Experience in an Emergency Department and Hospital Admission

The next series of posts will relate to recent experiences I have had while being a patient or involving personal experiences with family members as patients. The goal is to share ideas from the VOC – voice of the customer – perspective and encourage all to consider these as well as your own experiences. This is a “research” project on understanding the customer experience.

Recently, the EMS team was called to my home to take a family member to the Emergency Department of the closest hospital to our home. We had a very nice experience in the ED, staff worked well, kept us informed as to what was going on and what would happen while there. It was determined that an inpatient admission was in order. We were told that a “hospitalist” would see us either in the ED or shortly after arriving on the floor.

We waited and waited and no one came. Finally we asked the nursing staff and were informed that Dr. Jones (name changed) was our doctor but he had made rounds earlier that day and would not be coming into until the next day. Upset is an understatement – an expectation was created that could not be met!

We later found out (maybe I should have been more proactive related to the Medicare Advantage plan) that there was only one primary care provider with privileges at that hospital that accepted the advantage plan! The hospitalists were not part of the plan! We had checked our primary care provider personal web site, which indicated that the group had privileges at that facility! We could have chosen to be transported to the ED a little further away and may have been able to have our own primary care provider.

The key points here – communication and expectation.

• The primary care provider web site should reflect the true relationships with hospitals, payers, etc. 
• Medicare advantage plans are great for general care but when you need more, it is important to understand the narrowing of networks and selection options. As providers we need to be more proactive in understanding and communicating with our patients all options within key plans, especially if admission or specialty referrals are in order. Also be proactive for your own family members. 
• The ED staff again did a nice job while there, should have a better understanding of the differences in plans and not create an expectation that could not be met. The assumption that all patients would be treated the same so they could always say the hospitalist will soon see you is not true. 

Transparency with patients, education of staff, and effective communication with patients and/or family will lead to a more satisfactory outcome.

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