Use of a Semi-Automatic Text Message System to Improve Satisfaction with Wait Time in the Adult Emergency Department: A Cross-Sectional Survey Study (Preprint)

Abstract

Many factors influence patient satisfaction during an emergency department (ED) visit, but the perception of the waiting 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.

We aimed to improve the perception of waiting time through the implementation of a semi-automatic text message (SMS) 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.

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 (UTAUT) for the caregiver perspective. We also monitored the frequency of system use with logs.

In total, 110 usable responses were collected (patients, 100; caregivers, 10). Findings revealed a very high level of patient satisfaction (97%), with most patients waiting outside the ED, but inside the hospital. Caregiver evaluation showed that it was very easy to use, but adoption of the system was more problematic because of the perceived additional workload associated with its use.

Although not suitable for all patients, our system allows those with a low severity sign 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 reduces the risk of hospital-acquired infection, but also improves the patient experience and was perceived as a real improvement. Further automation of the system needs to be explored in order to reduce caregiver workload and increase its utilization.