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Improving Outpatient Services at Pretoria Academic Hospital

In 1991, a workshop addressed issues causing staff dissatisfaction at the hospital's outpatient clinic, leading to long patient waiting times, high "no shows," and overcrowded areas. The workshop implemented actions like an appointment system, a waiting list, and filling vacancies by phone. Results showed reduced waiting times, increased clinic utilization, and changed patient complaints. However, issues with records availability persisted.

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Improving Outpatient Services at Pretoria Academic Hospital

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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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