Melanie Michael, Susan D. Schaffer, Patricia L. Egan, Barbara B. Little, Patrick Scott Pritchard Abstract: A strong and inverse relationship between patient satisfaction

50 Journal for Healthcare Quality
Improving Wait Times and Patient
Satisfaction in Primary Care
Melanie Michael, Susan D. Schaffer, Patricia L. Egan, Barbara B. Little, Patrick Scott Pritchard
Abstract: A strong and inverse relationship between patient satisfaction
and wait times in ambulatory care settings has been
demonstrated. Despite its relevance to key medical practice outcomes,
timeliness of care in primary care settings has not been
widely studied. The goal of the quality improvement project described
here was to increase patient satisfaction by minimizing
wait times using the Dartmouth Microsystem Improvement Curriculum
(DMIC) framework and the Plan-Do-Study-Act (PDSA) improvement
process. Following completion of an initial PDSA cycle,
significant reductions in mean waiting room and exam room
wait times (p = .001 and p = .047, respectively) were observed
along with a significant increase in patient satisfaction with waiting
room wait time (p = .029). The results support the hypothesis
that the DMIC framework and the PDSA method can be applied to
improve wait times and patient satisfaction among primary care
patients. Furthermore, the pretest–posttest preexperimental study
design employed provides a model for sequential repetitive tests
of change that can lead to meaningful improvements in the delivery
of care and practice performance in a variety of ambulatory
care settings over time.
Keywords
ambulatory/physician
office
community/public
health
patient satisfaction
performance
improvement models
quality improvement
Ambulatory healthcare is the largest and most
widely used segment of the American healthcare
system (Schappert & Rechtsteiner, 2008).
Office visits in these settings account for 25%
of U.S. healthcare expenditures (Centers for
Medicare and Medicaid, 2010) fueling pressure
for increased accountability from consumers,
employers, and payers. In Crossing
the Quality Chasm, the Institute of Medicine’s
(2001) Committee on Quality of Healthcare
in America defines six aims for improving
healthcare in the United States including
safety, effectiveness, patient-centeredness, timeliness,
efficiency, and equity. Despite its relevance
to practice outcomes and patient satisfaction,
timeliness of care in office and
other ambulatory care settings is among the
least studied (Leddy, Kaldenberg, & Becker,
2003).
A strong and inverse relationship between
patient satisfaction and wait times in primary
care and specialty care physician offices has
been demonstrated (Leddy et al., 2003; Press
The authors have disclosed they have no significant relationships
with, or financial interest in, any commercial
companies pertaining to this article.
Ganey Associates, Inc. [Press Ganey], 2009).
A large proportion of these studies focused
on wait time in waiting rooms, however, the
amount of time patients spend waiting in an
exam room is also important. A large-scale survey
of 2.4 million patients across the United
States conducted by Press Ganey in 2008 revealed
that among a list of key variables associated
with patient satisfaction, the fifth strongest
correlation was between exam room wait time and
the likelihood of recommending the practice to others
(Press Ganey, 2009). Medical practices that
are continually working to minimize wait times
can expect to see significant improvement in
the overall satisfaction of their patients (Press
Ganey, 2009) and associated medical practice
outcomes (Drain, 2007; Press Ganey, 2007a;
Saxton, Finkelstein, Bavin, & Stawiski, 2008;
Stelfox, Gandhi, Orav, & Gustafson, 2005).
Furthermore, reducing wait times can lead to
improved financial performance of the practice
(Drain, 2007; Garman, Garcia, & Hargreaves,
2004; Nelson et al., 2007; Press Ganey,
2007b).
Intended Improvement
The purpose of the quality improvement (QI)
pilot project described here was to increase
patient satisfaction by minimizing wait times
in a Florida county health department (CHD)
Adult Primary Care Unit (APCU) practice using
the Dartmouth Microsystem Improvement Curriculum
(DMIC) framework (Nelson, Batalden,
& Godfrey, 2007) and the Plan-Do-Study-Act
(PDSA) improvement process (Institute for
Healthcare Improvement, n.d.). Key study objectives
included (a) identification of factors
that contribute to long waiting room and exam
room wait times, (b) identification of opportunities
for improvement, (c) implementation of
one or more process improvements using the
PDSA model for improvement, and (d) evaluation
of the impact on patient wait times, patient
satisfaction with wait times, and overall satisfaction
with the care experience. Project approval
was obtained from the Florida Department of
Health and the University of Florida Behavioral/NonMedical
Institutional Review Boards.
Journal for Healthcare Quality
Vol. 35, No. 2, pp. 50–60
C 2013 National Association for
Healthcare Quality
Journal for Healthcare Quality

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Week 3 Assignment Instructions

Append the Week 2 Business Research Project Part 1 paper with the following:

Each team member should:

  • Find three articles relevant to your research problem with a minimum of one being peer-reviewed. Sources of non-peer reviewed articles may be trade journals or other sources recommended by your instructor.
  • Provide a brief summary of each article by selecting relevant research that addresses the variables in the research question(s) of the article.
  • Use an in-text citation and reference for each article.

 

This should be no more than 250 words in length.

Format your paper consistent with APA guidelines.

 

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