Issue 2: Patient Education/Information: Waiting Room

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Problem definition:

  • There is a lack of education/information regarding wait time after check-in, this can cause irritation and stress for patients who do not know where they are “in line” or how long they have to wait.

Research:

  • Violent or confrontational behavior towards Emergency Department staff has been a very important issue and much of this behavior is caused by long wait times with a lack of information. Patients may also observe what they may believe to be “unfair treatment” if another patient is pushed ahead of them in line. (O’Neill, 2004)
  • ”Previous work has shown that certain characteristics of queues, such as uncertainty of waiting times and lack of information, can cause stress and antagonism and more specifically, that urgent care patients who were told the expected waiting time for treatment and were kept busy while waiting, had higher satisfaction perceptions of their treatment.” (O’Neill, page 18, 2004)
  • It is important to note that there is a distinction between public and private information. Certain details about the patient's specific problem would not be available without consent of the patient and also could not be on a wall display or shown to the entire waiting room. (O'Neill, 2004)
  • Oftentimes patients enter into the ER in spurts; this unpredictability might make it difficult to give a specific expected wait time to a patient. (Garcia, 1995)
  • ”The total time spent in the emergency department comprises mainly drip, waiting, and treatment. Furthermore, the patients spend the longer part of their time waiting, depending on the number of patients to be processed. In addition, it is found that the waiting time for available emergency-treatment beds, doctors, drips, and stretchers accounts for the major part of all the waiting time in the emergency department.” (Takakuwa, 2006).
  • On average, wait time for a bed is approximately 48% of the total wait time. (Takakuwa, 2004)

Measuring the Problem:

  • Track the number and type of complaints and/or confrontations of the patients toward the staff.
  • Administer a Patient Satisfaction Survey
  • Track patient to patient complaints in the waitroom itself.


References:

Brailsford, Sally C. “Advances and challenges in healthcare simulation modeling: tutorial.” Proceedings of the 39th conference on Winter simulation. Washington DC, US: IEEE Press, 2007. Pages 1436-1448 http://delivery.acm.org.www.library.gatech.edu:2048/10.1145/1360000/1351796/p1436-brailsford.pdf?key1=1351796&key2=1495901221&coll=portal&dl=ACM&CFID=2342887&CFTOKEN=24262575

Garcia, Marelys L., Martha A. Centeno, Camille Rivera, Nina Decario. “Reducing time in an emergency room via a fast-track.” Proceedings of the 27th conference on Winter simulation. Washington DC,US: IEEE Computer Society, 1995. Pages 1048-1053. http://delivery.acm.org.www.library.gatech.edu:2048/10.1145/230000/224771/p1048-garcia.pdf?key1=224771&key2=8827601221&coll=portal&dl=ACM&CFID=2228123&CFTOKEN=30111027

O'Neill, Eamonn, Dawn Woodgate, and Vassilis Kostakos. "Easing the Wait in the Emergency Room: Building a Theory of Public Information Systems." Proceedings of the 5th Conference on Designing Interactive Systems: Processes, Practices, Methods, and Techniques. New York, New York: ACM, 2004. Pages: 17-25. http://delivery.acm.org.www.library.gatech.edu:2048/10.1145/1020000/1013120/p17-oneill.pdf?key1=1013120&key2=2532101221&coll=portal&dl=ACM&CFID=2228123&CFTOKEN=30111027

Takakuwa, Soemon, and Hiroko Shiozaki . “Functional analysis for operating emergency department of a general hospital.” Proceedings of the 36th conference on Winter simulation. Washington DC, US: Winter Simulation Conference, 2004. Pages 2003-2011 http://delivery.acm.org.www.library.gatech.edu:2048/10.1145/1170000/1162108/p2003-takakuwa.pdf?key1=1162108&key2=0342901221&coll=portal&dl=ACM&CFID=2228123&CFTOKEN=30111027