[Quality management: reduced waiting time and enhanced efficiency in a university ear, nose, and throat outpatient department]

[Analysis of patient waiting times in a polyclinic for surgery]

INTRODUCTION

Waiting times are a negative aspect for patients and therefore have a major influence on patient satisfaction. The aim of this research study was to evaluate waiting times from registration until first contact with a doctor in the outpatient department of the Polyclinic for Visceral, Thoracic and Vascular Surgery of the University Hospital Marburg.

MATERIAL AND METHODS

Waiting times for 253 patients in the outpatient department were measured over a time period of 3 months. The mean age was 59.6 years (range 13-91 years). Patients were asked if they were satisfied with the waiting time and whether waiting time is a criterion in the choice of hospital.

RESULTS

The mean waiting time of all 253 patients was 61 min, 48 (19 %) patients had to wait less than 15 min, 42 (16.6 %) patients 15-30 min, 57 (22.5 %) patients 30-60 min, 65 (25.7 %) patients 60-120 min, 36 (14.2 %) patients 120-240 min and 5 (2 %) patients had to wait 240-300 min. The mean waiting time was 109 min in the group of dissatisfied patients, whereas satisfied patients had a mean waiting time of 46 min (p = 0.000). We further evaluated patient satisfaction in correlation with waiting times at a cut-off of 30 min. Of the patients 163 had to wait more than 30 min whereby 106 (65 %) patients out of this group evaluated the waiting time as appropriate and 57 (35 %) as unsatisfactory. A total of 90 patients had to wait 30 min or less whereby 88 (97.8 %) patients out of this group were satisfied with the waiting time and 2 (2.2 %) were dissatisfied (p = 0.000). For 144 (56.9 %) out of the 253 patients the waiting time was a major criterion in the choice of hospital.

CONCLUSION

Short waiting times play an important role in patient satisfaction and therefore represent a major competitive factor. From our results we concluded that a waiting time of 30 min should not be exceeded in order to maintain a high patient satisfaction.

Studying the efficiency of inpatient and outpatient pharmacies using lean manufacturing

Purpose

– The purpose of this paper is to present a new approach to measure the service quality provided by a public health-care service provider using the lean manufacturing concept. The research shows that the adoption of lean manufacturing principles and methodologies may be used as a measure for efficiency. The relative efficiency measure concept is introduced.

Design/methodology/approach

– The inpatient and outpatient pharmacies providing medicines to the public at a large regional hospital in the southern part of the Kingdom of Saudi Arabia were the focus of this study. The lean manufacturing concept is used as a method to improve the service quality and reduce the time needed to deliver the medicine by comparing the efficiency between these two pharmacies based on a metric used in lean manufacturing called takt time. A team was formed to study the current situation, and recommendations based on lean manufacturing were suggested for implementations.

Findings

– The research shows that the adoption of lean manufacturing principles and methodologies may be used as an efficiency measure to compare between different departments working under the same managerial system.

Originality/value

– The results presented in this paper are reliable, objective and may be generalized for measuring the relative performance efficiency between several departments providing the same type of services.

Outpatient waiting time in health services and teaching hospitals: a case study in Iran

Background:

One of the most important indexes of the health care quality is patient’s satisfaction and it takes place only when there is a process based on management. One of these processes in the health care organizations is the appropriate management of the waiting time process. The aim of this study is the systematic analyzing of the outpatient waiting time.

Methods:

This descriptive cross sectional study conducted in 2011 is an applicable study performed in the educational and health care hospitals of one of the medical universities located in the north west of Iran. Since the distributions of outpatients in all the months were equal, sampling stage was used. 160 outpatients were studied and the data was analyzed by using SPSS software.

Results:

Results of the study showed that the waiting time for the outpatients of ophthalmology clinic with an average of 245 minutes for each patient allocated the maximum time among the other clinics for itself. Orthopedic clinic had the minimal waiting time including an average of 77 minutes per patient. The total average waiting time for each patient in the educational hospitals under this study was about 161 minutes.

