Student Dissertation

Agency : Out-Patient Department; Patient Waiting Time; Reengineering; Process Flow

Objective : The study was taken to identify the determinants which cause a delay in the consultation process, to bring transparency in the process, to map the process& identify wastes in process& to provide a new process that can decrease patient waiting time

Background : Out Patient Department is the first point of contact of the hospital, which reflects the face of the organization. Outpatient departments of the majority of the hospitals are facing long queue and waiting for time problems that are resulting in patient dissatisfaction & delay in various areas within the hospital. Pre-consultation procedures are some of the determinants which causes a delay in the OPD process flow. Provision of quick and efficient services is only possible with the optimum utilization of resources through multitasking in a single window system in the OPD.

Methodology : A descriptive cross-sectional study was carried out in OPD from 1st Feb 2018 to 30th April 2018 to study the events in their natural settings & natural treatment, to analyze the behavior, attitude, and interaction with the staff, the physical setup, and their effect on the patient. Primary data was collected through direct observations and verbal interviews with patients and staffs. A sample of total 500 patients was taken of which 100 samples were taken for the patients who were getting delayed only at the registration process for process complexity and other 400 samples were taken for the patients to identify the delayed areas after the registration to till consultation time.

Findings : The data analysis shows that there was delay in the process of some major steps like, an average of 41 minutes for each patient delayed at AR, NCT & VISION test, an average of 52 minutes is found for the IOL Master check, an average of 47 minutes has found in dilation procedure & for field test the average was 47.05 minutes. The patients who were coming for the registration process were delayed by 44 minutes in an average per patient. Main factors contributing to long waiting time in OPD were process complexity, lack of internal communication system, and passion in the staff; lack of coordination and communication among the staff; shortage of staff (Optometrist and OPD assistants); not well-defined roles and responsibilities of the staff; SOPs, professionalism, corporate culture and absence of a proper appointment system.

Recommendations : The comprehensive strategy for OPD management is taking actions like departmentalization of different departments, hierarchy formulation i.e., someone has to report to someone, defining the job responsibility of staffs, recruitment of trained and qualified staffs, develop an internal communication system for a better patient care facility. These activities will help in streamlining the processes in OPD and reducing the turnaround time of the patient at Dr. Virendra Laser & Phaco Surgery Eye hospital