Faculty of Engineering and the Built Environment (ETDs)

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Browsing Faculty of Engineering and the Built Environment (ETDs) by SDG "SDG-3: Good health and well-being"

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    An Investigation of Factors Contributing to Long Waiting of Patients Collecting Repeat Medication in a Tertiary Hospital Pharmacy
    (University of the Witwatersrand, Johannesburg, 2023-02) Oladipupo, Rekgopetse Victoria; Hattingh, Teresa; Sunjka, Bernadette
    According to the World Health Organization (WHO) patient waiting time is identified as a key measurement to a responsive healthcare service and is an important indicator of quality of services offered by hospitals (NDoH, 2011) as it affects the patient’s responsiveness to the services received (NDoH, 2011; SA FAM PRACTICE, 2008; Tegabu, 2008; Pandit et, al. 2016). Long waiting times at healthcare facilities undermines the services rendered resulting in compromised or unfulfilled patient care (Afolabi & Erhun, 2003). This research studies the processes associated with the collection of repeat medication in a tertiary hospital pharmacy in order to identify value adding activities and non-value adding activities that could be impacting patient waiting time using the Lean thinking concept of driving out waste. A qualitative observational method was therefore employed to observe all the steps involved during the journey of the patient collecting repeat medication from the registration point until medication was issued at the pharmacy. Value stream mapping (one of Lean Thinking principle) was employed to analyze the processes that took place. Patient waiting time was also measured from the registration point to the pharmacy. On average patients had to wait a total 159 minutes before they could access services both at the registration point (67 minutes) and at pharmacy (92 minutes). The service time was 29 minutes at both registration point (11 minutes) and pharmacy (18 minutes). Of the 18 minutes pharmacy service time; eight minutes were found to be value-adding while 10 minutes were non-value-adding mainly due to prescriptions waiting on queue to be picked, waiting to be signed by the pharmacist and waiting to be issued out to the patient. Lack of a dedicated pharmacy service points exclusively for chronic repeat patients, manual dispensing, illegible doctor’s prescriptions, were found to prolong the time it takes the Pharmacist to complete a prescription. Post Basic Pharmacist Assistants performing duties that could be performed by a less qualified staff (e.g., Learner Basic Pharmacist Assistants) during peak hours was not value adding and thus decreasing productivity. The level of staff commitment in addressing issues of quality such as long waiting time was questionable. The demand / workload and capacity during the early hours of business at the registration point did not seem to match, thus resulting in bottlenecks at the patient registration point and throughout the system.