Conclusion:

by applying some models, we can reduce the waiting time especially in the realm of time and space before the admission to the examination room. Utilizing the models including the one before admission, electronic visit systems via internet, a process model, six sigma model, queuing theory model and FIFO model, are the components of the intervention that reduces the outpatient waiting time.

Certifying a university ENT clinic using the ISO 9001:2000 international standard

PURPOSE

Against statutory duties to introduce quality management systems, the increased importance of this subject has led to numerous activities in various public health institutions. Following the International Standardization Organization (ISO 9001:2000) prerequisites, Frankfurt Goethe University Hospital ENT clinic staff introduced a quality management system. This paper aims to investigate this process.

DESIGN/METHODOLOGY/APPROACH

Designing, planning and implementing the quality management system is described. Under the supervision of an executive quality management board, clinic quality goals were defined. Thereafter, several quality management teams performed an actual state analysis as well as developing and realising improvement proposals. Finally a quality management manual containing binding standards and working instructions concerning all patient care, research and teaching aspects was written.

FINDINGS

Successful certification by a neutral body ascertained that the clinic's quality management system conformed to current national and international standards while restructuring and reform improved procedural efficiency.

ORIGINALITY/VALUE

The paper shows that mplementing the quality management system requires considerable effort but patients as well as staff profit considerably from the innovation. On the whole, the positive impact on structure and workflow in a specialist clinic predominates. Therefore, implementing a quality management system in all the clinic's wards and departments is recommended.

[Patient satisfaction in the outpatient department--a pilot study for customer satisfaction in ENT]

BACKGROUND

Customer satisfaction in German hospitals is becoming more important because of increasing competition in the healthcare market. Because the majority of patients with ear-nose-throat (ENT) problems are treated in an outpatient setting, this competition is not only taking place among hospitals but also among specialists in private practices. To assess patient preferences, reliable and valid questionnaires are necessary, which so far exist only for inpatients. The aim of the study was to develop an instrument with which to discover areas for potential improvement of the outpatient department.

MATERIAL AND METHODS

The questionnaire was developed according to the guidelines of the EORTC and tested in a prestudy. During the time of observation, 98 patients were available, of whom 79 could be included in the study. The return rate was 71%. Of these patients, 18 were female and 38 male; the median age was 56 years. There were no differences between the study group and the yearly clinic average in terms of age, gender, or ratio of tumor patients.

RESULTS

Patients mainly complained about waiting times in the outpatient department and diagnostic units as well as high patient turnover. Concerning positive aspects, patients mentioned the medical competence of the treating physicians; concerning negative aspects, the building infrastructure was noted.

CONCLUSION

The questionnaire showed sufficient psychometric properties and helped find areas for improvement in the outpatient department. However, a complete picture of the department will be feasible only with repeated measures, especially when taking steps to improve the department's processes.

[Quality assessment according to DIN EN ISO 9001:2000: certification in a university ENT department]

BACKGROUND

In 2003, our department inaugurated a quality management system. The certification according to DIN EN ISO 9001:2000 as required by the hospital management was achieved in August 2005. The aims were optimization of internal operating schedules and standardization of procedures according to logistic interfaces with external structures.

METHODS

Since 2000, the implementation of an internal quality management system is required by German law and threatened by penalty in case of non-implementation. Beside a basic audit and optimization of all organizational procedures, all core processes were determined and the approvals checked. These aims involve both the quality of operational procedures, in and outpatient treatment, research, study and teaching and aspects of service such as quickness of scheduling and forwarding of reports as well as economic aspects and efficiency. The department of "quality management", whose main tasks are the professional guidance and the training of the quality management representatives, plays an important role.

RESULTS

Realization of the new regulations and restructuring resulted in an increase in effectiveness and an improvement in operational procedures. In particular, patients and staff have benefited from the reorganized and modified sequence of operations.

CONCLUSION

Implementation of a quality management system in different hospital departments is recommended.