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Causes of Obstruction in the Outpatient Department of National Hospital, Sri Lanka: A Qualitative Study

Yıl 2021, Cilt 3, Sayı 3, 122 - 136, 15.12.2021
https://doi.org/10.52675/jhesp.980464

Öz

          Sri Lanka is a country in South Asia that has a high-level health care system. The National Hospital, Sri Lanka (NHSL) situated in Colombo, is the largest teaching hospital in Sri Lanka and the final referral centre in the country consisting of 3000 beds and the bed occupancy rate is 75 with 3.7 average lengths of stay.
           Outpatient care, sometimes called ambulatory care, is defined as medical care or treatment that does not require an overnight stay in a hospital or medical facility. The outpatient department (OPD) is considered as the window to hospital services and a patient's impression of the hospital begins at the OPD.
       The OPD of the National Hospital of Sri Lanka (NHSL) also faces the problem of congestion. This study aims to identify the causes of congestion at OPD of NHSL and provide solutions. Key informant interviews with relevant stakeholders, focus group discussions, desk review of secondary data, and direct observations of OPD processes were used as methodologies. Key informant interviews were conducted with the deputy director, OPD, medical officer-in-charge, and nursing sister in charge of the unit by the principal investigator. Two focus group discussions were conducted, with 12 randomly selected medical officers and 10 nursing officers with a minimum of one year of work experience at the OPD. Data retrieved from the desk review of the secondary data from the admission book, and OPD monthly statistics. Direct observation was used to triangulate the data.
          Around 690,000 patients are treated annually in OPD of NHSL. The average number of OPD patients per day is about 1900. Usually, a doctor at OPD of NHSL examines 36 patients per hour. Therefore, consultation time is limited to 1.6 minutes which is highly inadequate. Root causes for congestion were analyzed by using the Ishikawa diagram. Poor layout arrangements, delay of doctors and quota system of doctors, the non-availability of the patient information management system, absence of proper referral system in the country, the larger number of staff members were identified as root causes.
          Improvement of the layout of OPD in a unidirectional way, advised doctors to start duties on time abolish the quota system of doctors, establishment of the computer-based patients' registration system, establishing laboratory within OPD, establishing two more counters at OPD pharmacy were the major recommendation of this study to minimize the congestion at OPD, NHSL.

Kaynakça

  • Adisak, S., Higgins, P. (2012). Scalability for supporting the growth of hospitals: Application at Thailand Hospitals. Asia Pacific Industrial Engineering and Management Systems 2012 Conference (pp. 412-425). Bangkok: Asian Institute of Technology.
  • Akintomide, A. O., Ukweh, O. N., Efanga, S. A. (2019). An audit of the appointment booking system and patient waiting time in an ultrasound unit in Nigeria: A need to eliminate congestion in our public hospitals. Journal of Family Medicine and Primary Care, 8,2055-2060.
  • Andria, C. (2018). Overview of outpatient or ambulatory care, very well health. https://www.verywellhealth.com/outpatient-1736237.
  • Babalola, D., Meng. Y.X., Nichols, M., Omole, F., Sow, C., Perkins, V. (2013). Improving the patient flow at an academic primary care teaching clinic serving African American patients. Clinical and Experimental Medical Sciences, 1,241–250.
  • Blomberg, F., Brulin, C., Andertun, R., Rydh, A. (2010). Patient's perception of quality of care in a radiology department: A medical-physical approach. The Journal of Radiology Nursing, 29,10-7.
  • Dilrukshi, P.A.D., Nirmanamali, H.D.I.M., Lanel, G.H.J., Samarakoon, M.A.S.C.A. (2016). Strategy to reduce the waiting time at the outpatient department of the National Hospital in Sri Lanka. International Journal of Scientific and Research Publications, 2,281-287.
  • Gupta, K. (2007). Modern trends in planning and designing of hospitals: Principles and practice. New Delhi: Jaypee Brothers. Helbig, M., Helbig, S., Knecht, R., Kahla-Witzsch, H.A., Gstöttner, W. (2007). Quality management: Reduced waiting time and enhanced efficiency in a university ear, nose, and throat outpatient department. HNO, 55,29-35.
  • Jain, R., Rao, B. (2019). Role of laboratory services in primary health center (PHC) outpatient department performance: An Indian case study. Primary Health Care Research and Development, 20,112.
  • Jayamanne, D. (2010, January 07). Health Ministry to cut down congestion in main hospitals. http://www.island.lk/2010/01/07/news10.html
  • Lee, Y.J., Yoo, D.H. (1996). A study on model for decreasing an outpatient waiting time. Journal of Korean Society of Medical Informatics, 2,27–39.
  • Ministry of Health. (1995). Manual on management of teaching, provincial, base and special hospitals in Ministry of Health (pp. 29–33). Sri Lanka: Ministry of Health.
  • Mohebbifar, R., Hasanpoor, E., Mohseni, M., Sokhanvar, M., Khosravizadeh, O., Mousavi Isfahani, H. (2013). Outpatient waiting time in health services and teaching hospitals: A case study in Iran. Global Journal of Health Science, 6,172-180.
  • NHSL. (2015). Annual Hospital Statistical Bulletin 2015. Colombo: Medical Records Department of NHSL.
  • Osundina, K.S., Opeke, R.O. (2017). Patients’ waiting time: Indices for measuring hospital effectiveness. International Journal of Advance Academic Research: Social Management Science, 3,1-18.
  • Sakano, N. (2015). Introduction of regional health information network in Vietnam. Fujitsu Science Technology Journal, 51,84-89.
  • Thi Thao Nguyen, S., Yamamoto, E., Thi Ngoc Nguyen, M. (2018). Waiting time in the outpatient clinic at a national hospital in Vietnam. Nagoya Journal of Medical Science, 80,227-239.
  • Wijewardena, D. (2010, December 22). Better deal for OPD patients. http://www.island.lk/index.php?page_cat=articledetails&page=article-details&code_title=14120

