Waiting for scheduled surgery: A complex patient experience

2016 ◽  
Vol 22 (3) ◽  
pp. 290-301 ◽  
Author(s):  
Tracey Carr ◽  
Ulrich Teucher ◽  
Alan G Casson
Keyword(s):  
Cardiac Surgery ◽  
Patient Experience ◽  
Symptom Severity ◽  
Wait Time ◽  
Patient Experiences ◽  
Qualitative Approach ◽  
Wait Times ◽  
Complex Relationship ◽  
Healthcare Resources ◽  
Complex Patient

The aim of this study was to understand experiences of wait time among patients awaiting scheduled orthopaedic or cardiac surgery. Using a qualitative approach, 32 patients completed two interviews each regarding their wait time experiences, including effects of waiting. Patient experiences of wait time varied regardless of actual wait time and included reports of restriction, uncertainty, resignation, coping and opportunity. Participants’ waiting experiences indicate a complex relationship between greater symptom severity and less tolerance for wait time. We suggest healthcare resources focus on alleviating the deleterious effects of waiting for certain patients rather than reducing absolute wait times.

scholarly journals How established wait time benchmarks significantly underestimate total wait times for cardiac surgery

2010 ◽  
Vol 26 (1) ◽  
pp. e17-e21 ◽  
Author(s):  
Jean-Francois Légaré ◽  
Debbie Li ◽  
Karen J. Buth
Keyword(s):  
Cardiac Surgery ◽  
Wait Time ◽  
Wait Times

The next generation of quality improvement at MSK: Turning chemotherapy process delays into chemo express.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18230-e18230
Author(s):  
Jennifer Tota ◽  
Kathleen Levine ◽  
Jeanine Gordon ◽  
Abigail Baldwin ◽  
Jodi Wald ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Patient Experience ◽  
Wait Time ◽  
Wait Times ◽  
Pilot Program ◽  
Treatment Results ◽  
Average Wait Time ◽  
Major Bottleneck ◽  
Work Done

e18230 Background: Chemotherapy wait times can dramatically affect patient experience. MSK’s largest outpatient facility has 76 infusion spaces and 250-300 daily visits. A retrospective review of the facility’s infusion area wait times suggested that the lab (where all patients go to get their vitals and blood drawn) was a major bottleneck leading to process delays in infusion. Methods: We conducted a pilot program using a multi-pronged approach. Our goal was to decrease wait time from 40 minutes to an average of 15 minutes. Our initiative was defined as follows: (1) to redefine lab parameters that are relevant for toxicity and to only consider drawing those necessary labs; additionally, we created guidelines for timing of the labs prior to infusion treatment, (2) to introduce a program known as “ChemoExpress” which offers patients the opportunity to get blood work done prior to the day of their infusion appointment. After the labs result, the outpatient RN calls the patient, assesses symptoms and “clears them” for treatment cueing the pharmacy to prepare and “premix” the drug on the day of treatment. Results: 150 patients have enrolled in ChemoExpress. Patient satisfaction was high based on patient satisfaction surveys (n = 20). Average wait time was 9 minutes (76% less) in ChemoExpress participants as compared to an average wait of 39 minutes for those who did not participate in ChemoExpress. Conclusions: Implementing a process that enables patients to have their bloodwork drawn prior to the day of treatment and drugs prepared in advance of their treatment appointment results in greater efficiency in the overall workflow. It also offers the patient a lower wait time and a more efficient and satisfying experience.

scholarly journals Giving Voice to Patients Through Interviews and Qualitative Analysis- A Pilot Study

2020 ◽  
Author(s):  
Matthew H Loxton ◽  
Ebele Okoli
Keyword(s):  
Patient Safety ◽  
Patient Experience ◽  
Patient Perspective ◽  
Patient Experiences ◽  
Qualitative Approach ◽  
Patient Journey ◽  
Patient Voice ◽  
Patient Goals ◽  
Care Processes ◽  
Operational Metrics

AbstractModern healthcare is drowning in data, and burdened by quality, safety, financial, and operational metrics, but few relate directly to how patients experiences their care. This has a direct bearing on patient safety, and whether the care they receive meets their needs and goals. As such, a key concept in quality management, is to view all processes in terms of whether, and to what degree, these meet patient goals. However, the literature lacks sufficient specificity on how care processes are seen through the eyes of the patient. A thick account of patient experience of their care processes could provide us with a typology of what patients are seeing, how they conceptualize what they experience, and what risks, issues, and opportunities they can express.To fill a gap in awareness of the patient experience of the radiology processes, we used a mixed methods qualitative approach to elicit the patient view of their radiology experiences, and attempt to develop a typology and insights from the patient voice. We developed a typology of patient experiences of the radiology processes that centered on communication gaps, and reflected opacity, fragility, and unpredictability of administrative and care processes in radiology. Although care and administrative processes were described by participants as well-executed in isolation, from a patient perspective, processes frequently failed to interconnect efficiently or effectively, and did not work well as an end-to-end patient journey. Care processes were described by participants as fragile, solitary, and opaque, and required constant vigilance, supervision, and assistance by patients. Participants described a need for improved communication between radiology staff and patients that focuses on the patient journey and helps to identify and mitigate causes of process opacity and fragility

scholarly journals Improving Patient Experience of Wait Times and Courtesy Through Electronic Sign-in and Notification in the Phlebotomy Clinic

