A response to VA Secretary McDonald from a ‘veteran’ of patient flow solutions

Late last month, Veterans' Administration Secretary Robert McDonald made what turned out to be controversial comments comparing wait times at the VA with wait times at Disneyland.

"When you go to Disney, do they measure the number of hours you wait in line? Or what's important? What's important is, what's your satisfaction with the experience?" he remarked during a Christian Science Monitor breakfast with reporters. "And what I would like to do, eventually, is that kind of measure."

Secretary McDonald's comments quickly attracted attention (and criticism) from politicians, columnists, veterans and others. As the lead for STANLEY Healthcare's Patient Flow and Staff Workflow solutions, wait times are something I think—and care—about a great deal. Rather than simply echo those critics, I'd like to refute his assumptions with some data—about healthcare AND about Disney.

Wait matters—big time
Healthcare consultancy Press Ganey has estimated that the average patient spends about 22 minutes waiting to see a doctor at a clinic—and more than four hours from the time they arrive until they're discharged from an Emergency Department.

When wait times go up, patient experience goes down. In fact, one study by Press Ganey found that those who waited five minutes or less expressed 95 percent satisfaction with their experience. When the wait exceeded 30 minutes, satisfaction dropped to 80 percent. In a different study by Harris Interactive, more than half of patients (63 percent) said they believe the amount of time spent in a waiting room is "very" or "extremely" important.

Additionally, a study published in the American Journal of Managed Care concluded, "While it is well established that longer wait times are negatively associated with clinical provider scores of patient satisfaction, results indicated that every aspect of patient experience—specifically confidence in the care provider and perceived quality of care—correlated negatively with longer wait times." (You can read more at the AJMC website.)

Shorter waits can drive higher efficiency
The aforementioned studies—together with a dose of personal experience and common sense—suggest that wait times are inextricably linked to patient experience and satisfaction.
With his comments, Secretary McDonald overlooked another important reason to pay attention to wait times. As the VA works to improve capacity, reducing wait times helps drive efficiency—facilitating more care for more vets, which supports financial goals and better patient outcomes.

Disney DOES care about wait times
One can only assume that Secretary McDonald hasn't visited a Disney park lately. Disney absolutely measures, tracks and works to continually improve wait times. Its FastPass+ service empowers guests to schedule shows, rides, character visits and other attractions in advance—dramatically reducing the length of time that guests must wait in line. Even when guests haven't reserved a specific time, Disney is highly transparent about wait times—continually updating information both on its mobile app and by physical signs near each attraction.

To fix a problem—at the VA or in any other healthcare organization—you first need to acknowledge it. Care about it. Then be aware of the data that you can gather and use to understand the situation, and then improve. Pinpointing bottlenecks and identifying broken processes can help improve the flow of patients and, ultimately, reduce wait times.

The other imperative is to follow Disney's lead in terms of transparency and communication. With detailed data and the right platform for sharing it, patients and family members can stay informed about their care encounter. Having those real-time insights can be tremendously helpful in managing expectations and improving patient experience and satisfaction.

How does your organization currently measure patient wait times? What steps are you taking to reduce waits and increase satisfaction?

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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