Evaluating the Impact of Wait Time on Orthopaedic Outpatient Satisfaction Using the Press Ganey Survey

Abstract

The Press Ganey Outpatient Medical Practice Survey is a commonly utilized questionnaire that attempts to measure satisfaction with outpatient health care. A wide variety of factors have been associated with lower satisfaction scores among orthopaedic patients, including age, sex, presence of psychological disorders, and driving distance to the point of care. The impact of clinic workflows is less clear. In this study, we hypothesized that an increased clinic wait time was an independent predictor of lower patient satisfaction as measured by the Press Ganey survey.

Methods: We retrospectively reviewed 4,216 new outpatient orthopaedic surgery visits between January 1, 2014, and December 31, 2016, at a single academic institution. For patients with multiple visits, only the first new patient visit was analyzed. Satisfaction was defined as achieving a score above the 33rd percentile of the cohort. Univariate analysis followed by multivariable binary logistic regression was used to detect factors associated with patient satisfaction.

Results: Of the 4,216 unique patients, the mean age (and standard deviation) was 52.8 ± 15.8 years, and 58.9% of the patients were female. The mean total wait time was 17.8 ± 19.4 minutes. Univariate analysis revealed greater odds of achieving satisfaction on the Press Ganey survey for a wait time of <15 minutes compared with a wait time of ≥15 minutes; the odds ratio (OR) was 3.78 (95% confidence interval [CI], 3.30 to 4.33; p < 0.01). The multivariable model revealed an association between satisfaction and wait time while controlling for other potential contributing factors: the odds of achieving satisfaction after waiting for 15 to 29 minutes were 0.36 (95% CI, 0.31 to 0.43; p < 0.01) compared with waiting for <15 minutes, with significantly decreasing odds (p < 0.01 for all) observed with further increments of increased wait time.

Conclusions: A wait time exceeding 15 minutes in an outpatient orthopaedic clinic was an independent predictor of scoring at or below the 33rd percentile on the Press Ganey survey. Further increases in wait time significantly increased the odds of dissatisfaction. Measures to reduce clinic wait time may improve the patient experience and satisfaction with the orthopaedic encounter.

Fig. 1

Press Ganey total score by wait time. The asterisk represents significance at p < 0.05 compared with the reference category (wait time of <15 minutes). The dagger represents significance at p < 0.013 compared with the prior wait time category per multiple pairwise comparisons following the Kruskal-Wallis test (overall confidence level of α = 0.05). The red dashed line represents the 33rd percentile cutoff for the Press Ganey total score. The error bars indicate the standard error of the mean.