When Patients Are Impatient: The Communication Strategies Utilized by Emergency Department Employees to Manage Patients Frustrated by Wait Times

Abstract

Studies have documented the frustrations patients experience during long wait times in emergency departments (EDs), but considerably less research has sought to understand ED staff responses to these frustrations. In-depth interviews were conducted with 18 ED social workers, patient navigators, and medical staff members at a large urban hospital regarding their experiences and interpersonal strategies for dealing with frustrated patients. Staff indicated that patients often attribute delays to neglect and do not understand why their health problem is not prioritized. They voiced several strategies for addressing wait time frustrations, including expressing empathy for patients, making patients feel occupied and wait times seem more productive, and educating patients about when health issues should be treated through primary care. All staff members recognized the need for engaging in empathic communication with frustrated patients, but social workers and patient navigators were able to dedicate more time to these types of interactions.

Communicating in Hospital Emergency Departments

“…Development of effective clinician-patient relationships that balance the clinical focus of healthcare interactions with the development of empathy and rapport between clinicians and patients is essential for patient-centred care Slade et al , 2011Rider et al 2014;O'Gara and Fairhurst 2004;Hobgood et al 2002). Improving clinician-patient communication is fundamentaltranslating medical or clinical discourse and procedures into language that patients can understand, and adopting communication strategies that empower and encourage patients to engage in consultations and make informed decisions about their own health care (Cohen et al 2013;O'Gara and Fairhurst 2004).…”

“…Across the board, patient-centred care is being placed as a benchmark for quality care within all health care contexts. Studies have solicited patient feedback on patient-centred communication styles and information needs (see, for example, Andersson et al 2014;; Kington and Short 2010;McCarthy et al 2013a) and explored emergency department clinician's awareness of the importance and benefits of patient-centred care (Cameron et al 2010;Cohen et al 2013;Muntlin et al 2013). Studies have solicited patient feedback on patient-centred communication styles and information needs (see, for example, Andersson et al 2014;; Kington and Short 2010;McCarthy et al 2013a) and explored emergency department clinician's awareness of the importance and benefits of patient-centred care (Cameron et al 2010;Cohen et al 2013;Muntlin et al 2013).…”

Nursing management of aggression in a Singapore emergency department: A qualitative study

“…ED are a high-risk area for aggression, and abuse toward nurses is relatively common, accepted as part of the job, and embedded in the culture (Pich et al, 2010). Current evidence points to the need to further explore nurses' perspectives of how best to care for people exhibiting aggressive behaviors, which could contribute to efforts in reducing the adverse effect on nurses and identify the impediments for the required changes by organizations or individual healthcare professionals (Cohen et al, 2013;Hahn et al, 2012;Needham et al, 2005;Pich et al, 2010). It is against this background that the present Singaporean study was developed.…”

Managing patient expectations at emergency department triage

“…In addition, while some EDs are posting their wait times in the ED or internet or billboards, most don't due to forecasting challenges and liability concerns. Thus to improve the patient experience various improvement strategies such as formalized triage by nursing staff 6 , multi-staffed triage 25 , alternative staffing models 6 , patient liaison nurse 27 managing patient expectations upon arrival in the ED 22 , expressing empathy for patients 28 , reducing throughput times 5 , guaranteed service level with monitory benefits for unmet service levels 26,29 , improving communication and information delivery 18 and pamphlets, informational videos, and patient education interventions 30 among others have been utilized with varying success. Much of the previous literature supports the notion that communication is an integral piece of the patient care experience; however few studies explore innovative solutions to solve the complex issues that are associated with emergency care and communicating expected wait times to each individual patient.…”