Wait ‘App’!

Ask any active Western University student and they will tell you that their school has one of the best campus recreation facilities in Canada. The gym is consistently one of the most populated buildings on campus. The problem? Wait times. Locating an open treadmill or bench can take up half of your workout. It wasn’t until second year that I found the Western Weight Room Twitter account. By following @WesternWeightRm on Twitter, myself and four thousand other gym-goers receive hourly updates on the current numbers using the facility. Perhaps hospital emergency department administrators could learn from the innovators of this helpful tool that is based on accuracy, transparency, and relationship building with its users.

To frame the issue simply, emergency department wait times are out of control in Canada and patients are suffering because of it. According to an international survey released by the Canadian Institute for Health Information, “Half of Canadian patients will wait for more than four hours during emergency room visits”. [1] Adverse outcomes this issue poses include patients leaving without treatment and a general patient dissatisfaction. This reality places Canada among the world’s worst and does not paint an optimistic picture for the future when we consider the increasing needs of a changing demographic. [2]

So what if there were a way to empower the patient by informing them as to the current head count in hospital emergency departments? By following a similar framework as the Western Weight Room twitter account, patients could use this information to get an idea as to what kind of wait times to expect and to make an informed decision on where to seek care. However, the reality is that this idea has actually been tried, although not well. The Alberta Health Services app for iPhone and Android includes an “Emergency Wait Times” tab that was intended to provide the patient with a sense of which local emergency rooms are currently busier than others. [3] Where the app has fallen short is the execution. It has been subject to much criticism for displaying inaccurate values (sometimes up to several hours off from the actual wait times). Opponents of the app also point out that redirecting patients to different locations does not really solve the problem of wait times. [4] Mounting arguments such as these have really suffocated the concept and while some provincial healthcare websites in Canada have gone ahead and created “live” updates for ED wait rooms, they are neither comprehensive nor user friendly.

Similarly to many decision makers in the Canadian healthcare system, these naysayers express the same crippling resistance to change that is killing our healthcare system. This view of all healthcare services commencing in the emergency room or the doctor’s office needs to change. The Western Weight Room twitter account admittedly would not be the effective tool that it was if their updates were not engaging and accurate, but here is the key; they are. Techniques and strategies to accurately assess the number of users in the facility are included in training of Campus Recreation employees. It’s not a stretch to imagine that wait room administration staff could complete similar training and produce similarly useful information. A commitment to frequent and accurate data-collection would make this an invaluable tool.

But what about the second criticism? Simply indicating wait times to patients cannot truly not get at the heart of the issue, could it? Simple answer, yes. An indirect outcome of a more effective version of the app would be to generate transparency within wait rooms. The app should include some kind of national comparison so that their performance is tracked and compared against the national average. This would begin to create a culture of accountability. As the information becomes more accessible to the public, the pressure would move back to the emergency department to commit to efficiency through quality improvement.

The function of the app shouldn’t stop there. As it becomes popularized, an aspect of relationship building with the patient could be included to promote education. The hourly Western Weight Room tweets often involve friendly reminders to “put back your weights” or to “not curl in the squat rack”. An element of patient education should similarly be involved in updates from this app, reminding patients (for example) to “go to urgent care clinics” for conditions that are not life threatening. Hybridizing education with social media is a proven way to get a message across.

The real importance of applications like this is that they both inform and empower the user. This kind of patient involvement is the culture shift we need to promote in Canada. By reaching out to the patient, the app gives them a role to play in determining their healthcare path and engages them in a system that too often operates behind closed doors.


Footnotes

[1] Frketich, Joanna. “Hamilton Spectator.” Canada’s ER wait times among world’s worst. http://www.thespec.com/news-story/2264985-canada-s-er-wait-times-among-world-s-worst/ (accessed October 7, 2014).
[2] “Canadians still waiting too long for health care.” Wait Time Alliance 1 (2013). http://www.gov.nl.ca/HaveYouHeard/wta.pdf (accessed October 4, 2014)
[3] Alberta, Health Services. “AHS apps for iPhone and Android.” Alberta Health Services. http://www.albertahealthservices.ca/mobile.asp (accessed October 7, 2014).
[4] CBC. “High-tech solutions not the answer to ER wait times, experts say.” CBC, news. http://www.cbc.ca/news/health/high-tech-solutions-not-the-answer-to-er-wait-times-experts-say-1.1374283 (accessed October 7, 2014).


 

Jon Suckling

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Jon will graduate from Western University in 2015 with a Bachelor of Health Sciences. He plans to continue his studies of healthcare innovation and management at the postgraduate level.