Improving Emergency Department Patient Experience Through an Organizational Values-Aligned Standardized Behavioral Model.

Introduction: Patient experience in the setting of the emergency department (ED) is an area of strategic priority forall healthcare facilities. Patient experience can be affected by several factors that encompass the cultural, behavioral, and psychological domains of the healthcare organization. Al Hada Armed Forces Hospital, in its efforts to achieve the strategic objectives of continuously improving the patient experience at scale, implemented an ED-basedbehavioral model of service behaviors that was adapted to match the local community needs and practiced by the frontline healthcare staff at the ED during Q2-2021. Methods: A pre-experimental and postexperimental design was used for our patient experience quality improvement project. The Institute for Healthcare Improvement model for improvement plan-do-study-act was used to implement the quality improvement initiative. Our work is reported in accordance with the SQUIRE (Standards for Quality Improvement Reporting Excellence for Education) 2.0 guidelines from the EQUATOR network. Results: The ED patient experience mean score improved during the postimplementation phase by 5.23 points (8% increase) in Q1-2022 and reached a sustainability level during Q3-2022. Conclusion: This quality improvement project in patient experience at our ED provides strong evidence for adopting organizational values-aligned standardized service behaviors to improve the patient experience at scale across ED settings.

Patient and Family Engagement During Challenging Times: What Works and What Does Not?

A paradigm shift towards enhanced strategies to effectively engage patients and families in delivering safe and high-quality healthcare services was observed during recent times, particularly in the last decade. Immediately prior to the coronavirus disease 2019 (Covid-19) pandemic, the tri-institutional global healthcare quality reports from the National Academies of Sciences, Engineering, and Medicine, World Bank Group, and Lancet Global Health Commission reported the patient and family engagement measures used globally, highlighting the variations across the regions of the world. Through a pandemic for more than a year now, we aim to present the key lessons learned from practices and strategies to proactively engage patients and families. These strategies may continue to be implemented in the post-Covid-19 pandemic era to improve patient and family-centered care.

NO WAIT: new organised well-adapted immediate triage: a lean improvement project.

Long waiting times in the emergency department (ED) are associated with decreased patient satisfaction and increased morbidity and mortality. Triage may be a contributing factor to prolonged wait times in the ED. At Alhada Armed Forces Hospital (Taif, Saudi Arabia), patients other than level 1 and 2 on the Canadian Triage and Acuity Scale are requested to wait until triage. During peak hours (08:00-22:00), the waiting time prior to triage is prolonged, and several patients leave the ED before triage. In this project, a multidisciplinary team was assembled to revise patient flow from the time of arrival at the ED to the time of triage. Lean methodology was used to identify the redundancies and design a seamless flow process for ED patients. Through reorganising the triage area using minimal additional resources, the project team devised a novel floor plan for the triage area which provided a unique patient flow in the ED. The median patient wait time from arrival to triage was reduced from 27 min to 4.09 min and the percentage of patients leaving the ER before triage was reduced to 0%. This project is the first of its kind in Saudi Arabia, as well as in the Gulf region, and provides a radical solution to the problem of patient waiting in the ED during peak hours.