The Word on ED Wait Times

Added on Oct 19, 2015

There are a few undeniable observations about emergency departments (ED). Nobody wants to be there; nobody wants to wait; and the longer someone is kept waiting, the more they don’t want to be there.

clock2This being the case, the findings of a new Press Ganey analysis of survey response data from ED patients discharged to the community should come as no surprise. The data show a significant inverse relationship between duration of wait time and patients’ mean Likelihood to Recommend scores: the longer patients wait, the less likely they are to recommend the facility.

What is surprising, however, is what researchers found when they peeled back the layers of this relationship: Waiting in and of itself does not necessarily influence whether or not a patient will recommend the ED to friends and family. The degree to which waiting is accompanied by information about the care plan or reasons for the delay does influence patients’ Likelihood to Recommend ratings.

Specifically, when analyzing the pattern of relationship between wait time and Likelihood to Recommend in patients who receive consistent information about their delay—the cause of the delay and expected wait time, for example—Likelihood to Recommend scores remain high even as wait times grow longer.

The negative impact of wait times on the ED patient experience also appears to be mitigated by patients’ perception that their providers care about them as a person and kept them informed.

Our analyses show that the overwhelming majority of patients who gave Top Box ratings (Very Good) for Staff Cared About You as a Person rated their Likelihood to Recommend as Very Good.  Of patients who felt staff cared about them and also felt that doctors kept them informed, nearly all stated their Likelihood to Recommend was Very Good. 

Other differentiating factors, in order of relevance, were the courtesy of the doctor, followed by additional measures around information, education and attentiveness. Importantly, in this analysis, actual or perceived wait time did not emerge as a major predictor of Likelihood to Recommend outcomes.

Of course, this does not mean that wait time is unimportant. It does suggest, however, that there are many other elements of care that are more critical from the patient point of view. 

When ED caregivers are able to make an authentic connection that makes patients feel cared for in a very individualized way, and when they consistently communicate with patients to keep them informed about delays, the focus shifts from some of the variables that have traditionally been perceived as detrimental to the ED patient experience.