The John and Mary E. Kirby Hospital is pleased to accept the Press Ganey Summit Award for the second year in a row for Emergency Department (ED) performance. The challenge for 2007 was to not rest on our laurels.

It has been a year of continual growth with an expected calendar year census of 10,000 patients. To accommodate this volume increase, the John and Mary E. Kirby Hospital revamped its triage system by adding a bed and a triage station. This has resulted in an improvement in Press Ganey scores for measuring delays—our average time to triage is less than five minutes.

Secondly, the hospital has a proactive process for its Press Ganey scores. The scores are received and analyzed by the risk manager/quality director on a concurrent basis and are then individually customized by department. Individual evaluations in the very good or very poor categories and unsolicited patient complaints are sent to the ED director for action. We contact patients individually and develop a situation analysis with an action plan which is submitted to the risk manager/quality director. Copies of the evaluations are retained as part of the ED staff performance file.

We also look at the Press Ganey data collectively. We recently developed five parameters for focused improvement efforts. Four of these pertained to patient communication. The ED director performed a research review on patient communication and made a presentation to the medical and management staff on “Effective Patient Communication.” This presentation also kicked off two behavioral standards for ED staff—one of which is to end the patient encounter asking if there is anything else they need.

Finally, the hospital seeks to streamline medical record documentation operations. One issue has been the requirement for medication reconciliation. A paper form was developed for this and compliance is monitored by quality assurance. Since manual entry for each encounter is cumbersome, an automated system was investigated. After visiting another similar-sized ED in the region which utilizes an electronic medication reconciliation form, senior management committed to creating a customized form for this process and incorporating it into our current medical software program. This is an ongoing project that highlights the team building approach Kirby Hospital’s ED uses to create a culture of excellence.