Posted October 23, 2017

Engaging Emergency Department Patients for a Better Experience

By Karen Smith, MSN, RN, CEN, NE-BC

Scroll through any social media site or peruse clinician-authored blogs, and you’re likely to find some strong opinions about patient satisfaction, many of which aren’t positive. But if you consider the daily pressures of a physician or nurse in the emergency department, you can begin to understand why they may feel that patient satisfaction should take a back seat to patient care. I would suggest that much of the negativity toward patient satisfaction can be boiled down to simple nomenclature. “Satisfying” patients isn’t our primary focus; providing the best possible experience to ensure optimal clinical outcomes is much more important.

To start the conversation and begin shifting our perspectives about patient experience, let’s ask a few questions:

  • Don’t our patients deserve the same level of care and compassion that we would want for our families?
  • Can we agree that (almost) every patient who enters our EDs for care is anxious about their visit and eventual diagnosis?
  • If we can deploy simple tactics to improve patient experience and activate patients to participate in their own care plan, shouldn’t we commit to utilizing those tactics?

If we can all agree that it is important for medical professionals to help patients feel safe and comfortable and have a positive experience in our EDs, we have a responsibility to do everything in our power to accomplish that goal by engaging our patients in their plan of care. This involves much more than just satisfying them. We must become engaged with our patients, partnering with them and involving them in treatment decisions that will positively impact their clinical outcomes.

Engagement Begins with Effective Communication

Communication is the most critical aspect of maximizing our time with patients in the ED. The following five components break down the integral pieces of patient communication that drive their engagement.

  • Acknowledge: Begin by acknowledging the patient as an individual and actively listening to their concerns with empathy. In the ED setting, patients are often accompanied by family or friends who must also be recognized as they will provide vital support to our patients. We should also ask the patient what is most important to them to better understand any underlying anxieties and pave the way for an individualized plan of care. Ask: “What’s the most important thing I can do for you today?”
  • Introduce: When we introduce ourselves to patients and family members, we should start by stating our name and role on the team. The next step is often skipped, but it is vitally important to building trust with our patients – managing ourselves up and giving a snapshot of our experience to the patient. This is foundational for that patient’s engagement. While it may feel like bragging, the return is highly valuable. It’s as easy as saying, “I’ve been an ER nurse for 10 years, and you’re in great hands.” Focusing on a strong introduction and manage up will help your patient immediately trust you and your ability to provide great care.
  • Duration: We must be intentional in setting expectations with our patients related to duration in the ED. The more we communicate expected timelines, the more likely we are to prevent patient anxiety and frustration. For example, telling a patient that the doctor will be with them “shortly” allows the patient to decide how long that might be. Of course, there are circumstances beyond our control that sometimes cause timelines to shift. In these cases, it is important to keep communication open and update patients as we get new information. Many EDs have individual communication boards that extend the plan of care to patients as they progress through their visit.
  • Explanation: As the ED visit proceeds, full explanations of what we are doing and why we are doing it reinforces patient engagement while reducing their anxiety about any procedures.
  • Thank You: Don’t forget to show gratitude to your patients. You can thank them for choosing your ED, for their patience through delays, for engaging in their plan of care, or for following your instructions.

When care teams consistently use these communication techniques to build patient engagement, patients not only understand their plan of care for the ED visit but are also more likely to comply with instructions for follow-up care. It’s not just about patient satisfaction or even experience anymore. Evidence shows that patient engagement improves outcomes, which is what we are all striving for, and that goes beyond the warm blanket and the turkey sandwich.


  • Karen Smith

    Karen Smith, MSN, RN, CEN, NE-BC

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