The appraisal of factors affecting waiting times and recommendations for improvement at out-patient department (OPD) of Kopanong Hospital

Nhlapo, Mkholwane Thomas
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Background: Long waiting times and the quality of care are sometimes compromised by the ineffective systems caused among others by the bottlenecks at the reception and the treatment areas. The Hospital management of the Kopanong Hospital was concerned about the long queues and waiting times in the Hospital’s out-patient department. Therefore, the Hospital management would like to reduce the long queues and the length of the waiting times. The information from the customer care system showed that the average waiting times in the out-patient department was about five hours and that much of this time was spent at reception area waiting for files. However no study was done to systematically measure the waiting time in the OPD and the factors that might have influence on it. This study was planned in this setting to assist the Hospital management in setting the baseline that could be used in benchmarking for monitoring the situation. Aims: To evaluate factors affecting waiting times at the Out-patient department (OPD) of Kopanong Hospital Methodology: The setting of this study was Kopanong Hospital, in the Sedibeng District in the Gauteng Province. This was a cross-sectional study that looked at broad issues pertaining to the waiting time at the Out-patient Department of Kopanong Hospital, a district hospital in a the rural district in the Gauteng Province during three-year study period. The OPD has three sections: General OPD, Paediatric OPD and Antenatal Clinic (ANC). The MS excel software based data extraction tool was designed to obtain data from Hospital Information System. Results: The majority of the patients came from poor socio-economic class and had no medical aid. Therefore, these patients are dependent on public health facilities for their health care and would not be able to pay for their health care. The majority of the patients were self referred except ANC. This might be due to a well-functioning referral system for maternity patients in the District. The majority of the patients attended the General OPD and Paediatric OPD for medical reasons. The analysis of data showed that the patients spent a significant amount of time in the system before they were seen by the nurses and doctors. However, they were also spending a significant amount of time in the Pharmacy. The reasons for efficient record keeping for ANC and Paediatric OPD patients might be due to the fact patients caries their own cards (ANC cards and Road to Health cards). Similar system should be introduced for General OPD patients. Further study is necessary to identify the cause for delay in the Pharmacy. Conclusion: This study was the first of its kind to be done in this Hospital and the Sedibeng Health District. The study identified the areas where patients spent time in the OPD. This would assist the Hospital Management to develop appropriate measures to reduce waiting time in the Hospital OPD. In addition, further study is necessary at the PHC facilities in the District to identify reasons for high self-referral.