Care to wait

Impact

More than 55,000 patients go through the Emergency Department waiting room each year. The numbers of patients needing immediate and very urgent care have increased from 15,206 in 2019, to 20,258 in 2022 (a 33% increase over 3 years). This means that while the sickest patients are being attended to, patients who have less immediate care needs are waiting even longer than before. Similar challenges are experienced in Emergency Departments around the country.

Insights from research phase

Waiting process

As the waiting time increases patients can feel neglected as they have no visibility or clarity when they will receive treatment.

Triage system

Patients are not standardly informed of their triage category. Without visibility of their progress through the ED system, patients become increasingly frustrated and despondent within the process.

Environment and atmosphere

Emergency Departments can be a place of aggression and even violence, making it an uncomfortable environment to wait in. 

Name call – FOMO

Patients are told at each point of the process to listen for their name to be called by the nurse or doctor. This name call is the only line of communication which highlights their progress within the system. Patients are anxious of not hearing their name called due to the loud and disruptive waiting room.

Challenge

Emergency Department waiting rooms are notoriously high pressure and stressful environments. While prolonged waiting times are clearly the primary source of stress, the negative service experience is exacerbated by other factors, such as lack of information about what is happening and how long the wait is likely to be as well as physical comfort and environmental factors.  

This project seeks to explore:
How might we deliver a better emergency department waiting room experience for patients, with solutions that promote comfort, good communication, agency and inclusiveness.

Process

This project commenced with a five week design sprint conducted by a group of NCAD students in 2019, titled ‘Be patient’. Implementation was stalled due to the pandemic. The context of the challenge has shifted since 2019 and so to ensure that the project meets the current and future needs of the patients in the emergency department (‘ED’) waiting room, the design team across the Mater and NCAD are now carrying out additional observations, interviews, and workshops to refresh insights and build consensus re: what will now be tested and implemented.

Observations were conducted in ED to gain an understanding of the patient journey and the challenges faced by healthcare staff. This was followed by interviews with staff and patients to identify their pain points and areas where the patient experience could be improved. Patient personas were created based on these findings. 

A quantitative survey is currently being carried out with patients in the waiting room of the ‘ED’ to capture the baseline metrics of a patient’s waiting experience. The first metric captured user understanding – ‘how does the ED process work’. The second metric captured user expectation – ‘how the service operated’. These metrics will be used to compare the effectiveness of the piloted solutions.

Through this human centred process, the team were able to gain valuable insights into the emergency healthcare system and develop initial concepts that will undergo further design and user testing.

Output

Concepts currently being explored include:

• Signage displayed in the waiting room to explain the ED process
• Colour coded wristbands; to bring awareness and inform patients of their triage category
• An ED Dashboard; a visual display of the number of people waiting in the department, and more specifically, the numbers of people waiting in each triage category
• Way-finding and easy access to basic amenities; vending machines, cafés. 
• Redirect suitable patients to Smithfield Minor Injury Unit pathway.