The role of role play educational videos in increasing tolerance to triage waiting time

Research question: do the health education role-play videos increase the triage waiting time tolerance? Objective: to determine whether the use of the health education role-play videos increase the triage waiting time tolerance. Setting: the setting of the study will be The Al-Ain Hospital. The Al-Ain Hospital is located in the central part of Jimi district and is linked to the University of United Arab Emirates as a training center. The hospital sits in old buildings from the 70s, however, a new building for the hospital is under construction. In 2007, the management of the hospital was taken over by the Medical University of Vienna. Conclusion: the study will show that the use of the health education role-play videos in the triage waiting rooms was shown to increase the triage waiting time tolerance.

Besides, the use of the health education role-play videos in the patient waiting rooms was reported to improve the quality of healthcare services in the hospital, improve and promote patient satisfaction, and increases the health knowledge of the patient. Keywords: waiting room, waiting time tolerance, patient education, health education videos. Introduction The doctor-patient encounter is a dynamic and complex interaction that takes a considerable amount of time and often result in long triage waiting time. This is of particular concern especially for the emergency department where every passing second or minute is crucial given that mortality rates have been shown to be as high as eighty-five percent in patients arriving here within the first 20 minutes of arrival (Imperato, Morris, Sanchez & Setnik, 2013).

Patients have described the long triage waiting times as intolerable during their clinical encounters and acts as barriers to receiving healthcare services (Houston et al. The increasing triage waiting time has also been demonstrated to be among the single major barriers to the evidence-based practice in the provision of primary healthcare (French, Lindo, Jean & Williams-Johnson, 2014). Due to impatience, the Patient-doctor consultations may end up with incomplete information and unanswered questions since physicians will spend a good part of the consultation eliciting the symptoms and signs of the patient to establish the diagnosis (Mahmoodian, Eqtesadi & Ghareghani, 2014). As a result, less time is available for the physician to explain to the patient the nature of the disease or condition and as such health education does not happen properly.

Additionally, the physician is left frustrated because of unaccomplished work (Kumari, Amberkar & Nandit, 2012). While the triage waiting time may be long, the engagement that the patient gets from watching the video will lift the anxiety of waiting and the resulting impatience and in the end they will feel satisfied with the healthcare services of a facility (Amina et al. According to a survey, most patients feel that the quality of healthcare and physician encounters is directly related to impression during the triage waiting in the waiting room (Sherwin, McKeown, Evans & Bhattacharyya, 2013). Additionally, these videos are often informational and their role in distracting the patient further eases their stress. The triage waiting times of uncertain length makes it harder for the patients to tolerate the wait.

Besides, the nursing staff within the healthcare facility will say nothing regarding the triage wait since they are embarrassed and they do not know how to estimate the time for the wait (Greene & Hall, 2012). In the healthcare facilities, waiting rooms presents a space of boredom and frustration both for the patients as well as the physicians particularly when the waiting time become intolerable and undesirably long. In the Middle East and gulf area UAE / Dubai, some healthcare facilities uses role play videos in increasing time tolerance in the patient waiting rooms. These videos help the waiting patients to be engaged and pass time before they get to see the physician (Williams, Prabandari & LaBresh, 2015). With right video library and content, the role play videos in the patient waiting rooms offer various benefits to the patients in the Middle East and gulf area UAE / Dubai.

This will improve the experiences of the patients leading to patient satisfaction (Beckwith, Jean-Baptiste & Katz, 2016). Customer care is the third level of service delivery by the hospital which aims to provide adequate customer services to the clients, prompt feedback and ensures high level customer satisfaction. Al-Ain hospital operates with over 30 specialist departments which are served by an approximate 300 doctors, the hospital has 3 medical clinics with an inpatient capacity of over 20,000 and over 32,000 outpatient clinics (Seha. ae, n. d). The hospital has a staff mix of different cadres from different nationalities who work tirelessly providing high-quality patient care. Studies that included any other patient. Time October 2017 – January 2018 Before October 2017 Intervention Interventions involving a health education role-play triage waiting room video which was developed and installed in the patient waiting room.

