Urgent care clinics post wait times on web

Could this be the wave of the future?

To improve patient service, Park Nicollet Health Services in Minneapolis has begun posting the wait times in its urgent care clinics on its web site (www.parknicollet.com/clinic). The times are posted in 30 minute "ranges," such as 0-60 minutes, 60-90 minutes, and 90-120 minutes, and also indicates if the center is closed.

If administrators also hoped to ease the burden on their ED, however, experts say they are barking up the wrong tree. On the other hand, they add, this public posting of wait times may be a glimpse into the future of ED patient satisfaction efforts.

"We have six urgent care centers in our health system, and when patients would arrive at the one nearest their home they might find they had a two- or three-hour wait," recalls Shannon Mindt, RN, BSN, urgent care manager for Park Nicollet. "We felt that if they could see where the best wait was while they were still in their house, it would give them more choices."

This approach, which has been used for about two years, has contributed to greater patient satisfaction, says Mindt, although no formal survey has been conducted. "We have heard positive feedback from patients, and they are using the site more frequently," she says.

Mindt says that she has not heard whether the postings have made any impact on the ED at the system's main hospital. "In general, the ED waits tend to be a lot longer anyway, except during flu season," she says.

The ED does post its waiting times at the triage desk, Mindt says. "The sign tells you when the last patient was roomed and approximately how long you will likely have to wait until you are roomed."

Experts skeptical

ED experts don't see a direct connection between wait times in urgent care centers and those in the ED. Alfred Sacchetti, MD, FACEP, chief of emergency services at Our Lady of Lourdes Medical Center in Camden, NJ, says he isn't sure posting times in an urgent care center can decrease ED waits. "Patients who are shopping around on the Internet for the best waiting times are generally not the ones who are presenting to the ED for care, urgent or emergent," he says.

Richard O'Brien, MD, FACEP, an emergency physician in Scranton, PA, and a spokesman for the American College of Emergency Physicians, agrees. "I truly believe urgent care clinics and emergency departments serve a vastly different group of patients, by and large," he says.

Still, Sacchetti thinks the concept has some value for patients of urgent care clinics. "I think that idea works if someone has already decided that he or she is going to go to that urgent care center and is just waiting for the best time to show up," he says. "It would probably be even better if they did it like the Hair Cuttery and allowed the patients to sign in ahead of time and then show up in 30 minutes."

Sacchetti and O'Brien agree that this approach eventually may be adopted by EDs as well, although they are not sure how well it will work.

"I do know of one ED that posted times in patients' treatment rooms for estimates on how long it would take a test's results to come back," says Sacchetti. "They've stopped the process now because the patients took the times literally."

O'Brien says, "Many years ago, I worked in a small — new at the time — urgent care clinic, and I could never have envisioned the need to post waiting times in such a facility." However, waiting an hour or even two is the new "normal" in health care, even in a so-called convenience clinic, he says. "I think postings like this may become the norm, even for EDs, but it will do little to change the destination of a person who has the acute onset of significant symptoms and needs emergency services," O'Brien adds.

At present, he says, he knows of no ED that posts waiting times, "Perhaps due to liability concerns or most likely because our volume can change literally in a heart beat." However, O'Brien adds, such a move could be inevitable. "We now live in the era of instant information via cell phone, text messaging, and the Internet," he explains. "And with state-of-the-art ED patient tracking systems, this kind of 'estimated waiting time' information is at least theoretically available in real time."

It is this advancement in technology, and the public knowledge of such advancement, that at least opens the possibility of such a change, says O'Brien. "We may find some requirement to do so at some point, or the public may demand it," he says. "We will just have to 'wait' — no pun intended — and see."

Sources

For more information on posting waiting times, contact:

  • Richard O'Brien, MD, FACEP, Scranton, PA. Phone: (570) 340-2900.
  • Alfred Sacchetti, MD, FACEP, Chief of Emergency Services, Our Lady of Lourdes Medical Center, Camden, NJ. Phone: (856) 757-3803. Fax: (856) 365-7773.