CIT, or Critical Incident Technique,

CIT, or Critical Incident Technique, is a set of procedures that use direct observation of human behavior to meet definable criteria and help develop a flexible assessment of a particular set of behaviors, and incident, or an industry. It is used in a variety of ways, particularly in contemporary marketing and customer satisfaction studies in which individuals are able to form opinions based on a number of individual responses that, when combined, form a synergistic approach to the issue. For instance, CIT is widely used in organizational development as a research tool for identification of organizational breakdowns or areas of emphasis, which even sometimes are quite positive. It is used as an interview technique to help solve problems (White, 2005).

Issue - One very common area of stress for many people is the waiting room in the healthcare profession; particularly crowded doctor's offices in which appointments are not always possible to set in advance as in dental, eye care, or preventative medicine. Patients tend to be anxious, particularly if they are in pain or discomfort; and most waiting rooms are not conducive to relaxation or a patient centered approach. Often, too, due to the nature of modern medical care, the professionals are running late or overbooked, also stressors (Frampton, et al., eds., 2009).

Scenario- General Internist Office in upper middle class suburb. Five doctors share office, there are three receptionists; and 15 seats for patients. Receptionist notes that appointments are generally scheduled in 15 minute intervals, from 9am-1pm, and 2pm-6pm; Monday through Thursday. Most forms of insurance are accepted.

Participants - Four individuals; 2 male, 2 female. 1 M -- 26; 1 M -- 24; 1 F -- 39; 1 F- 25. All with at least some college. 2 Caucasians, 1 Latina, 1 Black. Within a two-week period, each had an appointment with one of the doctors at the Internal Medicine Clinic; two appointments were for route in blood work or checkups; 1 for a persistent flu; 1 for a work related burn follow up from Emergency service two days prior.

Critical Incident Issue -- Level of stress in the waiting room for XYZ Clinic. Only frequencies of 2 + were noted and only those with importance level of 1 (extremely important) or 2 (important) were noted.

Type of Incident

Frequency

Importance

Excessive wait time (> 30 minutes)

4

1

Atmosphere of waiting area pleasant, chairs comfortable

3

2

Regular interaction with reception; realistic expectations

3

2

Resources while waiting; magazines, Wi-Fi, television, etc.

2

2

We are aware that a sample of 4 is not large enough to be statistically inclusive of a larger population. However, based on dialog within the waiting room over a number of days, we did come to the conclusion that many of the patient's in the waiting room had similar opinions. Further, we believe that further analysis would show that there was a deeper and broader set of expectations and experiences that might go far to improve service and patient expectations at the clinic.