The current focus on patient-centered care and patient satisfaction has led imaging providers to pay close attention to wait times. Patients can forgive certain things, but making them wait too long is almost guaranteed to translate into a negative opinion about their experience, no matter what else may have happened during their visit.
With this in mind, Vilert A. Loving, MD, MMM, of Banner MD Anderson Cancer Center in Gilbert, Arizona, and colleagues crafted a four-step framework to help practices “resolve problematic queues,” which was published in the Journal of the American College of Radiology. In their analysis, the authors used RAD-A to represent a theoretical radiology practice working to improve wait times.
“By following these four steps, radiologists will understand why queues form at their practices, and they will learn strategies to effectively decrease wait times and improve their patients’ perception of the practice’s overall service quality,” the authors wrote.
Step 1: Analyze factors contributing to queue formation
To help improve wait times, it’s helpful to look at why patients end up waiting for appointments at all. In their article, Loving and colleagues wrote about a popular mathematical model, Kingman’s formula: W = Ts × [U / (1 − U)] × [(CVa2 + CVs2) / 2]. The equation looks complex, yes, but it spells out the three key factors when it comes to studying wait times: service time, utilization rate and variability.
So what could the leaders of that theoretical RAD-A take away from this step? They need to better understand how long the entire imaging process takes, look at how many patients are being cared for in a day and consider how different variables can impact the wait times of other patients. Study these primary factors and you can start to appreciate how they affect one another.
“Kingman’s formula allows RAD-A radiologists to rapidly predict wait times based on proposed operational changes,” the authors wrote. “Kingman’s formula also elucidates factors contributing to queues and, as a corollary, the methods to decrease patient wait times by addressing each variable within the equation.”
Step 2: Improve processes
The team’s second step almost speaks for itself. As the authors explained, whether a facility chooses Six Sigma, Lean or any other process improvement methodology, the bottom line remains the same. “The general strategy of all methodologies is to systematically dissect the component tasks within a process, identify potential problem points, develop and test solutions, analyze outcomes and implement successful solutions into a new process,” they wrote.
Step 3: Reduce variability
As the authors noted in Step 1, variability is a significant factor when analyzing a practice’s wait times. So when the theoretical RAD-A can reduce any variability, what they are doing is hammering away at long wait times bit by bit.
When considering the variability of patient arrival, for instance, what can a practice do? Loving and colleagues provide a list of suggestions: “acquire backup staff for demand spikes, separate priority queues, make appointments (when applicable) and use predictive analytics for demand spikes.”
Another variable to consider is effort. Some referring physicians make the imaging process as easy as possible for their radiologists, but others don’t seem to care much one way or the other about following specific processes. In this instance, the authors’ suggestions are as follows: “Reward compliance, penalize noncompliance, force compliance with decision support systems and acquire extra staff to accommodate.”
Step 4: Address the psychology of queues
The fourth and final step is related to how patients perceive their wait times. For example, there is often anger when patients think they are being treated worse than other patients in the same waiting room. “As feasibly as possible, patients should be serviced in the order that they check in with respect to their scheduled appointments,” the authors wrote. “Employees can openly announce patients’ appointment times to preserve the perception of justice.”
The team also suggests making improvements to the environment. Radiology-themed videos or computer programs can help a patient feel like they are learning about their procedure instead of simply wasting time.