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Community health centers grapple with high no-show rates, posing challenges to patient access and primary care provider (PCP) utilization. To address these challenges, we implemented a virtual waiting room (VWR) program in April 2023 to enhance patient access and boost PCP utilization. Academic community health center in a small urban city in Massachusetts. Community health patients (n = 8706) and PCP (n = 14). The VWR program, initiated in April 2023, involved nurse triage of same-day visit requests for telehealth appropriateness, then placing patients in a standby pool to fill in as a telehealth visit for no-shows or last-minute cancellations in PCP schedules. Post-implementation, clinic utilization rates between July and September improved from 75.2% in 2022 to 81.2% in 2023 (p < 0.01). PCP feedback was universally positive. Patients experienced a mean wait time of 1.9 h, offering a timely and convenient alternative to urgent care or the ER. The VWR is aligned with the quadruple aim of improving patient experience, population health, cost-effectiveness, and PCP satisfaction through improving same-day access and improving PCP schedule utilization. This innovative and reproducible approach in outpatient offices utilizing telehealth holds the potential for enhancing timely access across various medical disciplines.

If we cannot store all edges in a dynamic graph, which edges should we store to estimate the triangle count accurately? Counting triangles (i.e., cliques of size three) is a fundamental graph problem with many applications in social network analysis, web mining, anomaly detection, etc. Recently, much effort has been made to accurately estimate the counts of global triangles (i.e., all triangles) and local triangles (i.e., all triangle incident to each node) in large dynamic graphs, especially with limited space. Although existing algorithms use sampling techniques without considering temporal dependencies in edges, we observe temporal locality in the formation of triangles in real dynamic graphs. That is, future edges are more likely to form triangles with recent edges than with older edges. In this work, we propose a family of single-pass streaming algorithms called Waiting-Room Sampling (WRS) for estimating the counts of global and local triangles in a fully dynamic graph, where edges are inserted and deleted over time, within a fixed memory budget. WRS exploits the temporal locality by always storing the most recent edges, which future edges are more likely to form triangles with, in the waiting room, while it uses reservoir sampling and its variant for the remaining edges. Our theoretical and empirical analyses show that WRS is: (a) Fast and ‘any time’: runs in linear time, always maintaining and updating estimates, while the input graph evolves, (b) Effective: yields up to 47% smaller estimation error than its best competitors, and (c) Theoretically sound: gives unbiased estimates with small variances under the temporal locality.

This study explores the waiting space environment of pediatric clinics in general hospitals and the relationships between the use of space, behavioral activities and overall satisfaction. Patients often spend a lot of time waiting for doctors, and child patients waiting to be seen are particularly likely to feel bored, depressed and anxious, which negatively affects their overall experience of seeking medical attention. Since the launch of China’s second-child policy, the number of children born in China has surged. As medical resources for children are in short supply and of uneven quality, it is urgently necessary to carry out research on optimizing the design of children’s waiting space in Chinese hospitals to improve their medical environment and experience. Method: This study identified four first-level indicators and twenty-seven second-level indicators in four dimensions: functional layout (layout and area), flow organization, supporting facilities and environmental details (physical and landscape environment). The research combined subjective and objective methods, including comprehensive observation, a questionnaire survey and interviews, taking three hospitals in Shenzhen as case studies. Results: The study found that the waiting space in pediatric clinics currently fails to meet key patient needs in areas such as mother and infant rooms, children’s play areas and drinking water facilities, and there are widespread problems with the creation of natural environments, such as views of natural scenery from windows and indoor green plants. Six factors were found to significantly positively influence overall satisfaction with waiting space, describing 69.76% of the changes in the respondents’ degree of satisfaction with the waiting environment. Supporting facilities and aspects of the physical environment had the greatest influence on overall satisfaction with the waiting space. Conclusion: Optimizing the design of the waiting space in pediatric clinics, with a focus on functional layout, flow organization, supporting facilities and environmental details, can improve overall satisfaction with pediatric waiting rooms. The results are preliminary; they need to be further tested in practice to complete the process of evidence-based design. This will lead to suggestions for refining the design of pediatric waiting units which can be used by architects and hospital administrators.

Presenting attractive and useful health education materials in waiting rooms can help improve an organization’s health literacy responsiveness. However, it is unclear to what extent patients may be interested in health education materials, such as brochures. We conducted a three-week field study in waiting rooms of three primary care centers in Groningen. Three versions of a brochure on doctor-patient communication were randomly distributed, 2250 in total. One version contained six short photo stories, another version was non-narrative but contained comparable photos, and the third version was a traditional brochure. Each day we counted how many brochures were taken. We also asked patients (N = 471) to participate in a brief interview. Patients who consented (N = 390) were asked if they had noticed the brochure. If yes (N = 135), they were asked why they had or had not browsed the brochure, and why they had or had not taken it. Interview responses were categorized by two authors. Only 2.9% of the brochures were taken; no significant association with brochure version was found. Analysis of the interview data showed that the version with the photo narrative was noticed significantly more often than the non-narrative version or the traditional version. These results suggest that designing attractive and comprehensible health materials is not enough. Healthcare organizations should also create effective strategies to reach their target population.

