Student Dissertation

Agency : Radiology, Primary Health Check-up Station, Turnaround Time, OPD, EHCC

Objective : To reduce the TAT of patients in OPD by Root Cause Analysis ï‚· To observe the investigation process in OPD. ï‚· To understand the process flow at PHC. ï‚· To calculate TAT of patients after investigation at PHC ï‚· To calculate the TAT of OPD & IPD patients after investigations in Radiology Department. ï‚· To propose alternatives to make the patient flow process of investigations efficient with reduced waiting time.

Background : ‘OPD often called as shop window of the hospital. At EHCC a team of highly qualified and experienced medical personnel has developed the Health Check Program. For ease of patients a separate station is established in OPD known as Preventive Health Check-up 13 (PHC) station. Due to increasing patient loads, higher patient expectations are there, evolving new subspecialty services, and on-going research activities, clinic operations became complicated and inefficient. There were increasingly negative sentiments from patients, with many encountering long periods of waiting, often spending nearly a day at the hospital when they came with appointments. Confusion and disorder arose when patients had multiple same day appointments, as there was a lack of coordinated workflows between care providers.

Methodology : 1. Study type & design: It is a Qualitative, Analytical, Applied and Empirical type of study. 2. Type of data and collection method: Primary data collected by observation. 3. Sample size: 10% of the total OPD patients. 4. Sampling technique: Systematic random sampling technique.

Findings : ï‚· It was seen that only 21 % patients get the reports before 4 hrs after the billing of investigations, whereas 79% people take more than 4 hours to get the investigation reports. ï‚· Average waiting time was maximum for pathology reports that is three hours fifteen minutes and lowest for ECHO reports that is one hour forty-five minutes. ï‚· It was observed depicts that even after the last test was done ,28% people had to wait more than 3 hours whereas 72% got the result within 3 hours after the last investigation. ï‚· It was observed that on an average OPD reports are generated faster than the IPD reports as during the analysis it was visible that TAT for IPD X-ray was 3 hours 30 minutes whereas TAT for OPD X-rays was 2 hours 45 minutes. ï‚· From doing the root cause analysis it was evident that main factors contributing to long waiting time was Lack of coordination and communication among staff, Shortage of staff, not well defined roles and responsibilities of the staff.

Recommendations : This project clearly demonstrates that there is lots of scope of improvement in Eternal Hospital and shared observations and suggestions with the Quality team. The team for PHC management focusing on the suggestions have taken actions like recruitment of the new staff, preparation of monthly rota and monthly audit system complemented by employee of the month, preparation of duty roaster for General duty assistants, Training of the staff with regard to patient management, incorporating processes in the system separately for package patients. These activities will help in streamlining the processes at PHC and reducing the turnaround time of the patient at eternal hospital.

1. What is the Turn Around Time (TAT) of patients in Outpatient Department? 2. How to reduce TAT of the above patients?