Crystal Ball Reflections – The Incredibly Shrinking Waiting Room

Crystal Ball Reflections – The Incredibly Shrinking Waiting Room

The incredibly shrinking waiting room…..or is it?

What is the True Purpose of the Waiting Room?

One of the elements we are exploring within the Healthcare industry during this Coronavirus pandemic is the utilization of the waiting room. As waiting rooms have set mainly vacant in response to our social distancing mandates, we are working through the process of understanding what is the true purpose of the waiting room. Is the waiting room necessary? Do we need to expose patients to each other while they wait for their exams?  Can technology replace the need for a waiting room for all but a select few?

For years commerce has conditioned us to trust and rely on technology to facilitate the day to day functions of our lives: grocery store self-check-outs, attendant free gas stations, overnight deliveries from Amazon, pre-ordering coffee to avoid standing in line, pre-paying and picking your seat when going into the movies, Venmo, PayPal and on and on. All leveraging technology to avoid what we Americans hate to do…wait!

Will There Be a Transformation Limited to the Waiting Room?

So maybe, just maybe, this worldwide disruptive event will finally transform and compress the waiting component of healthcare delivery.

During our time of sheltering in place, society has embraced the use of video technologies that let us interact together as work colleagues, as congregations of faith, as families that can even visit loved ones hospitalized. We have collectively determined that tele-medicine is a viable substitute for some in person medical visits. We have seen some physician practices direct their patients to text when they arrive in the parking lot and ask them to wait for a return text that grants permission to enter straight into a specific exam room. We have accepted the use of apps to monitor our vitals with the assurance of a visit from a visiting clinician if any issue presents itself. We are beginning to get comfortable doing physical and occupational therapy through our laptop cameras. These are all reflective of the natural progression of our technology driven lifestyles. This pandemic has simply accelerated the continued integration of these into our healthcare.

There has been a strange dichotomy over the last 20 years regarding healthcare waiting spaces.  Inpatient waiting rooms have become smaller, encouraged by the gradual adoption of the single patient room model where families can gather, visit with their loved ones, and even wait while the patient undergoes a test or treatment. At the same time, outpatient waiting rooms have been growing to upwards of 30SF a seat from the 20SF at the turn of the century. The ‘bus station’ furniture layout in practice spaces no longer supports a positive experience as we want to accommodate smaller family sized independent seating groups and desire to support a comfortable location for patients of size.

Will our experience with social distancing be the catalyst to transform the ambulatory waiting room to a series of small family cubicles reserved for those using public transportation, ride sharing or simply lack technology; while those who drive themselves or their loved ones to appointments wait in their vehicle and then self-room when directed? Will we learn from Chick-Fil-A how to manage service delivery? Will ambulatory healthcare move to a ‘just in time’ model? These are all profound questions, but it is an unprecedent, unpredicted event like Covid19 that may provide the mandate for process change.

The public will still need to visit their doctor and medical professionals will still need to see their patients; therefore, how do we innovate respecting what may be the ‘new normal’? In the immediate time frame physician office waiting rooms will have the number of seats reduced. To manage and maintain throughput I would suggest that we may see technology, both new and existing, be heavily engaged. I can envision that the industry will quickly evolve such that scheduling will be all on-line, reminders and wait times will be pushed out via text, and registration and insurance verification will be electronic all to limit human contact. Those arriving by car may be asked to identify when they arrive and a Medical Assistant stationed in the parking area will collect vitals and direct the patient to their specific exam room via an electronic, or printed map. For those not arriving by personal vehicle, they will be directed to an identified socially distant chair or family seating group and be called to their exam room where all the vitals are taken. Discharge instructions, collection of co-pays, follow up appointments scheduled, and prescriptions emailed to their pharmacy will all occur in the exam room to reduce the number of multiple persons that are interacted with during an appointment. The patient will be given a map depicting the exit route and the visit will be complete.

The practitioner will be forced to develop a means for tighter scheduling as punctuality will be key to a positive patient experience and vital to their success in maintaining their patient panel. As proven over the last two and a half months the public can and will quickly adapt to a new normal and learn to be on time and respectful of the practitioner’s time and schedule.

Will we see these protocols be developed, adopted, and implemented? Will the ambulatory care waiting room shrink? Time will tell but for now it is interesting to peer into the Crystal Ball and see a new, efficient, and socially distant compliant new normal.

John Schrott AIA | ACHA | EDAC

President | IKM Architecture | Healthcare Group Leader | Pittsburgh | Cleveland