To evaluate the rate of return visits to the emergency department (ED) within 72 hours of discharge for patients evaluated in the waiting room. ED crowding challenges throughput, and we hypothesized that some patients may be suitable for the completion of evaluation without rooming. This was a single-center retrospective analysis of a tertiary hospital ED. The primary outcome was 72-hour returns following discharge from the ED, stratified by location of initial physician evaluation and discharge: waiting room only, waiting room followed by treatment space, and treatment space only. Categorical data were compared using a chi-squared test and continuous data using a one-way analysis of variance with Bonferroni correction. The primary outcome was analyzed using a chi-squared test adjusting for age, biologic sex, Emergency Severity Index, primary language, time of day, and day of the week using logistic regression. There was a statistically significant overall difference in return visits within 72 hours of discharge based on the ED location where the evaluation occurred (P < .05; 5.0% in the waiting room only, 4.4% in the waiting room followed by treatment space, and 4.9% in the treatment space only). However, when comparing groups individually, there was a significantly lower rate of 72-hour return only for patients seen in the waiting room followed by a treatment space compared with treatment space only (P = .032). The patients evaluated and discharged from the waiting room tended to be younger, more likely to be male, with lower acuity Emergency Severity Index scores, and typically seen during an evening shift compared with the patients who were evaluated in a treatment space during their visit. There was no significant increase in the rate of return for those patients seen primarily in the waiting room or for those where the initial work up started in the waiting room compared with those who were placed in a treatment space prior to a physician evaluation.

Lighting ambience in architecture is one of the important factors affecting the emotions of people, and the study of the psychological needs of architectural lighting may provide more rational guidelines for architectural design. There are many previous studies on the emotional impact of lighting in architecture, but most of them use a dimensional model of emotion to analyse emotions, which is difficult for the reader to understand. In this study, we used the dimensional model of emotion to analyse emotions and converted it into easily understood basic emotions through the PAD model. Participants (n = 32) were divided into three groups and subjected to three scenes with different colour combinations. The analysis showed that the arousal and dominance of the participants were significantly affected from white to coloured light. No effect on comfort was observed between white and coloured light. Our study suggests that the use of coloured lighting instead of white lights in a non-clinic windowless waiting room may not improve negative mood.

In the past decade, Internet of Things (IoT) technologies have become more and more pervasive, allowing the development of Ambient Intelligence and Context Awareness applications. While the smart home is the chosen scenario for such technologies, a variety of environments could potentially benefit from the synergies between IoT and digital applications. Among them, the clinical waiting rooms is an environment facing several challenges, particularly after the COVID-19 pandemic. Clinical waiting rooms are crowded places associated with stress and anxiety, often linked to patients’ idling time. Nonetheless, the rise of IoT-enabled telehealth has focused attention on the possibility of changing the functions of clinical waiting rooms. In this work, we conducted a systematic literature review to identify the existing solutions for “smart waiting rooms”. The review process started with 278 works, and it identified 16 papers relevant to the topic of smart clinical waiting rooms. Moreover, the results of this review underlined that waiting rooms are a neglected research area that could take advantage of IoT and Artificial Intelligence (AI) technologies to enhance patients’ experience and support the diagnostic process. Leveraging the research directions identified in the review process, this work proposes a “Smart Waiting Room” that exploits virtual reality (VR), AI, and IoT technologies to support the diagnostic process (via a cognitive assessment) and the personalization of the patient’s context—taking into account the features of the physical environment. The prototypical smart waiting room constitutes an example of the potentialities of novel technologies applied to healthcare and can contribute to shaping the future of clinical waiting rooms.

The setting of railway station waiting room and waiting zones relates to passengers' feeling and satisfaction. In this article, the authors develop an optimization model for railway station waiting room assignment, as well as considering adjustment of platforms. With four types of improvement strategies: zone optimization, room optimization, time optimization and interactive priority policy, this optimal model aims to effectively and efficiently improve the railway service quality and security.

The increasing burden of chronic diseases in the United States presents a major challenge to the nation’s primary care systems, so improving the efficacy and efficiency of patient education is an important goal. Understanding the current perspectives, practices, and needs of primary care providers should guide innovation towards this end. As a part of the authors’ongoing quality improvement work, a short internet survey was an effective method of enhancing this understanding in one health care system. With a response rate of 24.6 %, the survey revealed that primary care waiting rooms in the health system studied are not conceived of or used by providers as spaces to engage patients in health education. To change this, providers suggested using both printed and technological methods for delivering health information, primarily related to medications, diabetes, and healthy lifestyle practices. Common barriers to improvement cited by providers included diverse language and literacy backgrounds in the patient population, as well as difficulty sustaining change due to infrastructural and administrative barriers. These results suggest steps for development, implementation, and investigation of new educational interventions for patients in the local primary care context.