How to Improve Communication About Wait Times, Patient Satisfaction

A role like a Walmart greeter might be coming to healthcare, with new data published in the Annals of Family Medicine showing that having an employee physically present in the clinic waiting room can improve patient satisfaction scores, especially about communication and wait times.

Particularly, the greeter, or “waiting room concierge,” as the researchers called them, improved Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) scores by around 30 percentage points, the researchers wrote.

The waiting room can be a key location for patient dissatisfaction. Previous research has shown that long wait times in the clinic or hospital lobby can be a turn-off for patients, with 84 percent agreeing that a reasonable wait time is a crucial component of a quality patient experience.

“The waiting room is often cited as a major cause of anxiety, and lack of communication and personal attention degrades the patient’s experience,” the researchers wrote. “Additionally, patients dislike having to wait for extended periods of time, especially when they are sick.”

While it is important for healthcare organizations to manage schedules in such a way that prevents long wait times, half the battle is also managing patient expectations.

That much became apparent at Stony Brook Primary Care, an academic faculty practice affiliated with the Renaissance SUNY Stony Brook School of Medicine and which published the Annals study. In consultation with its patient and family advisory council (PFAC), organization leadership zeroed in on two components of the CG-CAHPS patient satisfaction survey in which it sought improvement: “communication about delays” and “wait times in clinic.”

The PFAC recommended the waiting room concierge, which would be embedded directly in the waiting room instead of the traditional administrative area.

“With their own desk and computer in the waiting room, the concierge helps to check in patients, and is analogous to the greeter at Walmart who interacts with them, assisting with office navigation, form completion, and patient portal sign up, as well as providing assistance for those with mobility issues,” the researchers said.

In addition to patient navigation duties, the concierge was also in charge of monitoring appointment wait times. The concierge would verbally notify a patient if there was a delay greater than 15 minutes. Additionally, the concierge would offer to reschedule the appointment if the delay is longer than 30 minutes.

Stony Brook Primary Care also borrowed from another leading service industry: the airline industry. The organization built a board prominently displayed in the waiting room to keep patients updated about the clinic’s schedule, much like airlines have displays to update on gates and arrival times.

The concierge would change colored magnetic buttons from green to yellow to red depending on whether the clinician was on time, 15 minutes late, or 30 minutes late, respectively.

Both changes were instituted to improve communication and expectation-setting for appointment timeliness. Preventing clinicians from going over their allotted appointment spots can be difficult, but these changes may make it easier for clinic staff to manage patient relationships regardless.

The intervention worked, the researchers reported. After implementation, the CG-CAHPS surveys showed improvement in the two target areas, “wait time in the office” and “communication about delays,” with top-box scores going from 60 to 90 percent of respondents.

“Patients commented that they felt more respected by being informed and welcomed in the waiting room,” the researchers added anecdotally.

The concierge was also a welcome change for clinicians, who themselves feel stressed when appointments go over and patients come in after a long wait in the lobby. Staff physicians particularly liked the reschedule option because it offered them an opportunity to realign their workflow for the day.

“The waiting room concierge is easy to implement without having to add additional staff,” the researchers concluded. “We plan to continue with this model and continue to refine and adjust the tasks for this new role. We learned that personalized service helps patients to feel understood and informed so they can have a more meaningful and satisfying visit with their physician.”