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How Can the Emergency Department (ED) Institute a New Mentality?


I am an ED nurse in a mostly chaotic emergency department. Our manager and medical director have recently attended one of your seminars and converted to your philosophy. Our ED historically has an overall poor customer satisfaction rating but receives higher marks for quality technical medical care. I understand that these are two different aspects of providing quality health care, but I am having a more difficult time adjusting to the concept of “consumerism in medicine.” Any suggestions for those of us who have always believed that the ED is for highly skilled medical care and stabilization?


While this is a common feeling among many emergency department staff, service and quality are not two different aspects of the ED. Indeed, they go hand-in-hand in delivering the kind of care that you want for your patients. Good service means great “door to doc” times; good quality means not waiting to see the doc if you have a kidney stone, belly pain, or any other condition that could deteriorate. Good service means being informed about care; good quality means having information to make decisions about your care. Good service is adequate pain management; good quality is adequate pain management.

In the ED, service and quality are interwoven. The stress that a patient feels when he has to access the ED is noted in his vital signs. That stress is lessened when his environment is not harsh and unfeeling. There are excellent studies from the medical community that note that children do better when compassion and touch comes along with their care.

The emergency department is also the front door to the hospital. It gives patients their first impression of the hospital, and many of these patients go on to fill inpatient beds.

Do not consider this new attitude “consumerism,” but think of it as going back to the roots of health care.