Yıl 2021, Cilt 3, Sayı 3, 122 - 136, 15.12.2021
https://doi.org/10.52675/jhesp.980464

Öz

Kaynakça

  • Adisak, S., Higgins, P. (2012). Scalability for supporting the growth of hospitals: Application at Thailand Hospitals. Asia Pacific Industrial Engineering and Management Systems 2012 Conference (pp. 412-425). Bangkok: Asian Institute of Technology.
  • Akintomide, A. O., Ukweh, O. N., Efanga, S. A. (2019). An audit of the appointment booking system and patient waiting time in an ultrasound unit in Nigeria: A need to eliminate congestion in our public hospitals. Journal of Family Medicine and Primary Care, 8,2055-2060.
  • Andria, C. (2018). Overview of outpatient or ambulatory care, very well health. https://www.verywellhealth.com/outpatient-1736237.
  • Babalola, D., Meng. Y.X., Nichols, M., Omole, F., Sow, C., Perkins, V. (2013). Improving the patient flow at an academic primary care teaching clinic serving African American patients. Clinical and Experimental Medical Sciences, 1,241–250.
  • Blomberg, F., Brulin, C., Andertun, R., Rydh, A. (2010). Patient's perception of quality of care in a radiology department: A medical-physical approach. The Journal of Radiology Nursing, 29,10-7.
  • Dilrukshi, P.A.D., Nirmanamali, H.D.I.M., Lanel, G.H.J., Samarakoon, M.A.S.C.A. (2016). Strategy to reduce the waiting time at the outpatient department of the National Hospital in Sri Lanka. International Journal of Scientific and Research Publications, 2,281-287.
  • Gupta, K. (2007). Modern trends in planning and designing of hospitals: Principles and practice. New Delhi: Jaypee Brothers. Helbig, M., Helbig, S., Knecht, R., Kahla-Witzsch, H.A., Gstöttner, W. (2007). Quality management: Reduced waiting time and enhanced efficiency in a university ear, nose, and throat outpatient department. HNO, 55,29-35.
  • Jain, R., Rao, B. (2019). Role of laboratory services in primary health center (PHC) outpatient department performance: An Indian case study. Primary Health Care Research and Development, 20,112.
  • Jayamanne, D. (2010, January 07). Health Ministry to cut down congestion in main hospitals. http://www.island.lk/2010/01/07/news10.html
  • Lee, Y.J., Yoo, D.H. (1996). A study on model for decreasing an outpatient waiting time. Journal of Korean Society of Medical Informatics, 2,27–39.
  • Ministry of Health. (1995). Manual on management of teaching, provincial, base and special hospitals in Ministry of Health (pp. 29–33). Sri Lanka: Ministry of Health.
  • Mohebbifar, R., Hasanpoor, E., Mohseni, M., Sokhanvar, M., Khosravizadeh, O., Mousavi Isfahani, H. (2013). Outpatient waiting time in health services and teaching hospitals: A case study in Iran. Global Journal of Health Science, 6,172-180.
  • NHSL. (2015). Annual Hospital Statistical Bulletin 2015. Colombo: Medical Records Department of NHSL.
  • Osundina, K.S., Opeke, R.O. (2017). Patients’ waiting time: Indices for measuring hospital effectiveness. International Journal of Advance Academic Research: Social Management Science, 3,1-18.
  • Sakano, N. (2015). Introduction of regional health information network in Vietnam. Fujitsu Science Technology Journal, 51,84-89.
  • Thi Thao Nguyen, S., Yamamoto, E., Thi Ngoc Nguyen, M. (2018). Waiting time in the outpatient clinic at a national hospital in Vietnam. Nagoya Journal of Medical Science, 80,227-239.
  • Wijewardena, D. (2010, December 22). Better deal for OPD patients. http://www.island.lk/index.php?page_cat=articledetails&page=article-details&code_title=14120

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Makaleler
Yazarlar

Samantha RANASİNGHE Bu kişi benim
University of Aberdeen
0000-0001-7624-0973
United Kingdom


Dlirukshi DEERASİNGHE Bu kişi benim
University of Kent
0000-0002-2620-4293
United Kingdom


Ranga SABHAPATHİGE> (Sorumlu Yazar)
University of Kent
0000-0001-6056-261X
Sri Lanka

Yayımlanma Tarihi 15 Aralık 2021
Yayınlandığı Sayı Yıl 2021, Cilt 3, Sayı 3

Kaynak Göster

APA Ranasinghe, S. , Deerasinghe, D. & Sabhapathige, R. (2021). Causes of Obstruction in the Outpatient Department of National Hospital, Sri Lanka: A Qualitative Study . Journal of Health Systems and Policies , 3 (3) , 122-136 . DOI: 10.52675/jhesp.980464