A lot of things come across my desk. That includes press releases, which I usually pass along to the editorial department. After all, the editors and reporters are the ones most interested in notices that someone has been promoted, a company has joined forces with another or a new entity has been formed by a syndicate of movers and shakers. But when a packet of materials from the Institute for Healthcare Improvement arrived recently, I gave it a closer read. And I was more than a little intrigued. The materials addressed something we all deal with and grumble about, yet nothing seems to change. But now there may be some movement.
One of the organization's key goals is reducing the lengthy waiting times patients usually face for physician appointments. We all know what they're talking about. I recently called a specialist to schedule an appointment because I was suffering some pain in my jaw. I was worried and wanted to get to the bottom of whatever was causing my agony. Things like that weigh on your mind. We probably all have a tendency to conjure up thoughts about what could be wrong and always seem to think the worst. When I talked to the physician's scheduler, she told me the next appointment available was in about a month. Although I don't necessarily like to visit physicians, when I feel the need to do so I hope the doc can see me within a reasonable amount of time. A month later just wasn't soon enough. If I had some strange condition in my jaw, maybe by the time I saw the physician in question the ailment could have progressed to an acute stage. I couldn't seem to convey the urgency to the scheduler, so I gave up and went to another doctor who was able to see me a lot sooner.
Donald Berwick, M.D., is a pediatrician and the CEO of the Boston-based Institute for Healthcare Improvement. Here's his view of what's going on in healthcare: "We have come to accept excessive waiting times in healthcare-from scheduling a physician appointment to the hour-upon-hour delays for surgery, routine tests and emergency room visits. Yet we don't tolerate such prolonged waits in other service industries, and we shouldn't accept them in healthcare." He points out how this kind of thing can have very serious consequences. "Think of the trauma a woman faces when she's been told she may have breast cancer and may have to wait for a follow-up appointment. Or the patient who must wait days for a crucial lab result. These situations not only cause unnecessary discomfort, they even prove hazardous."
Berwick has identified one of the great dilemmas in modern medicine, but it appears important progress is being made. For instance, Berwick's institute just announced the results from a group of 27 healthcare organizations that have worked together for a year to reduce delays and waiting times commonly found in healthcare settings. Two hospitals in Pennsylvania reduced waiting times in the emergency room by about 40%. Other organizations cut delays in surgery start times by more than half and reduced the wait time for routine physical exams by more than 70%. And a New Orleans medical center reduced the average wait for appointments at one of its clinics by 67%. That's pretty impressive.
To Berwick and his colleagues, I wish the very best for the institute's Eighth National Forum on Quality Improvement in Healthcare this week in New Orleans. Last year's attendance was about 1,700 physicians, nurses, administrators and others, but this year more than 2,000 already are registered. For you and me, as customers, nothing but good can come from such initiatives.
Time is precious,
Charles S. Lauer