Reducing Abandonment and Improving Attitudes in Emergency Departments : Integrating Delay Announcements into Operational Transparency to Signal Service Quality

Problem definition: Emergency Departments (EDs) impose a complicated service process on patients and accompanying family members (from now: people). ED patients typically encounter long waits, various procedures, and multiple staff members. People lack knowledge about the various elements their ED journey will comprise. We suggest that providing people Personalized Information about Operations and Time (PIOT), i.e., information about the procedures and anticipated wait times, will improve their sense of understanding and sense of progress during the ED journey, resulting in improved satisfaction. PIOT is also expected to directly reduce patients' likelihood of abandonment. We combine research on operational transparency (shown to improve attitudes) and delay announcements (shown to reduce abandonment). We build on signal theory to argue that PIOT signals service quality, thereby inducing positive outcomes. We show that perceptions of understanding and progress play an essential role in the complex context of medical service.Methodology/results: We ran a field study in a medium-sized hospital to test how PIOT affects people during their ED stay. PIOT is provided in "MyED'‘, a system based on Electronical Medical Records (EMRs) that reveals elements of the ED journey previously unknown to patients and family members. We tracked people's use of the system, and varied two dimensions of PIOT (i.e., operational and time information) over four cycles, or two weeks each. We show that providing operational information is enough to improve people's sense of understanding, but to improve people's sense of progress and satisfaction time information also needs to be provided. Interestingly, PIOT reduced patients' likelihood to abandon the ED by 26.67% (from 3% to 2.2%), but only if time information was not provided.Managerial implications: Providing PIOT offers a novel approach to improving healthcare service, addressing typically overlooked psychological needs of people in EDs for information and understanding