389 My Visit Board: Improving Patient Understanding of Emergency Department Care

Abstract

Improve the patient experience in the emergency department (ED) by providing information identifying the role of the various emergency department staff members, communicating expected wait times, and providing targeted health information. A rotating slide deck, termed the My Visit Board (MVB), was created and displayed on a screen in each ED patient room. The slide content was created by a multidisciplinary group including physicians, residents and nurses, with assistance from the Department of Patient Education. Survey data was collected both before and after implementation of the intervention. Patients were asked to a 3-question paper survey, to assess the patient’s self-reported understanding using a Likert scale. Patients were eligible to receive a survey if they had a final disposition entered in the electronic medical record. Exclusion criteria were an inability to understand English, intoxication, and cognitive inability to a survey as judged by their ED provider or nurse. A convenience sample patients were surveyed both before and after the intervention. Survey data was also collected from ED staff in order to assess any negative impact on clinicians. All nurses, residents, and attending physicians in the ED were eligible to participate. Surveying was completed using a third party online survey business. The survey data was compared using Wilcoxon signed-rank tests. Thirty-seven patient surveys were collected before and after implementation. Results show significant improvement in how well patients knew the members of their care team (6.57 to 7.84; p<0.018). Patients also were aware of information on general health topics more frequently after the intervention (5.22 to 6.89; p<0.016). There was no significant difference in patient understanding of wait times (6.05 to 6.43; p<0.560). Providers felt that their patients had improved understanding of wait times (3.55 to 5.20; p<0.001) but there was no significant decrease in the level of patient/provider conflict (5.99 to 5.75; p<0.430). Providers felt that overall, the My Visit Board significantly improved the patient/provider relationship (3.39 to 3.62; p <0.015). This data reveals that the My Visit Board improved patient understanding of the care team and resulted in better communication of general health topics. Providers indicated that there was a positive impact on the patient-provider relationship. Use of a slide deck in ED exam rooms to convey information to patients is a viable communication tool. Further work is needed to improve communication of wait times and identify other topics that could be shared with patients via this medium.