Children's Healthcare of Atlanta - Atlanta, GA

"Emergency Services: A Cinderella Story"

A score in the 33rd percentile provided the impetus for Children’s Healthcare of Atlanta’s Emergency Department (ED) to get serious about customer service. Shock, embarrassment, and a powerfully competitive spirit propelled the ED into action. This was a score that was not to be tolerated. Thus, the journey began.

Actionable Steps

A team of frontline staff and managers was assigned the task of developing a Customer Service Strategy Whirlwind tour of best practices (three hospitals in two days). This succeeded in getting the creative juices flowing. Next, the facility undertook a very strategic process for improvement.

2001: Benchmark Best Practices

Step 1: Approach
• Analyze the data and understand the competition
     –Multidisciplinary teams of frontline staff were developed to create and implement initiatives. The directive for each team was to focus on one issue until it was successfully resolved.
     –The >40,000 annual visit database was used for goal setting, with a goal of moving from the 53th percentile to the 90th percentile.
• Strategy
     –Define behavior changes needed for success.
     –Develop simple messaging for use by staff.
     –Provide the necessary tools, technology, and resources.
     –Measure effectiveness and communicate weekly.
• Obstacle to change—getting physicians onboard
     –Dr.Ganey came onsite as a guest speaker.
     –Medical doctors became integral members of the teams.
     –Twenty-five percent physician incentive bonus.

Step 2: Implementation
• Great First Impressions (1st and 2nd Quarters 2001)
     –Employees were instructed to practice WISE:
           • Welcome visitors and wear visible name tags
           • Introduce yourself and your role
           • Smile
           • Explain
    –Restaurant style pagers used in the waiting rooms.
    –Games, contests, and food were used to reinforce expected behaviors.
• Great Explanations (3rd and 4th Quarters, 2001)
     –“Key Words At Key Times” key chains worn on name tags to remind staff to use key words such as privacy, comfort, etc.
     –Clocks that “chirp” with various bird calls remind staff to update patients hourly.
     –An ED brochure was developed outlining the process from arrival to discharge.
     –Technician positions (Service Liaisons) were reallocated to ensure that individuals were responsible for meeting comfort needs and facilitating communication between the patient/family and the care team.

Celebrating Success—To recognize the ED for reaching the 95th percentile in the 3rd Quarter 2001, the CEO and other leaders served breakfast to the ED staff at 5:30 a.m.

2002: Building On Success

Service Recovery (1st and 2nd Quarter 2002)
     • All Staff members educated on the importance of service recovery and using LEAD  in their everyday activities:
          –Listen
          –Empathize
          –Act
          –Deliver an apology or thank you
     • Recovery toolkits were developed and made available for use by the staff. Each kit contains a certificate to local stores, parking passes, and meal/gift shop vouchers.
     • Staff attended classes on ways to help patients manage pain and their fear of painful procedures.
     • Team members at all levels continue to revisit and improve on the initiatives started in 2001—Great First Impressions and Great Explanations.

Celebrating Success—The ED surpassed the 90th percentile in the 3rd and 4th quarters.

2003 and Beyond: “Sustain the Gain” Strategy

After two years of improvement and success, the ED at Children’s Healthcare of Atlanta took a careful look at its initiatives and created a plan for implementing key changes.

     • Each quarter, fresh programs would be created for recurring priority issues:
          –Who’s who (introductions).
          –A turnaround time task force was created.
          –Hard-wire frequent service messages/rewards/recognitions.
          –“Turn Around Times” measurements included in electronic     medical records.
         –Expand support for Service Liaisons.

Continued Success
     • The ED reached the 90th percentile or higher 8 of 11 quarters (the lowest score was the 88th percentile).
     • Turnaround times reached the industry benchmark of 144 minutes.
     • Revenue/units per service increased from $302.34 to $455.91.
     • Visits increased from 105,413 to 111,161.
     • Retention increased from 84% to 91%.

Results:

Over the four year journey, the two Emergency Departments at Children’s Healthcare of Atlanta, which have always been committed to quality care, transformed the existing culture into one in which quality of service is a key component of the mission.