Experiment Design
The study was structured into two main categories: a control group and an experimental group. In the first phase, both groups responded to questions regarding their expected waiting time (EWT) while also providing basic demographic information, including age, education, gender, and medical history. The key difference between the groups was the introduction of waiting-time reminders for the experimental group. After this intervention, participants in the experimental group received updated EWT information, which was collected when they entered the consultation room.
Outpatient visits at the hospital were categorized into peak and off-peak times based on patient volume. The peak hours were identified as being from 8:31 to 11:00 in the morning and from 13:31 to 15:30 in the afternoon, while all other times were considered off-peak. Utilizing average waiting time (AWT) data from July, a median AWT of 30 minutes during peak hours and 16 minutes during off-peak hours was established as a reference for EWT adjustments within the experimental group.
An effective adjustment was defined as when patients modified their expectations to align with the indicated 30-minute waiting time. For example, if a patient initially anticipated a 15-minute wait but later adjusted their EWT to 40 minutes following the notification, the gap between the original EWT and the 30-minute reminder would be 15 minutes, while the difference between the adjusted EWT and the reminder would be 10 minutes. The latter adjustment is viewed as more effective due to its alignment with the prompt information provided.
The next phase of the experiment was conducted as patients approached the consultation room and were assigned a specific number. This sequential method aimed to gather immediate feedback on patient experiences and expectations, thus allowing for a comprehensive analysis of how waiting-time reminders influenced EWT adjustments and overall satisfaction. The satisfaction levels for both groups were rated based on their AWT at the time they were called in, using a scale from 0 to 100, where 0 represented extreme dissatisfaction and 100 indicated total satisfaction. Higher scores reflected greater levels of contentment. Given that many patients book appointments online and can pay registration fees via mobile, these preliminary tasks can be efficiently handled from home or while traveling to the hospital. As a result, AWT in this study was understood as the duration between check-in and the moment of entering the consultation room.
The study’s timeline saw the control group receive interventions in July 2023, while the experimental group underwent the same schedule in August 2023. This timing was strategically chosen based on previous observations that indicated higher outpatient visit rates in pediatric hospitals during the summer months of July and August.
Experimental Participants
The participants in this research were patients and their parents visiting the pediatric endocrine clinic between July and August 2023. The study maintained anonymity and was self-administered by the patients and their guardians. The sample size calculation was based on the formula: \(n={\text{Z}}^{2}\text{P}(1-\text{P})/{\text{E}}^{2}\), where \(n\) represents the minimum sample size. The Z value corresponds to the normal standard deviation at a 95% confidence level (1.96), and P reflects the prevalence of the study factor, which was estimated at 80% from prior studies.
Experimental Implementation
The experiment was executed in two phases. The first phase commenced as soon as participants arrived in the waiting room, while the second phase involved a single question posed as they entered the consultation room.
In the initial phase for the control group, participants completed the first segment of the questionnaire upon signing in and entering the waiting area. This entire process, which included an explanation of informed consent, research objectives, and completion guidelines, took about six minutes. After filling out this segment, a staff member noted their registration code, date of visit, and check-in time on the back of the questionnaire, which was temporarily held by the participants. The implementation for the experimental group was similar to that of the control group, with the main distinction being that those visiting during peak and off-peak hours were informed about potential waiting times while completing the questionnaire, and they received the corresponding adjusted EWT.
In the second phase, as subjects approached the consultation room, staff collected the initial questionnaire from them. Following this, the time difference between entering the consultation room and check-in was calculated, representing the AWT. Participants were then asked to provide satisfaction scores based on this AWT, and their responses were quickly recorded. This segment of the questionnaire could be completed in about one minute.
Variables
The demographic variables measured included gender, age, hospital history, and education level. Initial EWT refers to the expected waiting time before any time-related information was provided. Adjusted EWT, applicable to the experimental group, reflects the waiting time expectation after receiving waiting time information. AWT is defined as the time difference between entering the consultation room and the time of check-in. To assess satisfaction, participants were asked to select a score from 0 to 100 to represent their feelings as they entered the consultation room, where 0 indicated extreme dissatisfaction and 100 indicated complete satisfaction.
Ethical Consideration
This research was conducted in accordance with the principles outlined in the Declaration of Helsinki and received approval from the Research Ethics Committee of the Children’s Hospital of Fudan University [No. (2023) 152]. Informed consent was obtained from all participants prior to the commencement of the experiment.
Statistical Methods
Data analysis was performed using IBM SPSS Statistics 22.0 software. Given that the waiting time data did not follow a normal distribution, Kolmogorov-Smirnov tests and Mann-Whitney U-tests were utilized to investigate any statistically significant differences in AWT or satisfaction scores between the control and experimental groups, with a p-value of < 0.05 indicating statistical significance. Additionally, Chi-square tests were employed to examine variations in satisfaction levels during peak versus off-peak hours, alongside the application of descriptive statistical methods.
