Keep patients satisfied while waiting
Physicians can ease tension for patients facing delays in treatment
A physician's ability to move patients quickly directly affects patient satisfaction, says Dighton Packard, MD, FACEP, medical director of the ED at Baylor Medical Center in Dallas. "Overall, the shorter the patient's length of stay, the better your patient satisfaction," he notes. "Patients want to be moved through quickly, and doctors need to be committed to making that happen," he says.
However, if a wait is necessary, it's still possible for patients to leave feeling they got quality care in a timely fashion. "Even if you don't shorten turnaround times, you can impact the patient's perception of that wait," says Richard Cates, MD, MS, vice chairman of the ED at Fairfax Hospital in Falls Church, VA. Here are some ways to improve how patients perceive the time they spend waiting:
Be specific about how long the wait will be. "Disney has the best system in the world for queuing people, because they tell you how long it's going to be, and keep you entertained while you're in line," says Packard. "And, if they say it's an hour from a certain point, it's always 45 minutes."
The same principles should apply to the ED, Packard says. "If you know it takes an hour to get a blood test, tell the patient that it takes at least an hour," he suggests. "Anything you can do to occupy them while they're waiting is good, such as [having] TVs in the room."
Keep patients updated on the wait. "Re-evaluate them in 15 or 20 minutes," says Packard. "You need to give people expectations about how long they will need to wait. If they sense you do care, generally the wait isn't perceived as nearly as bad."
Don't interrupt patients. Give the patients the opportunity to answer questions when taking the history. "Studies have shown that physicians will typically interrupt the patient within 15-20 seconds of asking a question," says Joseph Phillips, MD, FACEP, medical director of emergency medicine at Methodist Hospitals in Indianapolis, IN.
When patients start slowing down their history, doctors have a tendency to interject words for them, says Packard. "When we do that, we inadvertently lead them down one path or another," he notes. "Patients realize they are being cut off. Some people need to ramble a little bit, so let them finish their whole story."
Sit down. "Studies show that patients' perception of how much time you spend with them is greatly increased if you sit down instead of stand, so pull up a stool," Packard says.
Address what is on the patient's mind before ending the visit. "A lady may come in with a lump in her breast, and it doesn't take a genius to figure out she'd like your opinion on whether it's cancer or not," says Packard. "Some of our job is to find out what patients want to know, and it's not always what you expect."
Don't walk out the door until the patient is finished. "After you finish with the patient, wait that extra second until it's really over, instead of backing out of the room while saying goodbye," Packard suggests. "People can tell if you're looking at your watch and anxious to leave. It's not so much the time you spend, but the quality of that time and their perception of whether you're in a hurry."
If you do have to leave abruptly, be sure to explain why, advises Packard. "Tell them why you have to leave," he says. "Say, 'That call was for me, I have a very serious patient, and I'm very sorry but I have to go now.'"
Talk to the patient's family. If family members are waiting, let them know how long they can expect to wait. "You need to bring them in to the discussion and make sure everybody understands what's going on," says Packard. "Otherwise, the patient may be happy, but the entire family is annoyed."
Touch the patient. Body language has a major impact on the patient's perception of a wait, says Cates. "The physician has to put his hands on the patient and make sure the patient knows they're doing it," he adds.
Spend more time in the patient's room. "Do everything you can to increase the interaction between you and the patient. For example, do some charting in the room," Cates recommends.
Keep patients informed. Make a point of walking into a patient's room to update them periodically. "Give them information in pieces, instead of making them wait until the end of the visit," says Cates. "Say, by the way, that CBC is back and it looks good."
If patients are continually updated, they are less likely to become angry. "Often, the first thing that dissatisfied patients say is, 'I didn't know why I was waiting there that long,'" says Cates. "We are working in a high-contact service industry, and people want to be kept informed."
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