2019 ◽  
Vol 144 (6) ◽  
pp. 769-775
Author(s):  
Vincent Le ◽  
Elizabeth A. Wagar ◽  
Ron A. Phipps ◽  
Robert E. Del Guidice ◽  
Han Le ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Patient Experience ◽  
Patient Flow ◽  
Wait Time ◽  
Satisfaction Score ◽  
Wait Times ◽  
Notification System ◽  
The Mean ◽  
Patients Experience ◽  
And Training

Context.— The phlebotomy clinic, which sees on average 900 patients a day, was faced with issues of congestion and noise due to inefficient workflow and processes. The staff called each patient name for his or her turn, and patients were unsure of wait time and position in line. These factors led to unfavorable patient satisfaction regarding wait times and courtesy of the staff. Objective.— To improve patients' experience of wait times and courtesy in the phlebotomy clinic through an electronic sign-in and notification system, redesign of the area, and training of employees. Design.— An electronic sign-in and notification system was implemented in the phlebotomy clinic. Several sign-in stations and whiteboard wall monitors were installed in the clinic, along with a redesign of the patient flow. A Press Ganey survey was given to patients after their visit which included 3 questions related to wait times, courtesy, and information about delays, respectively. The mean responses for each month between March 2016 and December 2018 were aggregated and compared for each measure. Results.— Overall, wait time saw a 7.7% increase in satisfaction score, and courtesy saw a 1.0% increase in satisfaction score during the course of the several interventions that were introduced. The operational efficiency of the clinic also saw a veritable increase because the percent of patients processed within 20 minutes increased by 27%, from 62% (8212 of 13 245 blood draws) to 89% (11 703 of 13 143 blood draws). Conclusions.— The interventions implemented proved to increase the patient satisfaction in each of the measures. The electronic sign-in and whiteboards provided valuable information to both patients and staff.

Evaluating Virtual Care Experiences for Patients with Covid-19 Chief Complaints: Best-Practices Recommendations (Preprint)

2020 ◽  
Author(s):  
Saif Khairat ◽  
Malvika Pillai ◽  
Barbara Edson ◽  
Robert Gianforcaro
Keyword(s):  
Patient Experience ◽  
Wait Time ◽  
Secondary Outcome ◽  
Major Drawback ◽  
Cross Sectional ◽  
Average Wait Time ◽  
Adherence To Medication ◽  
Virtual Care ◽  
Chief Complaints ◽  
Virtual Visits

BACKGROUND Importance: Positive patient experiences are associated with illness recovery and adherence to medication. The shift toward virtual visits creates a need to understand the opportunities and challenges in providing a patient experience that is at least as positive as in-person visits. OBJECTIVE To evaluate the virtual care experience for patients with Covid-19 as their chief complaints. METHODS We conducted a cross-sectional study of the first cohort of patients with Covid-19 concerns in a virtual clinic. We collected data on all virtual visits between March 20-29, 2020. Outcomes: The main endpoints of this study were patient diagnosis, prescriptions received, referrals, wait time and duration, and satisfaction. The secondary outcome was the reported choice of alternative care options. RESULTS Of the 358 total virtual visits, 42 patients marked “Covid-19 Concern” as their chief complaint. Of those patients, 23 (54.8%) female patients, the average age of patients was 33.9 years, and 41 (97.7%) patients were seeking care for themselves and one (3.3%) visit was for a dependent. For all virtual visits, the average wait time (SD) was 157.2 (181.7) minutes and the average wait time (SD) for Covid-19 Concern visits was 177.4 (186.5) minutes. Covid-19 Concern phone visits had an average wait time (SD) of 180.1 (187.2), compared to 63.4 (34.4) minutes for Covid-19 Concern video visits. Thirteen (65%) patients rated their provider as “Excellent” with similar proportions among phone (64.3%) and video (66.7%). CONCLUSIONS This study evaluated the virtual experiences of patients with Covid-19 concerns. There were different experiences for patients depending on their choice of communication. Long wait times were a major drawback in the patient experience. We have learned from evaluating the experience of our first cohort of Covid-19 Concern patients.

scholarly journals Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty

2021 ◽  
Vol 8 ◽  
pp. 237437352110077
Author(s):  
Daliah Wachs ◽  
Victoria Lorah ◽  
Allison Boynton ◽  
Amanda Hertzler ◽  
Brandon Nichols ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Waiting Times ◽  
Wait Time ◽  
Primary Care Providers ◽  
Wait Times ◽  
Care Providers ◽  
Female Physicians ◽  
Online Ratings ◽  
And Gender

