The Ask Me to Explain Campaign: A 90-Day Intervention to Promote Patient and Family Involvement in Care in a Pediatric Emergency Department

摘要

Background: Patient satisfaction is a central outcome measure of patient-centered care and is associated with improved patient safety, but the effect of specific interventions in pediatric emergency medicine on patient satisfaction is not well studied. In 2013 the University of Chicago Medicine Comer Children's Hospital's Pediatric Emergency Department identified substantial room for improvement in communication both among physicians and nurses and between hospital staff and patients. A pilot study was conducted to quantify the impact of a specific package of improvement activities on patient satisfaction in the Pediatric Emergency Department. Methods: Using a 90-day action plan (December 2013-February 2014), the Ask Me to Explain campaign included visual signage to remind clinicians and staff to focus on addressing the concerns of their patients. Providers were educated on the campaign tools, their purpose, and how to use them to initiate discussion and provide answers to patient concerns. Education was then spread to support staff throughout the department. The primary outcome measure was the response to questions on a patient satisfaction survey delivered by a third-party vendor, specifically, "Likelihood of your recommending our Emergency Department to others." Results: "Top Box" scores increased for all questions during the 90-day intervention period. Specifically, staff sensitivity to patient concerns increased from 44.0% to 59.2% (p = 0.041), and patient satisfaction with being informed about delays increased from 34.7% to 51.1% (p = 0.024). Interestingly, patient satisfaction either remained above baseline or continued to improve for all questions after the campaign had concluded. Conclusion: A 90-day action plan may provide a successful template for improving communication between providers and patients in a pediatric emergency department or in other health care settings.