Abstract of Dissertation

Agency : OPD, walk-in patients, appointment slots, wait-time, buffer slots.

Objective : The objective of the study is to measure the waiting time for appointment and walk-in patients and find out the causes for it. Then, come up with reforms to decrease the waiting time and measure the effect of the interventions. Also, find out the correlation between number of walk-in patients in a day to the patient waiting time and motivating and educating the patients to book a prior appointment.

Background : OPDs act as a window to hospital services and a patient's impression of the hospital begins at the OPD. This impression often influences the patient's sensitivity to the hospital and therefore it is essential to ensure that OPD services provide an excellent experience for customers. It is also well-established that 8-10 per cent of OPD patients need hospitalization. The purpose of study was to understand the OPD patient flow process and come up with reforms to reduce patient wait time and then measure the effect of the reforms. It was seen that 92% patient complaints in OPD were about long waiting time. 50.06% of OPD patients came in as walk-ins, yet there was no provision in appointment schedule for walk-in patients. So long waiting times for walk-in patients was one of the biggest challenges. As OPD is first point of contact for most of the patients, their experience here determines their behaviour towards other hospital services.

Methodology : Sampling method: systematic stratified sampling method was used. Sample size: 6% patients of all doctors were followed. Study design: cross sectional analytical study. Study area & duration: Gastroenterology Out-patient department of 1200 bedded multi-super specialty hospital. Duration of the study was from Feb ’14 to April ’14.

Findings : After the intervention, i.e. increasing the number of appointment slots and adding buffer slots to accommodate walk-in patients, there was drastic decrease in waiting time of the walking patients and appointment patients decreased by 49.29% and 19.73%respectively.

Recommendations : In OPD, waiting time for the patients is one of the major key performance indicators for OPD manager. It also is the indicator for the smooth functioning of the OPD. Patient satisfaction also depends on waiting time. After 30 minutes of waiting time, the patients’ satisfaction level starts to fall. Thus keeping it minimal is essential for the better functioning of an outpatient department. The process of reducing waittime requires converting maximum number of walk-in patients to appointment patients, so that they arrive on their appointment times and waiting time is reduced. Also, it requires making provision for walk-in patients in appointment schedule. Major challenges faced during redesigning of the slots were, resistance from the staff and education/ motivating the patients to book a prior appointment.