The single change that will transform your COVID-19 testing

There are several widely-accepted pillars in the fight to overcome a pandemic. Among them are distancing, density control, testing, contact tracing, isolating, and wearing face masks. But near-universal acceptance – at least by the healthcare community – doesn’t mean implementing these measures is simple. Putting politics aside, we face the ongoing challenges of insufficient resources, including hospital space, equipment, staff, and PPE. And, of course, with any type of public health issue, we struggle with getting people to comply.

But we’ve made progress.

One area in which we’ve experienced improvement is in our testing. Now, getting results back to patients promptly remains an issue. But at least we’ve been able to increase the number of people being tested significantly. However, even with the progress we’ve made in this area, we can still improve.

Looking beyond the obvious challenge with having insufficient resources, there is one single change you can make that will transform your testing process.

That one change is embracing and applying queue theory. In layman’s terms, queue theory is all about how to most efficiently and effectively get people through a line. Unfortunately, we are all familiar with waiting in lines. It’s no fun. But, we also all know that in some situations, the experience is much better than in others. For the places that get it right, it’s not by happenstance. It’s because they’ve applied queuing theory principles.

Here are some ways you can apply some line science to your testing efforts.

Require appointments

Having all patients set appointments knocks out many typical queuing issues in one fell swoop.

A common complaint from patients is the time they have to wait to be tested. In the hundreds of outdoor testing facilities that have popped up, it’s not uncommon for people to have to wait for hours in their car before they can be tested. That’s a horrible experience for anyone, but especially for someone who is sick and needs to be resting.

In queue theory, two ways to speed up the process are to add more people to provide the service and to shorten the time it takes to administer the service. By requiring patients to book an appointment, you can prevent having to add more staff, and you can avoid having to rush through the testing process. Taking time to administer the test properly is critical to increasing the likelihood of accurate results.

Another principle that is crucial to get people through a line efficiently is queue discipline. That means having strict rules and adhering to them. When you have hundreds of cars lined up, or a filled-to-capacity waiting area at your facility, there is a lot of pressure to bend the rules. Because appointment scheduling controls the flow of patients, it allows you to maintain discipline.

Focus on how they feel

Queue psychology is part of queue theory. Research shows that even in situations in which the wait time is extended, if there is a focus on making it a more pleasant experience, it makes a big difference.

One way to do this is to try to keep communication flowing. Providing estimated wait times is helpful. If it’s not possible to do that, a simple “We haven’t forgotten about you” message is welcomed. And if it can be delivered personally, all the better. For example, in the outdoor testing scenario, having someone go car-to-car letting them know they haven’t been forgotten will be very much appreciated. It also allows people to ask questions.

If the wait is going to be longer than expected, always give a very specific reason why. People don’t want to hear a vague “We’re experiencing longer wait times.” It just frustrates them. They want to know why.

Another simple strategy is to have them feel like the process has started. In-and-Out Burger has mastered this. They have an individual walking along the car line taking orders. Even if the wait is 30 minutes, at least the customers feel like the process has started. In the case of testing, it’s not unusual to have patients fill out paperwork while waiting. But go beyond that. Provide them information on exactly how the process will go and what they can expect.

Similar to that, find ways to engage them with distractions. Give them a page of trivia questions – they can even be educational – or other simple games.

Also, find ways to re-humanize the process. Although wearing masks is critically important to control the spread of the virus, it’s uncomfortably dehumanizing. It’s amazing how much we depend on the lower half of our faces to communicate. The eyes can say a lot, but nothing can take the place of a smiling mouth to convey happiness or acceptance.

Imagine being approached by someone in full PPE, which is the experience for thousands at temporary testing facilities. Our lizard brains are expecting a human, complete with all the common characteristics of a human. But we get what looks like a robot. While the protection of our healthcare workers is essential, what they look like can create a lot of angst.

So why not re-humanize the process?

Some simple actions can go a long way. One thing you can do is to wear a name tag. If you can include some humor on it, all the better. For example, your name tag may say, “Mary Jones. Yes, it’s a human underneath this getup.” Or hang a smiling picture of yourself around your neck or pinned to your clothes.

Even saying something that breaks up the seriousness of masks or other PPE can help. For instance, you could say, “I know I look scary, but I’m pretty harmless underneath.” And, of course, just old-fashioned friendliness, even if they can’t see your mouth, helps them to remember that we’re all just people.

Testing for the COVID-19 virus is critically important in our fight to control this pandemic. And, because of the efforts of thousands, we’ve made incredible strides in our testing capacity. But, we can always do better. If you’re involved with testing, apply some of these principles of queuing theory. While none of us like to wait, there are definitely steps we can take to make it a more pleasant experience.