Taking Care of Those Who Wait: Creating the Ideal Waiting Room Experience

This article describes the new waiting room experience for patients at the University of Michigan’s Cardiovascular Center, Cardiac Procedures Unit.

Introduction

Our journey begins in a small crowded waiting room in the basement of the hospital with loud TVs, old magazines and the smell of burnt coffee. Patients and families often arrived for their “heart procedure” to find no chairs available and a line at the counter. Once checked in and seated, they would wait anxiously for their name to be called to go through “the door.” This is when the wait really began for the families. Updates on their loved one were sporadic and sometimes missed with the patient returning to their room with the family still waiting. Families that needed a break from this small area would take walks, but with no means of reaching them, they sometimes missed that all-important meeting with the physician. When updates were given, physicians and staff called out names of the family and then proceeded to give updates on the patient in this small crowded waiting room for all to hear. Something had to change! The planning of a new building gave the Cardiac Procedures Unit (CPU) team an opportunity to redesign work flow as well as staff functions through a Lean team workshop. Overall, this was a large effort with many staff members, physicians and leaders participating along with a Lean coach. The waiting room project was one initiative that came out of this team’s work. The project was led by Donna McQuillen partnered with Marc Whitted, RN. They examined best practices within our hospital, and a new vision began to take shape. We wanted to make sure that every family member was taken care of, that they received updates every 30 minutes and that their needs were being met — whether they needed a blanket, a pillow or coffee — the staff needed to anticipate the needs of the family and not wait for them to ask. So with this strong customer service focus, the redesign began. The team videotaped the waiting room experience in the pediatric operating rooms at Mott Children’s Hospital, assessed the needs to make the vision the new reality, and presented the new vision for the adult cardiac procedures unit waiting room to the larger team as well as hospital administration. The presentation was a resounding success! We were on our way…

Arrival and Check In

Patients now arrive in a spacious and peaceful waiting room with new magazines, games and activities, and no TVs. While the patient is checked in by the clerk, the family checks in with the family waiting room coordinator. A description of the family members is recorded on a clip board so that they can be quietly approached with updates later. The family also receives a restaurant style pager so that they can leave the area with the assurance that they will not miss updates or conversations with the physician. The family waiting room coordinator works with the charge nurses to escort patients to their prep rooms, and then later escorts the families to join them as well. Lockers are available for patients’ personal belongings, with the family members holding the key.

Uniformed Staff

As the team looked at best practices, they observed the front desk staff of the main University Hospital in their crisp uniforms that clearly identified them as someone that could help. The entire Cardiovascular Center at the University of Michigan decided to adopt a uniformed environment for the clerical staff at front desks on all levels. The uniform presents a professional image and projects the level of service expectations the patients and families can expect from every staff member every time from the very first moment they are in the building.

The Wait

While families wait, we offer several activities to fill their time. Magazines are provided through a service to ensure they are up to date. Staff donated table games and puzzles to help time pass. One of the nurses came up with the idea to have greeting card supplies available so the family members can make a get well card for the patient — we have had many patients’ days brightened with a handmade card ready for them when they woke up. The building also offers Wi-Fi for the convenience of the families. Our patient resource area has an iPod program that allows families to check out a device for the time they are here. It provides educational information for them as well as web access. The family waiting room coordinator works with the staff in the labs to receive updates on the progress of the procedure. When the procedure is complete, the family waiting room coordinator receives a page or phone call to escort the family to a consultation room, where the attending physician meets with them to explain the procedure and outcome in a private setting. Computers are also available for the physicians to share pictures from the procedure to explain any intervention completed or to access educational websites to help explain the procedure or follow-up care. Also in the consult rooms are the cards of the physicians performing procedures so that they can readily give them to families for questions later.

Customer Service Standards

To ensure that staff clearly understand expectations, documents were created to outline specific behavior that was defined as non-negotiable. Outlined in Table 1 are the techniques expected in all interactions with patients and families. Next, the expectations of behavior and appearance of the front desk area are shown in Table 2.

Feedback

We have received much positive feedback from families about the new waiting room. One comment we have received said “Very friendly and prompt with information. And caring.” Another family told us “The waiting room experience is superb. Being updated was very beneficial to us, it made the wait much more comfortable, more knowledge is better…all hospitals should pattern themselves after the University of Michigan.” The family went on to say that being updated made the wait much less stressful. They have had care at many other hospitals, but none as good at the University of Michigan.

For more information, please visit www.med.umich.edu.