Wait Time and Patient Satisfaction—Improving Outcomes Can Be as Easy as Child’s Play
Background: Breast Care at IU Health North Hospital is a multidisciplinary clinic comprised of breast surgeons, medical and radiation oncologists, plastic surgeons and geneticists. It has consistently achieved excellent patient satisfaction scores; however, one area needing improvement was in office wait time. Patient responses to the Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) survey question “During your most recent visit, did you see this provider within 15 minutes of your appointment time?” had been ranked in the 3rd, 38th and 63rd percentile consecutively for the first three quarters (Q) of 2012 by the National Research Corporation (NRC) Picker data.
Objective: To improve patient satisfaction on wait time.
Methods: Wait time for the first patient of each clinic session (morning/afternoon) for each provider was measured each day. Team members (providers, registration staff, medical assistants and nurses) were rewarded with incentives if the patient was seen within 15 minutes of their scheduled appointment time regardless of patient arrival time. On time starts were tracked in full view of the team. Rewards started October 1, 2012, with a communication to all providers and staff in our program. Total cost of implementation was $50 per quarter for incentives.
Results: One week prior to the intervention, baseline wait time was measured. With an average wait time of 17 minutes, only 50% were seen on time. After initiation of the intervention, Q4 of 2012, 96 first starts were measured. The average wait time for all first starts after intervention was 9 minutes and 77% of the patients saw her provider within 15 minutes of her appointment time. In 14 of the 23 late start cases, the patient arrived more than 10 minutes after her appointment time. Patient satisfaction on the CGCAHPS recent wait time question was in the 100th percentile for Q4 2012.
Conclusions: Seeing a change on CGCAHPS recent wait time from the 63rd percentile in Q3 to the 100th percentile in Q4 represents an encouraging trend for this intervention. This project is ongoing to determine if this trend will continue. Patients do arrive late which in turn causes the clinic to run late. However, we realized the timeliness of the patients’ arrival was a much smaller factor than originally anticipated. Accountability played a key role. By setting our goal at 15 minutes, there was no room for excuses. It was much easier to address the problem when all team members realized their role in on time starts, not just the providers. This intervention also anecdotally improved team morale and a sense of efficiency.