The waiting game.
A recent article on CNN.com takes a fascinating look at the decades-old science of “queuing psychology,” or what happens to people when they are forced to wait in line. Could hospitals and clinics learn a thing or two from this curious study? Let us count the ways.
Waiting is the bane of the healthcare experience. It so permeates everything patients encounter, it’s easy to forget how often it comes into play. We wait to get on a doctor’s schedule for an appointment. We wait on the phone while we schedule the appointment. We wait to park our cars at the hospital. We wait for test results. We wait when it’s urgent. We wait when it’s an emergency. We wait in line to check in. We wait to go into the exam room. We wait for the doctor to show up in the exam room. We wait for the nurse to come back in after the doctor has left with instructions or a prescription. Doesn’t it say something that healthcare is the industry that gave birth to the term “waiting room?” We don’t even try to hide this deficiency – we name our rooms after it!
Of course, there are many aspects to delivering care where having a patient wait is unavoidable. But that doesn’t change the negative impact it has on patient satisfaction. And it doesn’t excuse our acceptance of the phenomenon, our industry’s shrug of the shoulders, “what can you do?” attitude. As the article points out, many industries deal with waiting. It’s how they deal with it that separates them from most healthcare organizations.
Take Disney, a master at turning the wait into part of the experience – a positive part. Disney theme parks do this by helping make the time go faster while customers wait in line, using design or technology. For example, says the article, the line to one Epcot attraction features cameras and large interactive screens that allow visitors to see themselves and play games. In another, people waiting in line for a comedy show are encouraged to text message jokes that may be used in the show.
How could clinics and hospitals help patients and their families better pass the time while waiting? This is where one of the oldest clichés in healthcare comes into play – the “old magazine in the doctor’s office” bit. Amazingly, after all the comedian jokes and movie references, this is still a fairly common occurrence. Those who see this as a trivial ding to the patient experience are missing the point. Out-dated magazines deliver a message that a clinic or hospital doesn’t seem to care how patients feel when they visit their facility. If they did, why wouldn’t they take the minimal time necessary to provide enjoyable, updated reading material for patients during their wait? Outdated magazines just exacerbate the bigger problem of having to wait in the first place.
The article also talks about how a sense of fair play is crucial to a person’s willingness to wait patiently. As the article states, many retailers and banks are switching from individual counter lines to one long line, to eliminate the problem of some customers feeling cheated as they watch a faster line move beside them. This issue also shows up in physician waiting rooms, and especially in emergency rooms. There’s nothing worse than seeing someone arrive after you, but getting ushered back to receive care before you. Patients often feel a dramatic loss of control (“Do they know I’m still out here? What if they forgot me?”), which can lead to impatience, frustration or anger. Yet here’s where the medical mantra of “transparency” could alleviate these issues. The article notes that researchers have found that people who know ahead of time how long they will have to wait in line are less anxious than those who don’t. This research is why we are now seeing travel time signage on major highways (“Est. Time to I-35: 17 min.”). These signs provide clear information, giving the observer a feeling of control over the situation and lessening frustration. Here’s a quote from a Los Angeles Times article on this effect.
“In general, the research shows very clearly that better information about arrival time significantly reduces the burden people perceive,” said Brian Taylor, director of UCLA’s Institute of Transportation Studies. He pointed to a study showing people felt less stressed on the Metro’s Rapid bus line when they were able to see how many minutes until the next bus arrived. Another example of this technology is new electronic signage at airport gates showing a list of names for stand-by and first-class upgrades, now being used by Northwest Airlines.
How could healthcare take advantage of this? Imagine electronic signage in the waiting room that provided a real-time update of the queue of waiting patients (using first names, or some other coding). Perhaps estimated wait times could be shown for each individual. Maybe color coding could be used to highlight differences in patient acuity, to help communicate the triage-philosophy of an area like the emergency department. Many hospitals and clinics already provide real-time updates of surgery patients in family waiting areas, and the goal would be the same here: provide clear, updated information to help give the patient or family member a regained feeling of control and reduce anxiety.
It’s not realistic to expect the elimination of most waits in healthcare – it’s part of the deal. But exploring innovative ways to reduce the pain of the wait? What are we waiting for?