Hurry Up and Wait: Patient Satisfaction Is Measured in Minutes
Time spent waiting for health care services is time spent dissatisfied with those services.
Raise your hand if you like to wait in lines. Nobody? I thought so. Whether it's at the supermarket cashier queue (Somehow I always stand behind the person who needs a "price check on aisle 3"), for amusement park rides (Attraction wait times at Disney theme parks? There's an app for that!), outside the hottest no-reservations eatery (Hint: Purple Pig in Chicago for all you RSNA-bound folks), or the airport trifecta of waiting in traffic to get to the airport, waiting in TSA lines, and waiting as a result of gate delays, people do a lot of waiting for things they want or need.
No matter all the other things people wait for all the time, there's something particularly disheartening about waiting an hour (or more) to dress in a flimsy cotton hospital gown, lay down on a cold hard surface, have someone stick a needle in your arm, be cramped in a tight space, and other equally pleasant experiences in a radiology facility. And then, of course, patients must wait days to receive test results (whether those results turn out to be devastating, confusing, equivocal, or reassuring) and then, after a few weeks, get a jaw-dropping bill for services rendered but not covered (or only partly covered) by insurance. Good things do not always come to those who wait.
Have you ever received messages from a health care facility, like the following from the "Frequently Asked Questions" webpage of a well-known large urban academic hospital's website? "In general, please plan on arriving 15 minutes prior to your scheduled appointment time." It's an innocuous reminder to hurry up and not be late that even includes Mom's favorite magic word, "please." Then there's this statement intended to minimize "no-shows" and unfilled appointments: "If you miss your appointment and do not call to cancel, additional fees may apply." I understand the business rationale for this punitive approach. An unfilled appointment generates zero revenue, while you still have to pay staff, keeping the lights on, etc. However, when I put myself in the patient's shoes for a minute, I cringe as I read it.
So let's flip this around. Imagine patients have their own "policies" that health care facilities must follow or face consequences. "In general, please plan to call my name to get changed into a gown and start my appointment within 15 minutes of my arrival. If you are unable to take me within 15 minutes of my scheduled appointment time, you will bill me or my insurance company at a discount to be determined afterwards based on the amount of time I wait and how valuable my time is." You probably don't like the sound of that if you have a business to run, especially if you are part of the problem, contributing to or causing delays for patients. On the other hand, if you are a patient who always arrive on time (or early) for your health care appointments, but repeatedly wait (and wait, and wait) long past your appointment times, you might be nodding your head vigorously in agreement.
Your time is valuable. Your patients' time is valuable. So creating well-managed queues (and by extension, wait times) should be a no-brainer that is not only important for your radiology business bottom line, but also essential for patient satisfaction. That's why this recently published four-step process should be required reading for every radiologist and every radiology manager.
Maybe you won't go on a gemba walk, use Kingman's formula, or create a value stream map as part of your quality improvement process to address queue problems. However, even small changes that alter how patients perceive their wait times can go a long way to decreasing patient boredom and anxiety while improving satisfaction with radiology services. So what are you waiting for?