Studies not involving a health education role-play triage waiting room video which was developed and installed in the patient waiting room. Studies not involving other interventions. Design A Qualitative research Phenomenology and the data was collected through observation. This will be measured using 4-point Scale that ranged from short (with a score of 0) to too long (with a score of 3). Data analysis The prior sample size will be determined and found to be 1132 participants of which 581 of them will be in the waiting room that will have health education videos while the other 551 will be in the waiting room where there will be no health education videos for 90% power and 0. 05 significance to detect for the 5% improvement between the two study groups using the means and parametric sample size determination (Taylor & Benger, 2004).

This approach will be used for its simplicity and the difference will be based between the results of the participants in the waiting room that will have health education videos and the results of the participants in the waiting room where there will be no health education videos, with the aim of improving the triage time tolerance of the participants. The comparison of the proportions will be done with the use of the χ2 analysis (Kasssan, 2008). The possible explanation for the increased triage waiting time tolerance include: educational videos have been linked to the increasing patient satisfaction. While the triage waiting time may be long, the engagement that the patient gets from watching the video will lift the anxiety of waiting and the resulting impatience and in the end they will feel satisfied with the healthcare services of a facility (Amina et al.

According to a survey, most patients feel that the quality of healthcare and physician encounters is directly related to impression during the triage waiting in the waiting room (Sherwin, McKeown, Evans & Bhattacharyya, 2013). Additionally, these videos are often informational and their role in distracting the patient further eases their stress. Besides, when the patients do not have something that keeps them busy and engaged, the triage wait time will feel longer as compared to when the patients have something keeping them busy and engaged (Gignon, Idris, Manaouil, & Ganry, 2012). Unsatisfied patients will get bored if the wait is too long, and if the triage waiting time is longer than expected, they will lose their patience and they are likely to leave the hospital even before seeing their physician (Papa et al.

The use of the health education role-play videos in the triage waiting rooms provides a patient-education approach that is low-cost and an effective means of improving the overall patient satisfaction, improving healthcare staff performance, improving the quality of the healthcare services and patient safety, and most importantly, increasing the triage waiting time tolerance for the patients (Willis, Ozturk & Chandra, 2015). Through the study, it was also found that the use of the health education role-play videos in the waiting rooms, the patients had the highest patient information and satisfaction as compared to the use of the written health education materials like flyers and leaflets (Göttlich, 2015). Apart from keeping the patients captivated and engaged, the health education role-play videos were advantageous to the illiterate patients or low-level literacy patients who are not able to read and understand the written information (de Oliveira Souza et al.

Such patients are likely to get bored if only written health education material is provided in the patient waiting rooms. Limitations of the study The major limitation of this study is that the participants were not randomized and that the study took place only in one site. The historical control studies have suggested that this research design is a valid method and assumes that some of the important confounders have been accounted for. To account for the differences in the two study groups, the baseline characteristics of the participants were assessed as well as the triage time tolerance and overall patient satisfaction (Waltz, 2017). The demographic data were not statistically different but comparable in the two study groups, and this included the actual patient stay in the waiting rooms (Harding, Leggat, Bowers, Stafford & Taylor, 2013).

Furthermore the effects of several covariates on the triage time tolerance and overall satisfaction of the patients was assessed by the use of multivariate analysis and it was revealed that the health education role-play triage waiting room videos was the strongest predictor (Ardagh et al. The intervention fidelity involves asking the participants, who are the waiting patients whether they were understanding the research intervention. Besides, no surrogate marker of fidelity was applied ion the study (Ansell, Crispo, Simard & Bjerre, 2017). The study did not have blinding, and this implies that there is possibility that biased assessment was done. The research assistant was not blinded and he is the same research assistant who was used in performing the study in the two study groups (Weingessel, Wahl & Vécsei‐Marlovits, 2018).

