SMITHFIELD - Johnston Health, long dogged by complaints of long waits in its Smithfield emergency department, is making strides in improving patient satisfaction, a survey shows.

In a November survey of hospital emergency rooms nationwide, the Smithfield emergency department ranked in the 55th percentile in patient satisfaction, according to the survey by Press Ganey, a health-care consulting firm. The November number was 25 points higher than the Smithfield ER's average score for the prior 10 months.

Johnston Health's Clayton emergency department ranked in the 97th percentile.

"We're always on top of patients' concerns to make sure they get what they need," said Johnston Health spokesman Jim Perpich.

The high marks reflect a trend in how patients view Johnston Health. In a similar patient survey conducted earlier, Johnston Health scored at or above the national average in six of 10 categories. Patients gave Johnston Health good marks for the staff's communication skills, hospital environment and low noise level at night. They also said that hospital staff responded promptly to emergencies or requests for help.

Johnston Health is also making financial strides.

In October, the hospital began making interest payments on the $140 million it borrowed for the medical center in Clayton and the new patient tower in Smithfield.

Perpich thinks the payments show fiscal efficiency within Johnston Health. "We've done a great job saving money in the financial areas that we can control," he said. "And with the new health-care laws coming into effect next year, all hospitals will have to be more efficient to get paid."

Johnston Health tightened its belt during the fiscal year that ended in October. The hospital system came in under budget for expenses such salaries and benefits. But it still operated at a net loss for the year after revenue fell well below expectations.

And in November, the hospital reported a net operating loss of $588,217. It had expected to lose $406,000. Again, revenue was to blame - down 4 percent from what the hospital had budgeted. Expenses, meanwhile, were 6 percent below budget projections.