Access, waiting times put crimp on patient experience

Patients may like their doctors and hospital staff, but the ease of getting appointments or the amount of time they wait to see physicians may be areas of concern.

A survey of 651 Minnesota clinics and 230,000 patients detailed what patients liked and didn’t like about their doctors’ visits by asking them 38 questions about waiting times, doctor communication, staff demeanor and appointment access. The survey was meant to assess the patient experience. The survey didn’t say how many practices were operating formal patient experience efforts — a set of protocols designed to increase patient satisfaction and outcomes, which is being instituted as payment is increasingly tied to quality.

Although it’s a state survey, the Minnesota report may shed light on areas of improvement in other clinics across the country because its backers say it’s the most comprehensive statewide study of patient experience in the country.

The state used a national patient experience survey called the Clinician and Group Surveys — Consumer Assessment of Healthcare Providers and Systems. Although some clinics have conducted internal surveys, the statewide survey offers comparison among clinics.

Most patients gave physicians an average of 9 out of 10 for communication. Individual clinics ranged from a low of 66% of patients giving doctors similar high marks, up to 98% of patients.

Physicians were scored on how well they knew patients’ medical histories and whether patients thought doctors’ instructions were easy to understand. Ninety-two percent of patients gave office staffs high marks for helpfulness and courteousness.

But only 60% of patients gave high scores for access to care, with many saying they had trouble making appointments in a timely fashion. Others reported that they waited more than 15 minutes before seeing physicians for scheduled appointments.

“The most interesting results were about access and wait times,” said Jim Chase, president of the MN Community Measurement, a nonprofit organization that helped facilitate the state survey.

“There’s a considerable difference compared to the other measures,” Chase said. “That was a big surprise. Minnesota prides itself on access, and we thought those scores would be high, but they were surprisingly low.”

Doctor office waiting times are of particular concern across the country.

The average waiting time jumped nationally to more than 16 minutes, which is up by about a minute from 2011, based on a March report from Vitals, a health care survey organization that analyzed patient-reported waiting times.

Alaska had the shortest average waiting time at 16 minutes, 28 seconds, while Mississippi had the longest at 24 minutes, 25 seconds. Among major cities, Denver had the shortest wait at 15 minutes, 15 seconds. Charlotte, N.C., came in with the longest at 18 minutes, 19 seconds.

Vitals said waiting times aren’t likely to go down anytime soon, not with newly insured patients expected to hit the health system in 2014 through the Affordable Care Act.

Clinics see room for improvement

The survey didn’t indicate why some clinics scored higher than others. But typically clinics that are high achievers in patient experience scores tend to share survey information with their staffs and discuss how they can improve their scores.

The state plans to survey patients every two years to see how clinics are improving, said Stefan Gildemeister, state health economist and director of the Health Economics Program at the Minnesota Dept. of Health.

“These initial results are just the beginning of what we can learn from the data,” Gildemeister said. “We are eager to better understand how well patient experience relates to improved clinical and performance as high-value, efficient providers.”

The initiative was in partnership with the Minnesota Dept. of Health, and the data are part of Minnesota’s Statewide Quality Reporting and Measurement System. Patients were surveyed between Sept. 1 and Nov. 30, 2012.

In 2008, the Minnesota Legislature enacted health system reform laws that require clinics to report their performances based on select standards.