HCB News: You’ve recently written an article in Trustee Magazine about emergency departments being on the front lines of patient satisfaction. What are the key dynamics and drivers there?

Dr. Derik K. King: Because EDs are often the first, and sometimes only, place people interact with their community’s hospital, they have a huge impact on a hospital’s reputation. They also generate a large percentage of inpatient admissions, a major source of hospital revenue. When run well, with a stable group of providers who deliver high quality care and excellent customer service, an ED can make a hospital’s reputation and boost its revenue. But if an ED is inefficient, with poor customer service, patients will be dissatisfied—regardless of the quality of care they receive. Positive or negative, a patient’s experience in the ED triggers a ripple effect that can be felt hospital-wide.

HCB News: Let’s explore the role doctors who you identify as the lynchpin in getting patient satisfaction scores in the ED up. Is this well understood and what happens when it is not?

DK: I think everyone in healthcare agrees that physician performance drives the patient experience. But what I think many overlook is the support physicians require to perform well—efficiently, compassionately, and consistently. Education and incentives are a great start. But a high-functioning practice environment, which is to say, one where operations, finances, and the team are stable and not a source of stress, is vital. So too is work-life balance and outstanding clinical leadership. You can’t have happy patients if you have miserable doctors. And you won’t ever have happy doctors unless you create an environment where they feel valued, supported, and can thrive.

HCB News: The Affordable Care Act’s newly created pool of insured individuals is fueling the growth of urgent care centers. In these somewhat uncharted waters, what are some of the challenges they face operating efficiently and profitably?

DK: Because of the growth, one of the biggest challenges new and established urgent care centers face is the ever-increasing competition. A location near a hospital or in a commercial area with 25,000 cars passing by is ideal—but it’s likely a competitor will agree. Many assume increasing volume is the way to survive and thrive. But I’d argue that mastering economies of scale and implementing lean processes must be done first.

So, cross-train staff to step into each other’s jobs as needed to maintain flexibility and flow. Keep costs lower by staffing only one shift initially—ideally 9 a.m. to 9 p.m. Utilize advanced practice professionals and other support staff to ensure good customer service and flow without overwhelming your existing physician—or adding another. The goal is to maximize your capacity without compromising patient safety or satisfaction, then marketing to increase volume and adding resources when volume truly permits.

More Voices