When I joined OrthoIllinois in 2022 and took on leadership responsibilities at Injury Express, our orthopedic urgent care practice was already delivering high-quality clinical care. But as I became more involved in reviewing our patient-experience data, I noticed that some of our biggest opportunities for improvement had little to do with the medical care itself. Many involved waiting.
In 2022, our overall patient satisfaction score was 92.10 percent. When we looked at the individual measures, however, there was room for improvement. Satisfaction with waiting time to the treatment area was 80.60 percent. The score for the wait after arrival to see a care provider was 82.03 percent. Our “moving through your visit” measure was 82.40 percent, while keeping patients informed about delays was 82.27 percent.
Looking at those individual measures was useful because it changed the conversation. Rather than simply asking how we could improve an overall satisfaction score, we started paying more attention to what patients were experiencing as they moved through the clinic.
Looking at the whole visit
Waiting in an orthopedic urgent care setting can be difficult to predict. Patients may need X-rays, splinting, procedures, additional evaluation, or transfer to a higher level of care. Several complex patients arriving within a short period can quickly affect the flow of the clinic.
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Communication certainly matters in that environment, but communication alone cannot solve a workflow problem. We needed to look at the entire visit: where patients were waiting, where bottlenecks were occurring, whether expectations were being set appropriately, and which parts of the process could realistically be improved.
This work was also part of a larger patient-experience effort at OrthoIllinois. In 2022, the organization established a five-year goal of reaching the 75th percentile across all service lines and created a dedicated patient-experience and process-improvement coordinator role. Over time, that effort expanded to include service standards, clinician feedback, leadership development, patient-experience measurement, and LEAN process improvement. As a physician leader at Injury Express, my role has been to help translate those broader organizational goals into what happens during a busy clinical day.
Waiting time and uncertainty are different problems
One thing I have learned is that some waiting is unavoidable in health care. What we can often improve is the uncertainty surrounding that wait.
A patient who has been waiting without an explanation may assume that he or she has been forgotten. When a member of the team explains why there is a delay, provides a realistic expectation, and updates the patient when circumstances change, the actual waiting time may not be different, but the experience can be.
At the same time, communication should not become an excuse for inefficient processes. If the same delay keeps occurring, it is worth asking whether something in the workflow needs to change. Over the four-year period, we saw substantial improvement in both areas.
- Satisfaction with waiting time to the treatment area increased from 80.60 percent in 2022 to 95.09 percent by June 2026, a 14.49 percentage-point improvement.
- Satisfaction with the wait after arrival to see a care provider increased from 82.03 percent to 94.71 percent.
- The score for moving through the visit overall increased from 82.40 percent to 94.69 percent.
- The measure for keeping patients informed about delays increased from 82.27 percent to 94.53 percent.
By June 2026, all of our reported wait-related scores exceeded 94 percent.
Looking beyond the overall score
Another lesson was the importance of looking beyond a single patient-satisfaction number. An overall score can tell you whether things are generally moving in the right direction, but it does not necessarily tell you what needs to be fixed. The individual survey questions and patient comments were often more useful.
If patients repeatedly mention waiting, for example, the next question should be where that waiting is occurring and why. If they consistently report that they are not being informed about delays, that may point to a communication problem. Other patterns may reveal issues with workflow, expectations, or how patients move from one stage of the visit to another.
Over time, OrthoIllinois developed several ways of responding to this information, including patient-experience dashboards, clinician feedback, service standards, communication training, service-recovery tools, and LEAN process-improvement training. For physicians and other clinicians working on the front lines, the practical challenge is taking that information and determining what can actually be changed during day-to-day care.
What the improvement meant
By June 2026, overall patient satisfaction at Injury Express had increased from 92.10 percent to 95.71 percent. I am proud of that improvement, but I do not think the lesson is simply that we found a way to increase a satisfaction score.
There was no single intervention responsible for these results, and the improvement cannot be attributed to one person. It involved physicians, advanced practice providers, nurses, staff, operational leaders, and patient-experience teams working on different parts of the same problem.
What changed for me over these four years was how I interpreted the data. A lower patient-experience measure was not necessarily evidence that someone needed to be friendlier or communicate better. Sometimes it pointed to a problem in how care was organized.
That distinction matters. Patient experience reflects not only what happens between a clinician and a patient, but also how effectively the larger system functions around that interaction.
If we want to fix the waiting room, we have to look beyond the waiting room. Patient experience in urgent care is a workflow issue too
Manoj Sreedharan is a board-certified family medicine physician and the medical director of Injury Express at OrthoIllinois in Rockford, Illinois. He is also an assistant professor at the University of Illinois College of Medicine Rockford and a practicing emergency medicine physician at MercyOne Clinton in Iowa.
His work focuses on health care quality improvement, patient safety, patient experience, clinical operations, and evidence-based medicine. He is actively involved in clinical research, including biologic therapies for rheumatologic conditions, and serves as a peer reviewer for medical journals. He is passionate about advancing health care through physician leadership, medical education, and continuous quality improvement.
His peer-reviewed work includes a study of blood pressure control among U.S. adults with hypertension stratified by glucagon-like peptide-1 (GLP-1) receptor agonist use, drawn from the National Health and Nutrition Examination Survey, 2017 to 2020. He shares updates on LinkedIn.m
