EM Best Practice: Standardized Patient Callbacks Performed by a Dedicated Staff by Tom Scaletta, M.D.
Sunday, August 23, 2009
Tom Scalleta, M.D.Try your hand at this multiple choice question:
An ideal survey of a patient’s emergency department visit:
(a) Is unobtrusively completed within days of the visit
(b) Promptly identifies patients getting worse or with questions
(c) Reduces lawsuits, claims, premiums and payouts
(d) Accurately determines caregiver trends and facility issues
(e) Improves patient satisfaction
Of course, the best response is “all of the above.”
In 1999, my interest in emergency medicine callbacks and nerdy database programming skills facilitated the creation of a callback system for two high-volume emergency departments. Several-hundred-thousand phone calls later, the program was acknowledged by the Robert Wood Johnson Foundation as an EM best practice. While this report detailed how other hospitals could institute their own programs, a recent poll showed that 29% do not call patients back at all. The majority that do follow-up in this way thrust this duty upon physicians and nurses during clinical shifts, leading to resentment and haphazard data collection. Only 15% of those surveyed utilize a dedicated staff.
About two-in-three patients complete phone-based surveys versus one-in-eight for mail-based surveys. Thus, callback data has far greater statistical power, required when multivariate analysis such as individual physician or nurse performance is desired. And, there is no significant recall bias as patients are contacted within days and not weeks. AAEM’s position is that only surveys with excellent reliability and validity should be used to measure patient satisfaction.
An impressive business case for a dedicated, standardized patient callback system is nicely summed up by Vicky Vance, Former Director of Litigation for The Cleveland Clinic, “It makes sense that calling back Emergency Department patients in a timely manner will lead to improved patient care and satisfaction, a significant drop in claims and, in turn, saving expenses on insurance premium, captive insurance funding, and a decline in the indemnity dollars paid to resolve matters.” In my estimation, every dollar invested in a patient callback results in at least a five dollar return on investment.
Lastly, since hospital CEOs are hell bent on paper surveys to measure patient satisfaction (which satisfy none of the multiple choice answers above), it is time to significantly boost those results by creating goodwill both through the personal well-being check and by extending the opportunity to provide feedback.
Disclaimer: I am co-founder of Emergency Excellence, an emergency department performance improvement company that now offers EmEx-Contact, a patient callback and satisfaction service
Reader Comments (1)
I recently came across your post and have been reading along. I thought I would leave my first comment. I don't know what to say except that it caught my interest and you've provided informative points. I will visit this blog often.
Thank you,
Business Loans