hospital Wait room experience
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Description
Improve the wait room experience of one of the top Michigan hospital’s emergency department.
The hospital is one of the leading medical care facility in Michigan, however the surveys conducted by Press Ganey reflected that patients were not satisfied with the amount of wait and the experience associated with it. As a part of coursework project, our team of 4 had to come up with recommendations to communicate the wait and improve the patient experience in the Adult emergency department (ED).
Role
User Researcher.
Responsibility
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Understand the depth of the problem and get familiarized with medicine sector
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Conduct interviews and observations to get both patient’s and provider’s perspective.
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Provide recommendations with a lot of solid backing.
Skills used
Secondary research, contextual inquiry.
Learnings
It was helpful for us to not start the ideation with a mobile application in mind. It was important to consider the situation of a patient in urgent need while providing solutions which will help them less anxious about their condition.
Team members
Gaurang Alat, Kelsey McCormick, Andrew Miller.
Understanding depth of problem
Since this was a completely new field for us, our team conducted research to identify how wait times have affected patient experience of other hospital and if there is some relation of wait time in other domains too.
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Sector analysis
While doing research on the wait time experience in medical field, I read about the psychology of waiting and how it is applicable to all the domains. The outcome of this analysis gave me a brief idea about the lack of ED education amongst patients and a disconnect between the understanding of communication between patients and care providers.
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Competitor analysis
Wait time forms a very important part of customer satisfaction in a lot of businesses. While doing sector analysis and based on my own experience of a customer who has waited for some service I analyzed and got some learning points from domains like airports, public transports, banks and restaurants.
Stakeholders
Care Providers
3 interviews
Patients
Caregivers
2 interviews
2 wait room observations
Our interviews with the stakeholders reflected that patients expected a different kind of communication from care providers. They felt the nurses were not empathizing enough. They didn’t understand why it was taking time to see a physician or why the care providers are not telling the exact time. Some of them even assumed that the hospital had forgotten about them or they were not in the system.
We did observations to get a better sense of the ED space and the environment. We observed that the space was small, patients were not sure about their wait time and kept asking the check-in desk about it. Patients looked afraid with the probable reason being that they didn’t know what was happening to them, why it was taking the hospital so much time to treat them and whether they are going to be more sick while waiting in the room.
Affinity Mapping
Based on the interview interpretations and observation, we found 5 factors associated with patient’s wait time experience.
Current ED infrastructure negatively impacts waiting experience
The current ED space is small and not fluid for patient care. The wait time is affected the number of beds available and hence their limited number affects the number of patients that can be admitted. Since the waiting room is small, often times patients end up sitting on floor which further affects the mindset of anyone entering the room at that time.
Brainstorming
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We identified that patient education and communication amongst staff and patients affects all the other factors associated with wait time experience. In order to identify the solutions we conducted "how might we" for these 2 factors.
Limitations affecting the kind of solution:
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Lack of beds
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Small waiting area
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Unpredictable nature of wait time
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Scope limited to waiting room area
Final Solution
(Designed by team mate)
(Designed by team mate)
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The uncertain time predictor makes it clear to the patients that this is just a guess and not a certainty. It is better to provide a higher limit guess rather than an inaccurate shorter wait time.
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Showed intermittently with ED process, triage information
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The key to resolving the miscommunication, Jung determines, is not to provide a more accurate prediction, but to make it clear that the visualization is just a guess, not a certainty. “Makes the nature of the estimate more salient” and “imprecision in visualization can emphasize the uncertainty of information”
How will this help?
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Freedom to choose another medical option
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Patient education that ED is dependent on triage level
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Regular update on wait time
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Visual medium better than verbal information for anxious patients
Research on ED info-brochures about wait times and ED processes have noted a positive impact on patient satisfaction (Ekwall et. al, 800-809)(Nelson et al., 39-41)(Meek et al., 212-217). For example Hong Kong, patients are usually told their allocated triage category, and there are notices in the waiting room explaining what these categories mean (Slade, 147-154). Patients prefer to be notified of delays and the reason than kept in the dark (Slade, 147-154).
Ekwall A, Gerdtz M, Manias E. The influence of patient acuity on satisfaction with emergency care: Perspectives of family, friends and carers. Journal of Clinical Nursing 2008; 17: 800–809.
Meek R, Phiri W. Australasian Triage Scale: Consumer perspective. Emergency Medicine Australasia 2005; 17: 212–217.
Slade, Diana, et al. Communicating in hospital emergency departments. Springer, 2015. Pp 1-154
Our main recommendations focus on patient education and patient communication. Patients value their satisfaction based on treatment as a person by the hospital staff. They consider their treatment as positive if they are treated with respect and dignity and have all their expectations met. Hence by setting the right expectations in the beginning, and achieving them will boost the patient satisfaction.
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Stage in visit (helps them understand right away what is happening and gives them an idea for what’s ahead)
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Time stamps (gives them a realistic understanding of how long they’ve been waiting)
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Triage level (provides information about their ailments)
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Test results (lets them know they are being treated even while waiting)
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Symptoms (allows patients to be aware of their own feelings and can provide detailed information eventually to physicians)
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Educational information
How will this help?
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Educates patients about ED process hence reducing their anxiety
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Regular update about their condition
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Assurance to patients that care has already started in the back end
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Don’t have to repeat the symptoms again to the physician