On the Bright Side: Analysts rank Fox ER among best in New York


From left, A.O. Fox Hospital emergency department staff members Eric Benjamin, computed tomography (CT) supervisor; Joann Titus, emergency services receptionist; Tonya Ryan, emergency services technician; Dr. Kelly Robinson, emergency department medical director; Erica Holoquist, registered nurse and emergency department nursing director; and Margaret Bischoff, registered nurse, pose in an undated photo.

If you've noticed a positive change lately inside A.O. Fox Memorial Hospital's emergency room, you're not the only one.

The hospital's emergency department was recently ranked in the 97th percentile out of 165 ERs in New York by Press Ganey, a national patient satisfaction database that uses advanced analytics and advisory services to give hospitals feedback on their patients' experiences, according to its website.

Fox Hospital's ranking report was released in April and reflects patient satisfaction from the first quarter of the year, according to a media release from the hospital.

The good news comes after a concerted effort by Fox to refine its emergency department and improve the overall patient experience there, according to several Fox officials interviewed Tuesday. As a result, the emergency room now offers shorter wait times and has had significantly higher patient satisfaction scores, which Press Ganey's ranking attests.

The improvement effort began two years ago after several doctors left the emergency department, according to John Remillard, Fox Hospital's president and chief executive officer. The hospital then sought the help of a national company called Pegasus, which provided a new medical director for the ER, Dr. Kelly Robinson.

“After a review of the issues the ER was facing and processes for handling patient flow, we took a series of steps to positively impact the patient experience in a dramatic way,” Robinson said.

Adoption of more efficient measures has led to a number of improvements in the ER, according to Justine Johnson, Fox's regional marketing community engagement manager. The average waiting time to be seen by a doctor is now under 30 minutes, and the time from arrival to discharge is just over two hours.

Each year, more than 15,000 patients are cared for at the hospital's ER, according to Johnson. The department, which is staffed by two physicians, one advanced practice clinician and three to four nurses, sees about 40 to 50 patients a day.

Recent surveys completed by patients show a high rate of satisfaction, and "many favorable comments," according to Remillard. Yet, sometimes, "actions speak even louder than words," he added, noting that the emergency department has experienced a 9 percent growth in 2015 in the number of patients seen.

The positive change can be attributed to a couple of factors, Robinson said.

For one, more efficient bedside triage means patients are brought to a treatment area immediately and assessed at their bedside instead of waiting in the lobby, Robinson said.

Second, there are now computers on wheels, Robinson said, which allow for bedside entry of patient information and orders.

Other important improvements include more frequent rounds by nurses and technicians to check on patients’ needs and comfort, and an overall strive for compassion, Robinson said.

Robinson also noted that he has instituted a process in which the on-duty physician, when seeing a patient in an exam room, acknowledges everyone in the room, introduces him- or herself, discusses the expected duration of time in the ED, explains the diagnosis and what’s next, and thanks everyone.

“It’s not only the compassionate way to approach the patient’s ED experience, it also confirms everyone’s understanding of the situation and allows the patient and family to ask any clarifying questions,” Robinson said.

According to Press Ganey officials, health care providers who want to improve their patients' experiences must first "be able to see and understand the complex relationships between satisfaction, clinical, safety and financial measures" and give every patient the opportunity to be heard, according to the company's website.

Remillard said putting on emphasis on the patient experience has helped all of the individuals who work in Fox's emergency department to "truly act as a team."

“When everybody is working toward the same goal, that's when you achieve great things,” Remillard said. “From the first person you meet when you come in to the department, to the nurse, to the technician. They're all focused on one goal, which is to make the patient's experience the very best it can be.”

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