Excessive time spent in the waiting room is one of the most common patient complaints. Before the examination even begins, patients can become frustrated and dissatisfied with the quality of care.
Long patient wait times are not only a problem for the patient, but also for the provider. It’s best practice for any physician to limit patient wait times as much as possible.
Who waits the longest?
Quality care studies usually focus on differences in health outcomes from specific treatments or the nature of prudent care. Studies of wait time are fewer and further between.
Results of a recent Health Affairs study saw investigators assess ambulatory care wait times based on data from more than 21 million outpatient visits. The investigators found that one-fifth of patients had to wait more than 20 minutes, with 5% waiting more than 45 minutes. However, wait times were less for early morning appointments, as well as for younger patients and in larger practices.
The investigators also found that Medicaid patients experienced longer wait times than their privately insured counterparts. Medicaid patients were also 20% more likely to have to wait 20 minutes or more than were privately insured patients.
These differences could be due to per capita income measures and urban status of practices and physicians who serve Medicaid patients. Other factors that could play a role in provider wait time include medical school attended, years in practice, and board certification status.
Other research bulwarks the association between patient wait times and satisfaction. Results from a study published in the Journal of Clinical Orthopedics and Trauma demonstrated that among 102 orthopedic sports-medicine surgeons, older age of the physicians and longer wait times were linked to lower provider scores on ratings websites. These lower ratings occurred regardless of surgeon skill set.
In a separate study published in the Journal of Patient Experiences, investigators found that reducing patient wait times boosted patients satisfaction—although it failed to increase the rate at which patients recommended the practice to others.
“Commonly cited factors affecting patient satisfaction in the literature include timely access to appointments, provider–patient relationships, academic vs private practice setting, overall wait times, and time spent with the provider,” the authors wrote. “Several studies have shown a correlation between reduction in patient wait times and increased patient satisfaction in the outpatient clinic.”
Managing patient wait times
There are various ways to decrease patient wait times, and many of them are actionable.
Consider supply and demand. Although it’s impossible to control the number of patient-initiated or walk-in appointments, physicians can control internal demand and schedule follow-up appointments for times of the day that are less busy, according to the Institute for Healthcare Improvement. Furthermore, in multi-provider practices, more physicians can work during busier times of the day to facilitate patient visits.
Reduce appointment variety. Sometimes pigeonholing appointments by service or specialist is necessary. For example, a room used for specialized procedures may only be available at certain times, or a specialist is only working during certain times of the week. Doing away with regimented appointment times, however, can open up loads of extra time, decrease wait times, and increase work flows.
Continuity of care. When a patient visits with their physician and there is established continuity of care, appointments are faster. The provider likely already understands the patient's medical history and can more efficiently address complaints. Clinical outcomes are better and costs go down, to boot. Specialists can also decrease visit time by delegating certain responsibilities to primary care physicians via service agreements.
Patient portals. In a survey-based study of 4,296 Canadians, researchers found that 2.7% of participants using portals were able to avoid one or more ED/urgent-care visits, with 48% not needing a clinic visit at all due to communication using the portal. The number of missed appointments also dropped in those using patient portals.
“If the decreased no-show rates scale up to a wider set of users, patient portals may have significant positive impact on wait times and clinic efficiency,” wrote the authors.
In other words, the increased use of patient portals may help decrease patient wait times, and should be considered.
Wrangle the phones. One time suck in offices involves receptionists multitasking by answering phone calls, checking in patients, and scheduling appointments. Instead of having one person do it all, delegate different responsibilities to different staff, with one person concentrating on patients in the office.
Scheduling and physician communication can also be done via secure messaging, with texts serving as referential records in lieu of time-consuming and ephemeral phone conversations.
Like it or not, patient satisfaction is an important measure to physicians and healthcare institutions alike. One surefire way to boost patient satisfaction is to cut down on patient waiting times. Fortunately, there are various actions that can be taken to do this. Many of these actions just require some planning, efficient delegation of duties, improved communication, and foresight.