A couple of weeks ago, Grace Cordovano, a regular contributor to the HCLDR community, sent out this tweet:
45 min & counting in the exam room. Staring at the blank wall.
What would you change?
What would you add to make this a better #PtExp?
Please entertain me & the millions of patients & carepartners trapped in their exam room. #PatientAdvocacyProblems #hcldr pic.twitter.com/qIfuUFCLwl
— Enlightening Results (@GraceCordovano) January 8, 2020
Her tweet generated over a hundred “likes” and responses, including:
I would change it to a learning room, not an exam room! Add voice to evolve the medical history to be more robust. Of course empower it with AI
— John Nosta (@JohnNosta) January 8, 2020
My other suggestion would be, if it was feasible, giving you a pager while you wait. Be nice to have the ability to go to a book store or run an errand. Then they would page you with 15 minutes to go before start of your appointment.
— Amy Ma (@Ctzen_Improver) January 8, 2020
It’s so exhausting to wait that long in an exam room and especially if that’s added on time from the waiting room. Most of the time I curl up on the exam table and take a much needed nap or just close my eyes with controlled breathing✨ Or …..
— Lisa Davis Budzinski (@lisadbudzinski) January 8, 2020
1. Access to your record in the EHR, so you can review what they say about you
2. DIY collection of vitals, including height, weight, BP, resp, etc. Most people are quite capable of recording their own
3. Whiteboard to write down your questions and encounter objectives, or doodle
— Matthew Loxton (@mloxton) January 9, 2020
I think it’s a universal truth in healthcare – waiting sucks. No one likes to sit in a waiting room or exam room. It’s a lonely and frustrating experience.
No one benefits from long waits. Patients who experience long waits are more likely to seek a different healthcare provider. Physician offices with long wait times are more likely to receive low online ratings. Most staff genuinely feel awful that patients are made to wait.
Healthcare wait times are a bit of an obsession here in Canada. Since Canadian patients do not directly pay for the care they receive (healthcare is funded through taxes), there is a high demand for healthcare services. Plus the system lacks sufficient capacity. The result is a system that is constantly strained. Long wait times are the manifestation of that strain.
To combat wait times, provincial governments have:
- Invested in building Urgent Care Centers (UCCs) to reduce the # of ER visits
- Built telemedicine capabilities to allow patients to book virtual visits
- Staff a nurse hotline where patients can call to speak with a nurse who can direct them to the best level of care
- Started to post wait times online so that patients can see how long they can expect to wait at local ERs – and decide if it is worth it.
Personally, I have found UCCs to be very effective. On the occasions I’ve gone to my local UCC, I’ve only had to wait a few minutes before being brought to an exam room where a physician arrived within 15 minutes. This was much shorter than the 3 hours that I normally wait in an ER.
I count myself lucky that I’ve never had to wait more than an hour in a doctor’s office. However, I have heard many stories from friends about being “forgotten” in an exam room for more than 2 hours. There’s only so much beige paint that a person can take!
Although there are many causes for long waits in healthcare, one that is self-inflicted is overbooking. Some doctor’s offices will purposely book appointments for more patients than can be seen in a standard day. They do this because a certain % of patients do not show up for their appointments or show up so late that they are forced to rebook. Overbooking is the simplest way to avoid gaps in a physician’s schedule.
Unfortunately, on days where patients DO show up, the resulting log jam means long wait times for patients.
Software can help eliminate the need for overbooking. Automated reminders, for example, can ensure more patients show up on time for their appointments. Some vendors even offer wait-list functionality where patients can be contacted by the system when a cancellation occurs.
My favorite wait time solution is one that I have yet to experience personally – the restaurant-like check-in process. This is where a patient checks in for their appointment via a kiosk and enters their cell phone number. They can then leave the office to grab a coffee or wander around the mall. When the doctor is in the appointment just ahead, a text is sent to the patient asking them to return to the office.
[PS. I’ve often wondered why mall operators don’t offer to pay for this type of technology for the doctors that rent an office in their facilities. I think it would be a traffic generator for the surrounding shops.]
Other ways to make the wait time more tolerable:
- Keep patients updated on their wait status. Don’t force patients to walk up to the desk to ask what is going on. Staff could be more proactive and provide waiting patients with an honest update on why things are delayed.
- Educational materials. Offer reading materials that promote healthy living or the latest on chronic conditions.
- Fill blank walls with art. Maybe from local artists or even better, from patients.
- Recent magazines. It’s 2020. So please don’t have any magazines with a date older than 2019.
- Nothing more needs to be said.
- Water station. With paper cups or one where people can refill a water bottle (like at airports)
Join use Tuesday January 21st at 8:30pm ET (for your local time click here), when we will be discussing waiting in healthcare:
- T1 Describe your best and worst healthcare waiting experience.
- T2 At what point do you pack it in and refuse to wait any longer? 1hr? 2hrs? Would you find a different healthcare provider?
- T3 What ideas do you have for patients, physicians and organizations to reduce/avoid wait times?
- T4 What technologies or techniques would you like to see adopted in healthcare to improve waiting rooms and wait times?
Way back in 2014, we covered the topic of waiting. You can read that blog here – “What are we Waiting for? Rethinking the waiting experience in healthcare”.
Thank you Grace for the inspiration!
Daniels, Chrissy. “Why Wait Times Matter”, Industry EDGE, September 2018, https://www.pressganey.com/docs/default-source/default-document-library/why-wait-time-matters.pdf, accessed 18 January 2020
Petros, Steven. “My doctor kept me waiting forever. Can I get some sort of refund?”, The Washington Post, 20 January 2018, https://www.washingtonpost.com/national/health-science/my-doctor-kept-me-waiting-forever-can-i-get-some-sort-of-refund/2018/01/19/7533793e-fbab-11e7-8f66-2df0b94bb98a_story.html, accessed 18 January 2020
Globerman, Steven. “Wait time for Healthcare Care – What Canada Can Learn from Theory and International Experience”, Fraser Institute, October 2013, https://www.fraserinstitute.org/sites/default/files/reducing-wait-times-for-health-care.pdf, accessed 18 January 2020
Seervia, Shanoor. “The Truth About Waiting to See a Doctor in Canada”, The Commonwealth Fund, 30 October 2018, https://www.commonwealthfund.org/publications/podcast/2018/oct/truth-about-waiting-see-doctor-canada, accessed 18 January 2020
Chu, Holly et al. “The psychology of the wait time experience – what clinics can do to manage the waiting experience for patients: a longitudinal, qualitative study”, BMC Health Services Research, 8 July 2019, https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4301-0, accessed 18 January 2020