Why patients should arrive late: The impact of arrival time on patient satisfaction in an academic clinic.

INTRODUCTION: 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.

Tissue procurement strategies affect the protein biochemistry of human heart samples.

The ability to analyze the biochemical properties of human cardiac tissue is critical both to an understanding of cardiac pathology and also to the development of novel pharmacotherapies. However current strategies for tissue procurement are not uniform and are potentially biased. In this study we contrasted several commonly used approaches for tissue sampling in order to determine their impact on contractile protein biochemistry. Not surprisingly our results show that different tissue handling strategies have the potential to produce a wide variation in the phosphorylation and proteolysis of selected contractile proteins. However this was not uniform: phosphorylation of troponin I (TnI) and myosin light chain 2 (MLC2) varied significantly depending on approach whereas changes in desmin and myosin binding protein C (MyBP-C) were relatively unaffected. Moreover, some strategies increased whereas others reduced TnI phosphorylation, suggesting a dynamic balance between kinase and phosphatase activities. Overall, procurement strategies that involved maintenance of tissue in cardioplegia solution deviated most dramatically from prompt and rapid tissue immersion in liquid nitrogen.