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Waiting room for improvement

If you are a doctor who (despite your best efforts) often runs behind, and consequently has to deal with a waiting room full of unhappy, anxious or angry patients, you will be glad to hear that help is at hand. Some familiarity with the science of waiting may help you take practical steps to improve the waiting experience of your patients — even in situations where a medical wait may be inevitable.

The reassuring finding from the literature is that overall patient satisfaction correlates poorly with the amount of time spent waiting.

A study from patients waiting in a busy Chicago emergency department showed that patient satisfaction was better predicted by other (modifiable) factors, such as satisfaction with information delivery (regarding tests, procedures and reasons for delays) and the courtesy, friendliness, and professional attitude of the doctors and nurses.

Staff potentially subjected to repeatedly listening to Engelbert Humperdinck and Roger Whittaker may need to be consulted

Additionally (and although it may seem obvious), patient satisfaction was also higher where the actual waiting time was less than expected. Unfortunately, this rarely occurs in practice — unless scheduling is engineered to give that appearance. Deliberately misleading patients is not recommended — but at the very least, offering them a realistic expectation of what to expect in terms of waiting times can do a lot to placate an anxious patient.

Some other potential contributors to consumer dissatisfaction that may also be relevant include…

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Occupied time feels shorter

Boredom, it seems, results from being attentive to the passage of time itself, so anything that can be done to distract those waiting may help — reading material unrelated to the medical agenda, for example.

Unfortunately, out-of-date copies of Hello magazine or Horse and Hound can give the reader the impression that he or she has moved back in time rather than forward, but suppliers can provide waiting rooms with an up-to-date selection of magazines on subscription (and at a significantly reduced cost).

Some restaurants will provide a library of books for customer perusal in the waiting area — an increasing number of doctors’ surgeries are creating similar libraries of books for use by their patients. A UK charity ‘Poets in Waiting Rooms’ provides packs of cards of poetry of suitable length and content for this environment.

There is also emerging science to support the anxiolytic effects of music and radio played in waiting rooms. In a study which explored the preference of patients awaiting radiotherapy, ‘easy listening’ seemed the most popular, with jazz being the least popular. Staff potentially subjected to repeatedly listening to Engelbert Humperdinck and Roger Whittaker may need to be consulted.

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Get them started

People like to get started, or at least feel that they have started the process of their medical consultation. This is one of the reasons that customers are handed menus while waiting to be seated in restaurants.

Although there may not be a menu equivalent to this in most medical practices, handing the patient a questionnaire to complete or somewhere to write down questions that they would like to ask the doctor may help pass a few minutes. It implies ‘service has started. We know that you are here’.

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Slow down

Whereas waiting even a short while for something of perceived little value can feel unbearable, the converse is also true — the better they perceive their doctor to be, the more patient the patient will be.

Whereas we can’t always control how patients perceive us, providing good-quality care (even if that means spending extra time with patients that results in delays to others) may help keep patients calm in the waiting room.

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Privacy

While all those sitting in a waiting room need to feel they have been noticed and not forgotten by office staff, this needs to be balanced with their need for privacy. One way of keeping patients abreast of progress in hospital environments is a paging system, which will allow a patient to go for a stroll or a coffee while waiting. A company who provides this service to Irish hospitals is SS Communications.

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Design

Barcelona-based design company Fuelfor (www.Fuelfor.net) specialises in the systemic redesign of the medical waiting room experience, including: special patient-friendly signage; customisable modular furniture; integrated play areas for children; acoustic separators for privacy; mobile phone apps (which update patients on appointment delays); and printed notepads for patients to prepare questions for their appointment.

This approach has been shown to improve the perception and effectiveness of healthcare service delivery.

With increasing pressure on doctors’ time, it seems likely that medical waits are going to continue, if not worsen. Although there are certain types of delays that no amount of information, reassurance or distraction can prevent, quality medical treatment or heart-felt apologies will make it bearable. There is something we can do to ease the wait.

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