MRI centers that provide a comfortable waiting environment with a variety of conveniences may see happier patients -- who may even believe they're spending less time waiting, according to a study published online January 4 in the Journal of the American College of Radiology.
Researchers from Emory University linked positive patient feedback to free Wi-Fi, large-screen TVs, abundant reading material, beverages, and staff who periodically check on and update patients about their scheduled exam.
The effort put forth at Emory's outpatient MR facility, which has two MRI scanners and an annual volume of approximately 11,500 exams, resulted in patients underestimating their total wait time by approximately 50% and their scan duration time by approximately 33%.
"People don't want to be aware of their wait times, especially with long waits," said lead author Dr. Anna Holbrook, an assistant professor of radiology. "There are things you can do to make the patients feel like they are waiting shorter periods of time by improving the environment."
CMS initiative
One catalyst for the study was the U.S. Centers for Medicare and Medicaid Services' (CMS) movement away from traditional fee-for-service payment models toward reimbursement based on the quality of care, a facility's performance, and patient satisfaction.
Dr. Anna Holbrook of Emory University.The CMS directive is not without merit: Previous research has shown that "longer wait times contribute to patient anxiety and dissatisfaction and are frequently cited as a common reason for patients leaving a medical practice," the authors wrote (JACR, January 4, 2016).
"Part of our interest in this study is how radiology and all of medicine is headed away from fee for service and toward quality of care, which includes patient satisfaction," Holbrook told AuntMinnie.com.
To that end, Emory's outpatient MRI waiting room is stocked with reading material, multiple large-screen TVs, and free Wi-Fi. The staff members also check on patients periodically to give them updates on the progress of their appointment and offer them amenities such as an iPad, warm blanket, and coffee or water.
To evaluate the effectiveness of the program, Emory gave patients a survey after their scan, which asked them to provide demographic information and the reason for their MRI. It also included the following questions:
- How many minutes did you wait between checking in and prep?
- How many minutes did you wait between prep and starting the actual test?
- Roughly how many minutes was your actual test?
- How long did you anticipate being here today?
- While waiting, were you offered anything to pass the time?
They were also asked to rate their experience on a five-point scale, ranging from 1 for "very poor" to 5 for "very good."
Patient feedback
A total of 147 patients completed the questionnaire during a period of 15 weeks between October 2014 and February 2015.
Of the respondents, 73 (50%) were offered something to pass the time. The mean actual wait time between patient arrival and the start of the MRI exam was 53.4 minutes (± 33.8 minutes). Patients perceived the mean wait time to be 27.8 minutes (± 23.1 minutes), which underestimated the actual time by 25.6 minutes, a statistically significant difference (p < 0.001).
In addition, while the mean duration of the MRI scan was 47.1 minutes (± 22.7 minutes), patients perceived it to be 31.6 minutes (± 15.2 minutes). This difference was also statistically significant (p < 0.001).
Most importantly, patients gave Emory a median satisfaction score of 5, with 116 surveys (79%) giving the highest possible rating. There were also 24 grades of 4 and four ratings of 4.5, meaning 144 surveys (98%) gave Emory a patient satisfaction score of 4 (meaning "good") or higher.
There was a statistically significant correlation between the patient satisfaction scores and the various components of the actual and perceived wait times, with shorter wait times leading to greater patient satisfaction.
The results were a "pleasant surprise," Holbrook said. "We also were happy to see our relatively high satisfaction rate."
Skip the iPad
Interestingly, the offer of an iPad to use while waiting had no effect on the patients' perceived wait times or satisfaction scores.
"My gut feeling is that when people have downtime, they are on their personal phones," Holbrook said. "Since everyone is doing that, an additional tablet device did not really change their habits."
Given the results, the researchers concluded that when facilities make a concerted effort to improve comfort in the MRI waiting room, patients believe they are spending less time waiting and less time in the scanner, thus increasing satisfaction.
"As satisfaction surveys play a larger role in an environment of metric transparency and value-based payments, better understanding of such factors will be increasingly important," the authors wrote.
"We are very satisfied with what we see," Holbrook said, adding that Emory's strategy to improve the patient experience "may be helpful to other institutions that don't see such good patient survey results relative to wait times."
