Nobody Wants a Waiting Room

With his nose buried in a binder full of specifications for standardized outpatient
clinics, the architect asked, �Where do you want your waiting rooms?�
�I don�t think anyone wants a waiting room,� came the earnest reply.
Chuckling, the architect persisted, �Yeah, you�re probably right, but let�s figure out
where they�re going to go in this building.�
�Actually, we�re not going to have waiting rooms. Nobody wants a waiting room.�
The room grew quiet, and a few people shifted uncomfortably. The architect,
sensing no jest in the exchange, looked up and gently closed his binder. �But
everyone has waiting rooms . . .�

Health Reform cannot take place only in the Digital Health Space, but also the physical space, we call our offices or clinics.  A twenty minute wasted time at the very beginning wastes a lot of patient time, and if we really want to be patient-centric we cannot ignore the patient’s needs.

This initial conversation would be the spark for a series of struggles over the next 2 years as we attempted to establish a new model of care, with a service blueprint and an environment to enable it.

In the summer of 2015, as the new Dell Medical School at The University of Texas at Austin began planning for the launch of its specialty clinics, the school�s embedded Design Institute for Health was asked to assist in the design of both the service model and the physical layout of the clinic.

The possibility of eliminating waiting rooms represented one opportunity to transform the patient experience. For patients and family, the feeling of wasted time, alongside others who were ill, was a source of frustration and anxiety, and reinforced the prioritization of the system�s needs over the patient�s. We felt it was impossible to address these drawbacks, no matter how many amenities were included, and waiting rooms wasted valuable floor space

This concept produces a windfall of cascading improvement in patient satisfaction. While at first it may be disorienting to patients and staff the learning curve will be swift, in fact much quicker than the transition to electronic health records.

The possibility of eliminating waiting rooms represented one opportunity to transform the patient experience. For patients and family, the feeling of wasted time, alongside others who were ill, was a source of frustration and anxiety, and reinforced the prioritization of the system�s needs over the patient�s. We felt it was impossible to address these drawbacks, no matter how many amenities were included, and waiting rooms wasted valuable floor space


�But I need a waiting room. Where else will I get my patients from?�

A clinical leader at the medical school, when told that we wouldn�t be building waiting rooms, insisted quite sincerely that the clinic wouldn�t be able to operate efficiently without a ready supply of patients at hand. The concern reflected a �factory� metaphor that is almost universal in traditional clinics paid on a fee-for-service basis.

The waiting room is nothing more than a temporary stock room, or intermediate warehouse for patients with billable conditions that feed exam rooms every 10�15 minutes, ensuring the unbroken stream of billable encounters demanded by RVU targets or other measures of productivity. No health care provider I know actually views patients as a packaged revenue opportunity, but the fee-for-service system has incentivized this warehousing behavior.

Rather than delivering patients serially to one exam room after another, each owned by a different provider, we made the patients the owner of their own rooms, and instead, circulated the providers to the patients.�

All of this is well and good if you are building out a new space or as leasehold improvements. But what about your office that is already built out.  How can you improve your space to make it more pleasant?

Enter the office:
Snack Bar
 The Concourse
The Boarding Pass

Open Office Concept




Here are some relevant sources:

https://www.accentoffice.com/five-ways-to-make-waiting-rooms-more-welcoming/

https://www.btod.com/blog/2017/02/01/the-best-colors-for-an-inviting-waiting-room/

http://www.digitalsignbuilder.com/adslide-medical-waiting-room

https://www.nuemd.com/news/2017/03/03/5-tips-making-your-medical-practice-more-inviting

https://www.careinnovations.org/resources/14-ideas-to-transform-your-waiting-room/

https://www.patientpop.com/blog/running-a-practice/6-strategies-turn-waiting-room-asset/

https://www.warehouse-lighting.com/articles/Lighting-for-Hospital-Waiting-Rooms

Remember that the modifications to your physical space can produce a return on investment in produdctivy with increased number of patients and improved staff and patient satisfaction.

Attribution: https://catalyst.nejm.org/nobody-wants-waiting-room/

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