The purpose of this study was to explore patient perceptions of primary care providers and their offices relative to their physician’s philosophy (medical degree [MD] vs doctorate in osteopathic medicine [DO]), specialty (internal medicine vs family medicine), US region, and gender (male vs female). Using the Healthgrades website, the average satisfaction rating for the physician, office parameters, and wait time were collected and analyzed for 1267 physicians. We found female doctors tended to have lower ratings in the Midwest, and staff friendliness of female physicians were rated lower in the northwest. In the northeast, male and female MDs were rated more highly than DOs. Wait times varied regionally, with northeast and northwest regions having the shortest wait times. Overall satisfaction was generally high for most physicians. Regional differences in perception of a physician based on gender or degree may have roots in local culture, including proximity to a DO school, comfort with female physicians, and expectations for waiting times.

scholarly journals Determinants of Long Immunization Clinic Wait Times in a Sub-Saharan African Country

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110282
Author(s):  
Osayame Austine Ekhaguere ◽  
Rosena Olubanke Oluwafemi ◽  
Angela Oyo-Ita ◽  
Burke Mamlin ◽  
Paul Bondich ◽  
...  
Keyword(s):  
Focus Group ◽  
Critical Mass ◽  
Wait Time ◽  
Wait Times ◽  
Group Discussions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Group Data ◽  
Focus Group Data ◽  
Sub Saharan

The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed.

scholarly journals Categorizing and Rating Patient Complaints: An Innovative Approach to Improve Patient Experience

2021 ◽  
Vol 8 ◽  
pp. 237437352199862
Author(s):  
Stephanie Bayer ◽  
Paul Kuzmickas ◽  
Adrienne Boissy ◽  
Susannah L. Rose ◽  
Mary Beth Mercer
Keyword(s):  
Patient Experience ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Experiences ◽  
Innovative Approach ◽  
Satisfaction Survey ◽  
Patient Complaints ◽  
Academic Medical ◽  
Survey Results ◽  
Improve Patient

The Ombudsman Office at a large academic medical center created a standardized approach to manage and measure unsolicited patient complaints, including methods to identify longitudinal improvements, accounting for volume variances, as well as incident severity to prioritize response needs. Data on patient complaints and grievances are collected and categorized by type of issue, unit location, severity, and individual employee involved. In addition to granular data, results are collated into meaningful monthly leadership reports to identify opportunities for improvement. An overall benchmark for improvement is also applied based on the number of complaints and grievances received for every 1000 patient encounters. Results are utilized in conjunction with satisfaction survey results to drive patient experience strategies. By applying benchmarks to patient grievances, targets can be created based on historical performance. The utilization of grievance and complaint benchmarking helps prioritize resources to improve patient experiences.

scholarly journals The impact of seasonal operating room closures on wait times for oral cancer surgery

2018 ◽  
Vol 25 (1) ◽  
pp. 67 ◽  
Author(s):  
N. Mundi ◽  
J. Theurer ◽  
A. Warner ◽  
J. Yoo ◽  
K. Fung ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Cancer Patients ◽  
Operating Room ◽  
Oral Cavity Cancer ◽  
Tertiary Care ◽  
Wait Time ◽  
Disease Recurrence ◽  
Health Science ◽  
Wait Times ◽  
The Impact

Background Operating room slowdowns occur at specific intervals in the year as a cost-saving measure. We aim to investigate the impact of these slowdowns on the care of oral cavity cancer patients at a Canadian tertiary care centre.Methods A total of 585 oral cavity cancer patients seen between 1999 and 2015 at the London Health Science Centre (lhsc) Head and Neck Multidisciplinary Clinic were included in this study. Operating room hours and patient load from 2006 to 2014 were calculated. Our primary endpoint was the wait time from consultation to definitive surgery. Exposure variables were defined according to wait time intervals occurring during time periods with reduced operating room hours.Results Overall case volume rose significantly from 2006 to 2014 (p < 0.001), while operating room hours remained stable (p = 0.555). Patient wait times for surgery increased from 16.3 days prior to 2003 to 25.5 days in 2015 (p = 0.008). Significant variability in operating room hours was observed by month, with lowest reported for July and August (p = 0.002). The greater the exposure to these months, the more likely patients were to wait longer than 28 days for surgery (odds ratio per day [or]: 1.07, 95% confidence interval [ci]: 1.05 to 1.10, p < 0.001). Individuals seen in consultation preceding a month with below average operating room hours had a higher risk of disease recurrence and/or death (hazard ratio [hr]: 1.59, 95% ci: 1.10 to 2.30, p = 0.014).Conclusions Scheduled reductions in available operating room hours contribute to prolonged wait times and higher disease recurrence. Further work is needed to identify strategies maximizing efficient use of health care resources without negatively affecting patient outcomes.

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