Use of a Semiautomatic Text Message System to Improve Satisfaction With Wait Time in the Adult Emergency Department: Cross-sectional Survey Study

Abstract

Background Many factors influence patient satisfaction during an emergency department (ED) visit, but the perception of wait time plays a central role. A long wait time in the waiting room increases the risk of hospital-acquired infection, as well as the risk of a patient leaving before being seen by a physician, particularly those with a lower level of urgency who may have to wait for a longer time. Objective We aimed to improve the perception of wait time through the implementation of a semiautomatic SMS text message system that allows patients to wait outside the hospital and facilitates the recall of patients closer to the scheduled time of meeting with the physician. Methods We performed a cross-sectional survey to evaluate the system using a tailored questionnaire to assess the patient perspective and the Unified Theory of Acceptance and Use of Technology questionnaire for the caregiver perspective. We also monitored the frequency of system use with logs. Results A total of 110 usable responses were collected (100 patients and 10 caregivers). Findings revealed that 97 of 100 (97%) patients were satisfied, with most patients waiting outside the ED but inside the hospital. The caregiver evaluation showed that it was very easy to use, but the adoption of the system was more problematic because of the perceived additional workload associated with its use. Conclusions Although not suitable for all patients, our system allows those who have a low-severity condition to wait outside the waiting room and to be recalled according to the dedicated time defined in the Swiss Emergency Triage Scale. It not only has the potential to reduce the risk of hospital-acquired infection but also can enhance the patient experience; additionally, it was perceived as a real improvement. Further automation of the system needs to be explored to reduce caregiver workload and increase its use.