title: Why patients should arrive late: The impact of arrival time on patient satisfaction in an academic clinic.
abstract: BACKGROUND
  When considering quality improvement of healthcare practices, patient flow, wait time, and satisfaction are important factors to monitor. Patient wait time can affect satisfaction with the care received, and it can be dependent on many different factors. The purpose of this study was to investigate the impact of patients' arrival times to his/her appointment (early vs. on time vs. late) on patients' wait times and satisfaction.
  
  
  METHODS
  171 patients in an otolaryngology outpatient clinic completed surveys that asked them to record wait times in various areas of the clinic and to provide a satisfaction level for these wait times. Statistical analysis tested for any significant differences in wait time and satisfaction for patients that arrived early, on time, or late.
  
  
  RESULTS
  Late, on time, and early arriving patients spent 18.2, 30.7, and 38.8min in the waiting room, respectively. Late, on time, and early arriving patients had a total visit length of 57.4, 68.6, and 81.9min, respectively. There was a significant difference with total time spent in the clinic (p=0.0034) and for overall satisfaction with the total length of the visit (p=0.0202) between late and early arriving patients.
  
  
  CONCLUSIONS
  This study indicates patients arriving late had shorter wait times and, not surprisingly, were more satisfied with the visit. The study provides evidence that patients view their wait as starting when they arrive to the clinic and not the actual time of the appointment. It questions the traditional scheduling systems that many clinics still use and proposes that there may be "out-of-the-box" approaches that positively impact patient satisfaction.
authors.affiliation: Texas Tech Health Sciences Center School of Medicine, Lubbock, TX, United States. Electronic address: Allen.Medway@ttuhsc.edu.
authors.forename: Allen M
authors.initials: AM
authors.lastname: Medway
authors.affiliation: Texas Tech Health Sciences Center School of Medicine, Department of Urology, Lubbock, TX, United States. Electronic address: Werner.Deriese@ttuhsc.edu.
authors.forename: Werner T W
authors.initials: WT
authors.lastname: de Riese
authors.affiliation: Texas Tech Health Sciences Center School of Medicine, Department of Obstetrics and Gynecology, Lubbock, TX, United States. Electronic address: deriesec@gmail.com.
authors.forename: Cornelia S
authors.initials: CS
authors.lastname: de Riese
authors.affiliation: Texas Tech Health Sciences Center School of Medicine, Division of Otolaryngology, Lubbock, TX, United States. Electronic address: Joehassin.Cordero@ttuhsc.edu.
authors.forename: Joehassin
authors.initials: J
authors.lastname: Cordero
mesh_terms: D000554:Ambulatory Care Facilities; D001071:Appointments and Schedules; D003430:Cross-Sectional Studies; D006801:Humans; D010036:Otolaryngology; D010045:Outpatients / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D013781:Texas; D013997:Time Factors
keywords: Arrival time; Patient flow; Patient satisfaction; Scheduling; Wait time