Wait Times Are Hard on Both Patients and Staff

Due to the extreme pressures of the COVID-19 pandemic on healthcare resources, many patients who need medical aid are heading to their local Emergency Department for diagnosis and treatment, and patient wait times are soaring.

Patients become frustrated when wait times are long They often don't know why they're waiting long periods of time for information.

Despite this data, the CDC reports that Emergency Department visits were down in 2020[1] because patients were delaying medical care, resulting in greater chances for later sentinel events. As the Emergency Departments of local hospitals are a primary point of entry to the hospital, this causes a ripple effect throughout the system.

Delays are hard on staff as well. Overburdened clinical and nursing staff don't have time to complete dry erase whiteboard information.

“Because of the high patient volumes that many EDs experience, the ED may be the clinical area that the public is most familiar with, thereby making it the de facto “public face” of the organization. When crowding leads to long wait times and a decreased ability to protect patient privacy and provide patient-centered care, the community’s trust and confidence in the organization may be compromised…Over the past several years, much effort has been devoted to investigating the sources of ED crowding and developing potential solutions.”

AHRQ.gov

Patients Are Spending 90% of their Time Waiting for Services 

In a large academic-level trauma center processing over 100,000 emergency department visits annually, this hospital reports that 90% of emergency department patients’ time is spent waiting. What are they waiting for? They’re waiting for an available exam room; waiting for the nurse; waiting for the doctor; waiting for tests; waiting for discharge or admittance. 

Most often, patients are not informed of the reasons they’re waiting. Because of the extended wait times and poor communication, this hospital’s emergency department reported the lowest patient satisfaction levels of any of the hospitals in their 35-hospital system. Emergency Department patients often complain that they don’t understand or know why they’re waiting for services.  

Patient wait times are exacerbated when labs are backed up in performing what would normally be routine tests, delaying getting that information to patients.
In part due to COVID, some individuals are delaying medical treatment in EDs, which can lead to later sentinel events.

With Emergency Departments trying to manage a large influx of clients, hospitals have concerns about treatments and patient safety. They must hire short-term Travel Nurses amid a critical Nursing shortage, and supplies may be delayed due to supply chain issues in delivery of equipment.

The main concern is ensuring that temporary Nursing staff follow their specific procedures for providing appropriate clinical care and “doing no harm.” Operational workflow systems become secondary to the caregivers’ clinical responsibilities, and consequently, those workflows suffer.

Dry Erase Boards Aren’t the Answer

The typical hospital Emergency Department uses dry erase boards in their exam rooms to communicate relevant information to the patient, family members, and care team; however, dry erase boards have stark disadvantages. The care team is actually taking time out of their clinical role to gather the information from multiple systems and write it on the board in the exam room. Nurses, especially new or traveling Nurses, often don’t have the time to complete dry erase board information. 

Dry erase boards are a hinderance rather than a conduit for information in EDs, because staff often don't have the time to update them.

Patient Safety Should Come First

When and if information is actually completed on a dry erase board, that information often becomes latent, misinterpreted or irrelevant as time passes. This poses an obvious risk to patient safety, not to mention a detractor to patient satisfaction.

Technology to Help Explain Wait Times and Increase Patient Safety 

There is technology available to help ease concerns of patients as they sit or lie in an Emergency Department exam room, using an integrated digital whiteboard. When integrated with existing systems in the hospital, like the EHR, nurse call, RTLS, lab system, and vitals monitor, data can be displayed and edited at the whiteboard level with just a touch. 

Technology use like touch-enabled hospital whiteboards offer relief to overburdened nursing staff to help reduce patient wait times.

A variety of information can be displayed to allay patient worries about wait times. Telehealth can be employed to speed consults and to observe patients. With touch-enabled whiteboards, care team members have visual cues to update patient data quickly and accurately with a touch to the capacitive screens. 

Test Status and Consults 

HCI digital hospital whiteboards can pull data from the EHR to display what tests have been administered, performed and if the results are ready for disclosure to patients.

Using MediaCare, the status of ordered labs and tests are displayed to patients, letting them know what tests or consults have been ordered and displaying time information. This helps patients understand that they’re “in the queue” for results or consults. Depending upon how the EHR is structured for consult notification, the digital whiteboard displays what consults the ED physician is waiting for. 

Telehealth 

Telehealth can be a valuable tool in reducing ED delays by providing fast clinical support to patients with non-life-threatening conditions.

Using the video capabilities of digital whiteboards, patients with non-life-threatening conditions can be processed and procedures can be determined more quickly. From the digital whiteboard, Nurses can start telehealth visits from the patient room to speed services using the built-in cameras, microphones and speakers.

“Adoption of the virtual care platform works best when there’s a surge in demand or a shortage of supplies, because it leads to a larger reduction in ER length of stay when those factors are present…new research in the INFORMS journal Information Systems Research finds that wider use of telehealth in the emergency room can yield positive results for both patients and providers” – Jeff Lagasse in Healthcare Finance

 

Observational Video Monitoring 

Patient observation using a bi-directional video monitoring system supports better collaboration between caregivers to increase patient safety.

When facilities need to monitor a group of patients, for example to monitor them for movement or behavior disorders, a digital whiteboard at a Nurses’ Station can be used with bi-directional audio and video to watch any number of rooms or beds. Observational monitoring can speed response and help the care team accurately observe and record patient issues. The ED may be able to provide an appropriate level of observation without posting a “sitter” for some health patients, freeing up staff time.

In summary, it’s possible to change a patient’s impression of wait times in the Emergency Department by automating processes associated with their care and treatment. Technologies like digital whiteboards and video boost patient satisfaction to increase CMS and insurance reimbursements. Care Teams and clinicians optimize their workflows by using touch-enabled, integrated digital whiteboards, thus eliminating the outdated and time-consuming dry erase boards. Video conferencing speeds patient processing and reduces wait times for patients. 

We welcome a discovery conversation to learn about your facility’s goals and processes for patient satisfaction. We can offer suggestions on lowering patient wait times in the Emergency Department.

[1] Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits — United States, January1, 2019–May 30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:699–704. DOI: http://dx.doi.org/10.15585/mmwr.mm6923e1external icon

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