A hat tip goes to my friend and fellow author Naida Grunden for sending me this picture. I have seen similar signs in many waiting rooms as both a patient and a consultant.
Sometimes the sign says to talk to the receptionist or clerk if you've been waiting 15 minutes – this one says 30. It's an arbitrary specification about how long is “too long.”
When I look at the sign, it seems first to be an indicator that this occurs often enough for it to be an issue. This sends a message to the patient that says “you're likely going to have to wait a while,” instead of the intended message of “we care about you and hope you don't have to wait.”
I've always wondered what the receptionist is supposed to do exactly if you've waited 31 minutes and you go talk to him. A Lean thinker would probably be asking, “Why are patients having to wait?” There could be any number of reasons – causes and root causes – but the receptionist seems to be the least likely to be able to do anything about the waiting problem.
The sign also doesn't account for people who arrive 45 minutes early for their appointment :-)
What can the receptionist do? She could say, “I'm sorry” or even “I'm really sorry, this hardly ever happens” (although that might be an ill-advised lie). The receptionist might, at best, be able to explain why the wait has occurred (although that wouldn't necessarily be a sure thing).
Seeing Naida's sign made me think that it would maybe have more of an effect on improving the process (and preventing future delays) if the sign listed the CEO's cell phone number and encouraged you to call her if you had waited too long.
The CEO (or maybe even the department director, if you listed his number) is more likely to be able to fix the system. Maybe if they were annoyed by enough phone calls (I mean, made aware of the waiting times), they would be inspired to help improve the system?
There are many times when I've needed or wanted a sign like that in a bleak windowless exam room that seemed more like a jail cell (and solitary confinement, at that!). Where is the sign that says that I should call somebody or pull a fire alarm or send a snippy tweet if I've waited in that room more than 30 minutes? Oh wait, I already feel empowered to send a snippy tweet without a sign directing me to do so. :-)
Putting up a sign is (relatively) cheap and (definitely) easy. But maybe leaders should work together with staff and physicians to reduce the waits – and then the sign can come down?
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Having the patient tell the person with the least authority that the system is broken won’t ever work. Wish they’d invest in the system, rather than in a fancy sign.
In my experience as a patient in offices with signs like this – you’re supposed to remind the receptionist that you’re there, so that you aren’t forgotten. The message this sends to me is worse than “you’re likely going to have to wait a while” – it’s “our system is so broken, we might forget you’re here.”
Contrast that to a model I’m seeing more and more in my work (patient flow technology) – offices that do away with the waiting room altogether. Here’s a recent article about one such clinic that recently opened in Washington state:
http://www.monroemonitor.com/2013/09/24/new-clinic-uses-tech-design-to-simplify-medical-visits/
“…maybe leaders should work together with staff and physicians to reduce the waits – and then the sign can come down?”
In the meantime, call ahead to see if the doctor is on or behind schedule.
Would your doctor’s office give you an accurate or honest answer, Bob?
Sure, they know exactly how long the doctor is delayed. But they’re really surprised that I would prefer to show up when the doctor is ready to see me as opposed to when my appointment was scheduled.
Having worked in medical offices as a manager for many years, the sign has its flaws. I never used them. My staff was empowered and often extremely proactive in avoiding long wait times. I offered coffee, juices, soda, water, and snacks on potentially long days as well as puzzles and magazines in the waiting room. All staff were responsible for wait times. Building in an extended block at lunch helped us catch up before the afternoon patients started. At the end of the day, I spoke with physicians that had an extended wait time of over 30 minutes. We worked it through until their schedules were built to more accurately reflect actual time spent with the patients. Physicians have things come up. Patients will need a longer appointment at times for serious questions and time to discuss a plan of healthcare that will be complied with for achievable goals. Many factors work in to a delayed appointment. Registration, clinician assessments, paperwork completion, and then physician patient face-to-face time. It is a system that can be wrought with problems. Proactivity is the solution. My staff and I would call patients and apologize and offer a delayed appointment or a reschedule to a different day if my physician was more than 1 hour behind. Staff would obtain test results 1-2 days before appointments to be sure the record had everything before the visit and if an issue was identified i.e. no results, we called patients and rescheduled them, if necessary, until the tests were done.
The medical office has to be a pro-active environment rather than a reactive one. Realistic expectations and a dedicated staff as well as physicians that are involved in decision making create a better office visit and better patient satisfaction.
One of the best signs I’ve seen is at an airport parking location in Oakland.
“Our agents are empowered to resolve any problem you may have.”
Luckily I never needed to test it but I did like the sentiment.
I hope they really were empowered, but somehow I doubt it.