The true penalty of the waiting room: the role of wait time in patient satisfaction in a busy spine practice

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OBJECTIVE

Most clinics collect routine data on performance metrics on physicians for outpatient visits. However, the relationship of these metrics with patient experience is unclear. The goal of this study was to investigate the relationships between the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey (CG-CAHPS), the standard patient experience survey, and clinic performance metrics to understand the determinants of patient satisfaction and identify targets for improving patient experience.

METHODS

The authors performed a retrospective single-institution cohort review of spine surgeon metrics over 15 months including demographics, waiting-room times, in-room times, lead times, timely note closure, timely MyChart responses, and monthly patient volume. Kruskal-Wallis tests and mixed-model regression were used to determine the predictors of 3 domains of patient satisfaction—Global, Access, and Communication.

RESULTS

Over 15 months, 22 surgeons conducted 27,090 visits. The average clinic visit total time was 85.17 ± 25.75 minutes. Increased wait times were associated with poor Global (p = 0.008), Access (p < 0.001), and Communication scores (p = 0.003) in univariate analysis. Every 10-minute increase in waiting time was associated with a 3%, 9.8%, and 2.4% decrease in Global, Access, and Communication scores, respectively. Increased in-room time was also an independent predictor of poor Access scores (p < 0.001). In multivariate analysis, increased wait times were negative predictors of Global (p = 0.005), Access (p < 0.001), and Communication (p = 0.002) scores.

CONCLUSIONS

Excessive waiting-room time significantly impacts unexpected dimensions of the patient experience and impacts communication with patients. Understanding the complex relationship between the factors that inform the patient experience will help target effective interventions to improve clinic efficiency and patient satisfaction.

ABBREVIATIONS BH = Benjamini-Hochberg; CG-CAHPS = Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey; PCP = primary care provider.
Article Information

Contributor Notes

Correspondence Oren N. Gottfried: Duke University School of Medicine, Durham, NC. oren.gottfried@duke.edu.INCLUDE WHEN CITING Published online February 21, 2020; DOI: 10.3171/2019.12.SPINE191257.Disclosures Dr. Gottfried is a medical consultant for Pioneer Surgical Technology, Inc.
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