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With Medicare revenues at stake, ED managers place new importance on elevating the patient experience.

With a portion of Medicare revenue soon to be on the line based on patient satisfaction, ED managers have a heightened focus on making sure patients not only receive first-rate care, but that they also come away from the experience with good things to say. Some hospitals have implemented "patient centric" training for all employees, including the clinical staff, and they're getting regular feedback from patients on things they could do better. Furthermore, patient throughput--always an important factor--has taken on added significance. Beginning this fall, Medicare will begin withholding 1% of payments to hospitals so that it can use these funds to provide incentives to institutions that score high on patient satisfaction. The percent of payments withheld will rise to 2% by 2017. ED managers have implemented rounding through the waiting areas so that patients and family members are kept informed, and they're coming up with new ways to shorten patient-to-provider times. Experts say patient views of time spent in the ED also impact satisfaction scores from inpatient stays. Sophistication in the art of cue management is helping some EDs clear waiting rooms and maximize resources.