Waiting Time and Family Experience

Many of us have been working on quality improvement projects in our offices that include improving immunization and well visit rates, reducing the use of unnecessary antibiotics, and other initiatives that improve the care of our patients. But how many of you have embarked on improving the patient and family experience using the same structured PDSA processes?

Traditionally, physicians were held in high regard, and waiting for the doctor was often seen as an acceptable inconvenience. As we move towards a faster-paced, results on-demand society, our practices are being judged by how long families are waiting to see us. They are talking about it on social media and they are judging you for it on reputation management sites. Do you know your own practice performance and how your customer satisfaction compares to your competitors?

Like any good Quality Improvement initiative, you have to start with baseline data. Do you know how long patients wait in each phase of your office flow? How long do they sit in the waiting room? What’s the average amount of time they spend in the exam room waiting for you? Before you can approach improvement, you have to gather the data in a consistent way. Do your providers actually change the stage of the patient when they walk in the room? Do they leave notes open for days so it looks like the patient has been in Room 4 over the weekend? If they aren’t using the staging, why not? Do you have too many stages? Not enough? Are they using a stage to remind themselves to finish documentation, and in doing so, make the data analysis invalid?

Once you have figured out the most important data points to collect, and everyone is following it pretty consistently, have you looked to see where the problems are in your office? Do you have enough exam rooms? Do you have enough check-in staff so everyone in the back of your office isn’t waiting for the front desk to get people checked in? This may take some qualitative analysis, such as actually spending a few hours watching what happens and following some patients from arrival until the provider walks into the exam room.

Do you have some providers that consistently run behind? If so, why? Do they come to the office late? Do they have trouble ending a patient visit? Are they unrealistic about how many patients they can actually see in an hour? Do you have catch up time built into your schedule for phone calls, tag-a-long visits, or an emergency that predictably happens in pediatric offices?

I’ve had patients transfer from other practices where they loved their doctor to ours because we run on time and they have busy lives. Everyone’s time is valuable. Make patient wait times the next QI project in your office and work to improve the patient experience. The return on investment may show up in ways you can only imagine.

Sue Kressly

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