial pilot, two patient experience officers were allocated to each emergency department and were recruited for their interpersonal skills and personal resilience, including working with challenging behaviours.
The NSW Ministry of Health project team, the pilot sites and Service NSW have worked collaboratively to design a training and mentoring program to support patient experience officers in the emergency department.
There are two parts to the information technology strategy:
- a web platform that allows staff to provide patients and carers with digital information in multiple languages
- real-time patient and carer feedback kiosks.
Digital information for patients and carers
GoShare is web platform that enables information to be sent to patients and their carers’ mobile devices.
Two ‘Welcome to ED’ animations were developed and translated into nine languages and describe the emergency department process:
The Agency for Clinical Innovation patient fact sheetsare linked to the platform. The fact sheets can be sent to a patient’s or carers’ device throughout their journey in the emergency department or on departure.
Customer feedback kiosks
The patient and carer real-time feedback kiosks allow emergency departments to collect specific patient and carer experience data, with questions translated into the five most frequently used languages at each facility. The real-time feedback is used to assist with process improvements, celebrate staff and support a culture of openness, care, kindness and respect.
The five kiosk questions were from the Bureau of Health Information Emergency Department Patient Experience Survey and allows for free text comments by patients and carers. The questions were translated into the five most frequently used languages at each facility.
Department amenity and facility design
Quick facility improvements
A gap analysis tool has been developed by Health Infrastructure and helps departments identify a range of simple enhancements to improve the waiting room experience for patients and families. The improvements included new signage/wayfinding, free patient wi-fi, comfortable seating, water coolers, mobile device charging stations and child friendly areas.
A longer term approach to facility design, based on the outcomes of the pilot, will also be recommended for future emergency department developments.
Staff support and development
A package of initiatives was trialed to support staff working in the emergency department reception, triage and waiting areas with the aim to provide professional support, and enhance skills and capability in customer service.
Two half day workshops were conducted at each site. The interactive workshops explored current approaches to communication and patient care by staff working in the emergency department, to challenge current thinking and practices.
Videos are also available to all NSW emergency departments to be used either in staff orientation or during inservice to facilitate reflection and discussion about patient experience in emergency department waiting rooms.
Implementing the initiative at your hospital
The initiative can be implemented in any emergency department and potentially any area where patients and carers are required to wait. The fundamental principles of effective communication, keeping patients and carers informed and providing care in an environment that is comfortable and safe, can be and should be part of every patient and carers’ journey in the health system.
If you would like any additional information please email MOH-PatientExperience@health.nsw.gov.au.