Improving the patient waiting experience in the ophthalmology clinic

Abstract

This graduation project arose from Erasmus MC’s mission to continuously improve the patient experience. The results of the patient monitoring by Erasmus MC showed that an intervention at their ophthalmology outpatient clinic (OOC) could contribute to this objective. The patient satisfaction scores on wait time experience were very low at this outpatient clinic. Previous research has already shown that wait time experience is an important impact factor on the overall patient experience.The project started with a literature study. The literature study looked at the topics of patient satisfaction, communication of patient information and the waiting experience. For each of these topics, patient expectations and uncertainty appeared to be among the most important drivers. The result of the literature study was a set of possible interventions, each based on adjusting and managing patient expectations and reducing uncertainty for the patient.Next in the project was mapping the context where these possible interventions happen. This user and context research concerns the environment and work flow of the clinic and patient needs and characteristics. For each sub-topic, the research method was chosen that provided the most valuable and reliable information with the least possible burden on the patients of the outpatient clinic. Methods used include walk-alongs, expert interviews, system analysis, user experience account analysis and empathy mapping.Three main causes of dissatisfaction of patients were identified in the research. Firstly, the unrealistic expectations that patients have about the length of a visit. Secondly expectations about the provision of waiting time information, partly caused by the hospital itself, that are not being met. Lastly the lack of a clear overview of the different steps a patient goes through during a visit for both patient and employee. The complexity of the patient cases at the ophthalmic outpatient clinic in combination with the work flow at the outpatient clinic makes it difficult to predict the steps and waiting times during a patient visit based on the information present in the system. However, three data sources were found in the study that can serve as a reliable source of information to provide personal appointment information to patients. Another important finding of the user and context study is the way in which patients’ visual impairments affects their waiting experience.The design phase consisted of designing ways to apply the proposed interventions within the described context while considering the limitations of the patient group. This resulted in the following three recommendations: adding information to the appointment letter, optimizing the provided digital and printed information for OOC patients, and providing OOC patients with personal, dynamic appointment information during their wait using a physical information booth in the waiting area of the clinic. These recommendations work in unison with each other to ensure the desired effects for all patients during the full patient journey. A prototype of the designed physical information booth was developed and used in user testing to evaluate certain aspects of the design concept.