There seems to be a mild rift in the health care industry, and I'm trying to figure out whether it's just a superficial crack or a deep chasm.
I'm putting the finishing touches on a feature story scheduled for next month's issue of H&HN, which explores the growing emphasis that some hospitals are putting on wait times that show up across the entire health care system. In our August roundtable discussion, GE Healthcare's Francis Dirksmeier points out that waiting is one of the biggest complaints of patients, and a key hurdle to improving both safety and their experience. "They had to wait for a test, wait for the test results, wait to see a physician. Everybody's always waiting for something. By reducing wait states in hospitals, organizations can improve patient satisfaction," he says.
Several experts who I interviewed over the past month seemed convinced that health care can eventually get to a point where there are virtually no waiting times. But not everyone is convinced that all down time is a waste. Some are finding ways to add value to the period between when a patient enters their hospitals' doors and when he or she gets face-to-face with a doctor. Health coaches or educational videos are just some of the ways that providers are making the wait time more meaningful to visitors.
George Tingwald — architect, M.D. and director of medical planning at Stanford University Medical Center — believes that patients expect and even appreciate some waiting in their care. His mother shows up an hour early for her appointment regardless of the circumstances, and Stanford has patients visiting from across the globe who aren't going to be there the second their appointment starts. Others told me that the wait can sometimes serve as a time for patients to gather their thoughts and prepare themselves for what lies ahead.
And operationally, eliminating wait times may be impossible, Tingwald argues. "You can't get away from [keeping patients waiting], and if you say you're not doing it, either you're lying, or you're shifting words. 'We don't have a waiting room, but we have a sub-waiting room. We may not have a lot of people waiting to register in the front area because we register quickly and put them in another waiting room in the back.' It's still a waiting area!"
Others, meanwhile, are convinced of the opposite. Some, such as Scripps Health in San Diego, have found ways to virtually eliminate ambulance bypass hours and cut wait times to near zero in the EDs. With reimbursement increasingly tied to patient satisfaction, those who ignore wait times might feel the sting in their wallets, points out Christy Dempsey, R.N., chief nursing officer for patient experience company Press Ganey.
"Reducing waiting is important to the patient, and, so, because it’s important to the patient, it has to be important to us. When we’re talking about driving value for patients, then reducing waiting times drives value," Dempsey says. "My advice would be you’re going to have to pay attention. You’re going to have to reduce them to improve patient experience, and reimbursement is going to be tied to it."
Reasons seem to be mounting for hospital leaders to target that down time. Safety for one, but also, the growing consumer-mindedness of the patient, who seems more and more willing to shop around for the best experience. Health care is looking increasingly retail-like, and the Walgreens and CVSs of the world seem to be embracing that mindset. Hospitals also are working to become as efficient as possible, with reducing wait times a natural goal of that work.
So my question for you: Is all waiting waste, or is there some value in having a little down time built into the process? Do you believe that hospitals can eventually get to a point where there is virtually no waiting in their facilities? Does it make sense to build spaces and use language that de-emphasize waiting? Share your thoughts in the comment section below, via email or Twitter, and watch for more on this topic in our November issue.