In the future studies aimed at determining the triage time tolerance, the design issues discussed under the limitations of this study should be considered and if possible corrected. Indeed, the development and use of the health education role-play videos in the patient waiting rooms is a noble idea with tremendous benefits both to the patient and the healthcare facilities and should be embraced by the healthcare facilities in the waiting rooms in the various departments to ensure that the triage waiting time tolerance of the patients is increased, the patients get satisfied, educated on the various healthcare issues, provided with the information regarding the various procedures and processes of the hospital including the hospital workflow, while keeping the patients busy and engaged (Gignon, Idris, Manaouil & Ganry, 2012).

Recommendations From the results of this study, the use of the health education role-play videos in the triage waiting rooms was shown to increase the triage waiting time tolerance. Thus, it is necessary that future studies are done to determine the other factors that increases the triage waiting time tolerance. This will be important since sometimes the hospital workflow system has issues and the patient have to wait for triage longer than expected. Increasing the triage waiting time tolerance of the patients is important and will ensure that they receive the highest quality medical care and healthcare services without putting much pressure on the physicians to hurry as this could be costly considering they are dealing with human lives. A. , & Feazbakhsh, N.

Measuring and analyzing waiting time indicators of patients’ admitted in emergency department: a case study. Global journal of health science, 8(1), 143. Ajami, S. , Soltanian, A. R. , KIMIAIE, A. H. , & SALIMI, R. R. G. , & Poeze, M. Fast Track by physician assistants shortens waiting and turnaround times of trauma patients in an emergency department. European Journal of Trauma and Emergency Surgery, 40(1), 87-91. , Manaouil, C. , & Ganry, O. The waiting room: vector for health education? the general practitioner’s point of view. BMC research notes, 5(1), 511. Sherwin, H. , & Horn, M. S. (2014, June). Waiting for learning: designing interactive education materials for patient waiting areas. In Proceedings of the 2014 conference on interaction design and children (pp. K. , Ozturk, A. O. , & Chandra, A. The impact of patient-to-patient interaction in health facility waiting rooms on their perception of health professionals.

R. , Khorasani-Zavareh, D. , Azizi-Naghdloo, F. , Hoseini, M. A. L. , Jean, E. W. W. , & Williams-Johnson, J. Kumari, K. M. , Amberkar, M. , & Nandit, P. B. Revue medicale de Liege, 66(4), 199-204. Papa, L. , Seaberg, D. C. , Rees, E. L. , Agada, N. O. , Bessman, S. C. Sun, B. C. , Brinkley, M. , Morrissey, J. , Rice, P. & Moreau, K. Education in the Waiting Room: Description of a Pediatric Emergency Department Educational Initiative. Pediatric emergency care, 33(10), e87-e91. Cassidy-Smith, T. N. , & Wood, K. Patient satisfaction data as a quality indicator: a tale of two emergency departments. Academic Emergency Medicine, 10(3), 261-268. Taylor, C. , & Benger, J. , Ozturk, A. O. , & Chandra, A. The impact of patient-to-patient interaction in health facility waiting rooms on their perception of health professionals. Hospital topics, 93(1), 13-18.

In Proceedings of the 2014 conference on interaction design and children (pp. ACM. Sherwin, H. N. , McKeown, M. , Silva, P. A. B. , Silva, L. B. Tako, A. A. , Kotiadis, K. , Vasilakis, C. , Miras, A. Waiting on Others: Gender in the Medical Waiting Room. In Sociological Forum (Vol. 32, No. 4, pp. Strathmann, C. , & Vécsei‐Marlovits, P. V. Patients’ maximum acceptable waiting time for cataract surgery: a comparison at two time‐points 7 years apart. Acta ophthalmologica, 96(1), 88-94. Weingessel, B. M. Interventions to reduce wait times for primary care appointments: a systematic review. BMC health services research, 17(1), 295. Naiker, U. , FitzGerald, G. , Simera, I. & Grilli, R. Interventions to reduce waiting times for elective procedures. The Cochrane Library. Moscelli, G. Kreindler, S. A. Watching Your Wait: Evidence‐Informed Strategies for Reducing Health Care Wait Times.