SS: What if I work in multiple emergency departments? Do I have to get surveys from each, or can I just pick one?

DP: Pick one. You do not need one from each emergency department you work in.

SS: What if my hospital doesn’t have Press Ganey or a similar survey?

DP: There are a number of things you can do. Some groups actually have someone who follows up with patients, either randomly selected or some subsegment of patients, such as those who left against medical advice. These callers often ask patients about the communication they received and the experience they had. They compile the responses and give it back to the group. If 10 of your patients were included, that would count. You could also create a four- or five-question survey that covers the communication categories mentioned previously and ask 10 patients to complete it and return it to you. Their responses would count, because you are assessing your ability to communicate with those patients.

SS: Let’s talk about quality assurance.

DP: The Patient Care Practice Improvement Activity is a four-step process that you have to complete twice during your 10-year cycle. You collect data that reflect what you are doing with your patients now. Then you compare those data to evidence-based guidelines. This allows you to assess where you are in your practice and answer questions such as, “Am I where I want to be?” and “Am I doing what I want to do?”

If you are hitting those benchmarks, that’s great. You can move on to look at something else. But if you are not hitting those benchmarks, you have the chance to develop a plan to do things a little better. Once you develop the plan and implement some new strategies, you then go back and resurvey 10 patients to see if you have improved things.

A perfect example is the ubiquitous aspirin in suspected STEMI. You want to give aspirin to those patients 100% of the time. We know many hospitals are looking at this initiative and giving feedback on patients who should have received aspirin. If you are missing patients, you need to consider and plan for how to remember to give aspirin the next time. You resurvey, or in this case the hospital will resurvey for you. This allows you to determine whether you are improving your efforts at giving aspirin to chest pain patients. This is one example of a qualifying activity that physicians are already doing.