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OUTPATIENT BLUES

OUTPATIENT BLUES. Antoine van Gelder Pretoria Academic Hospital TOC Upgrade Workshop August 1991. Undesired Effects. Staff dissatisfaction: Nurses Doctors Long patient waiting time (12+ weeks) Patient dissatisfaction High level of “no shows” (up to 25%) Overcrowded waiting areas

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OUTPATIENT BLUES

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  1. OUTPATIENT BLUES Antoine van Gelder Pretoria Academic Hospital TOC Upgrade Workshop August 1991

  2. Undesired Effects Staff dissatisfaction: • Nurses • Doctors Long patient waiting time (12+ weeks) Patient dissatisfaction High level of “no shows” (up to 25%) Overcrowded waiting areas Records often unavailable

  3. Undesired Effects Doctors’ complaints: • Wasting time (no shows) • Too many patients per session • Records usually not available • Nurse in charge “uncooperative” Nurses’ complaints: • Doctors arrive late & leave early • Many no shows • Records slow in reaching clinic

  4. Undesired Effects Patients’ complaints: • Doctors often late • Impatient doctors and nurses • Short consultation time • Long wait to see doctor • Overcrowding in waiting area

  5. Current Reality Tree (CRT)

  6. CRT

  7. CRT

  8. CRT

  9. Evaporating Cloud

  10. Actions • Institute appointments for clinic • Inform staff of appointment system • Obtain telephone numbers of patients • Maintain a waiting list (Buffer) (nurse in charge) • 1 week check by telephone • fill vacancies by telephone

  11. Results • Average waiting time decreased from 12 weeks to 4 weeks • Clinic time and space utilization increased from 60% to 90% • Patient complaints changed to long waiting time for medicines

  12. Results • Doctors complaints about nurses stopped • Nurses complaints about doctors stopped • Records still not available in clinic

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