Reducing Patient Aggression in Emergency with Digital Signage
Time moves slowly when you’re waiting in emergency. It’s a time when you’re usually in pain, anxious and frustrated. But what if you had more information? That there were five doctors available? That eight critical patients needed those five doctors’ attention before you? That your wait was likely to be 50 minutes?
How we perceive time is all about expectations. Providing more information reduces how long you think the wait is. Digital signage has been shown to reduce perceived wait times by 35%. Or put another way, uncertain and uninformed waits seem longer than finite, informed waits.
As we head towards the Australian summer break and the corresponding surge in emergency visits, it’s a timely reminder to reassess how to reduce frustration in emergency wards. At Westmead Hospital, the 20% jump in presentations around Christmas and early January are attributed to various reasons, the top being mental health issues, trauma due to increased outdoor activities, and alcohol-related presentations.
It’s not hard to see the potential link between this scenario and aggression towards hospital staff. Emergency departments have the highest incidence of violence in health care, with up to 90% of emergency department staff experiencing violence in their careers.
Unfortunately, violence appears to be increasing. In South Australia, the incidence of “code blacks” (where the safety of hospital staff is threatened), increased from 4,765 in 2015-16 to 6,245 in the same period the following year . Meanwhile, an ABC report found that attacks in several Queensland hospitals were increasing both in number and severity; while a recent academic article concluded that violent incidents in emergency were also underreported.
Physical strategies to increase staff safety
Improving safety for emergency staff must be a priority. The Australasian College for Emergency Medicine recommends a lack of hiding spaces outside emergency departments, the use of CCTV cameras, a visible security presence, physical barriers such as glass screens at triage, a restricted access area and good lighting.
There have also been calls for restrictions on alcohol sales, and intervention programs to follow up alcohol-affected emergency patients.
How communication can help
There is a missing piece in the advice above: the use of digital technology to lessen patient frustration and lower aggression. Managing wait-times and queues is about providing regular information and updates.
And it’s been proven to work. Some examples:
- Providing information to emergency department patients every 15 minutes improves patients’ perceived length of stay, efficiency and clinical skills of the emergency physician.
- The implementation of digital live wait time screens in two UK hospitals resulted in a 50 percent reduction in aggressive incidents, with 75 percent of patients reporting feeling less frustration at wait times due to improved signage.
Applying digital technology to emergency
Applications for digital technology in emergency departments include:
- Real time updates on wait time, doctors on duty, and the number of critical patients in care.
- Empowering patients to leave, then return when it’s almost their turn (where appropriate).
- Educational messages, such as home doctor service information, hygiene reminders or updates on symptoms that require immediate attention.
- Helping patients to relax through therapeutic imagery.
- Providing entertainment options for children to reduce disturbances caused by frustrated behaviour.
- Patient applications that provide information on multiple hospitals (such as wait times) to help patients choose which emergency department to attend.
- Wayfinding screens to quickly direct traffic from entrances and carparks to emergency.
Digital technology is a necessary addition to staff training and education, especially in hospitals where the physical space cannot be renovated, or where instances of violence are increasing. This year’s Christmas season will come and go; but a small digital investment can pay off for years in the additional protection it offers to staff and its impact on patient experience.