Find an Opportunity for Improvement

Organize a Team

Clarify Current Process

Select Desired Outcome

PLAN THE PROJECT

DO THE WORK THAT IS NEEDED

CHECK THE RESULTS

AFLAJ GENERAL HOSPITALDECREASE THE RATE OF NOT ATTENDING THE

PATIENT IN OPDPerformance Improvement Project

The data taken from appointment office shows that more than 43% patients were not attended the clinic with their appointment and the evidence is that there are many patients suffering to get appointment due to full showing by computer, so many patients are coming without appointment or asking favor from administration to reach the clinic..

ACT TO MAINTAIN THE CHANGES

LEADER: Mr. Mubarak Aerym (OPD Director)  FACILITATOR: Mr. Eid Al Bakar (Quality Director)MEMBERS: Dr. Muhammad Younus (Deputy Quality Director) Dr. Ahmed Hussein (Medical Specialist)   Sis. Nighat Yasmin (OPD Head Nurse) Sis. Ajna Ajas Mohammed (Nurse Educator)

To increase physician and patient satisfaction by proper appointment.Decrease work load in medical record department.Decrease Unexpected Patients Coming To OPD.To provide opportunity for other patient to get appointment To create smooth appointment process

Understand the Current Problem

Human

MachineMaterial

Environment Method

INCREASED NUMBER OF PATIENTS NOT

ATTENDING THE OPD

Appointment status

Send the patient to the clinic

Confirm Appointment in Appointment Office

File available in the clinic

PATIENT CAME TO HOSPITAL

CONSULTING THE DOCTOR

FORWARD THE APPOINTMENT CARD

FROM OPD

OBTAIN APPOINTMENT FROM APPOINTMENTOFFICE

NO MEETING THE OPD DIRECTOR

YESAVAILABILITY OF

APPOINTMENT IN THE SAME DAY

Send the patient to

OPD waiting area

DISCHARGE

NEED OTHER APPOINTMENT

YES

YES

YESNO

NO

NO

WHITE PAPER-no enough supply to print the appointmentAPPOINTMENT LIST-not ready earlier due to increased workload and shortage of staff in the appointment office

COMPUTER-no enough computers TELEPHONE-sometimes not properly working to inform the appointments from PHCPRINTER-no enough printersPHOTOSTAT MACHINE-no enough number

APPOINTMENT OFFICE STAFF- shortage of the staff.DOCTORS- ER and PHC doctors are not guiding the patient to appointment office.NURSES- not registering in the system and not guiding the patient to appointment office.PATIENTS- not responsible enough to come in the appointment time.ADMINISTRATION- helping the patients to meet the doctors without appointment.

CULTURE OF THE REGION-patients are used for not attending the appointmentAPPOINTMENT OFFICE IS WORKING ONLY ON OPD TIME-making difficulty in obtaining appointment in non OPD time.UNNECESSARY APPOINTMENTS FROM PHC-more appointments from PHC is without valid reasons

POLICY- is not clearPROTOCOL-no protocol to remind the patient before the day of appointmentLACKS OF MINISTRY APPOINTMENT SYSTEM- 5 PHC s have no ministry appointment system

Activity Responsibility Target Date Resource Outcome1. Formation of a check sheet for

data collection from each clinicQuality department One week Computer and

printerAccurate data will be available

2. Data Collection for the patient coming in clinics with or without appointment

Nurses in each clinic.

Every day for 6 month

- check sheet-OPD register

Get the knowledge about the unregistered patient coming to the clinic daily

3. Data collection for the patient not attending the clinic

Reception staff Every day for 6 month

Appointment list in the computer

Get knowledge about the wasting of appointment

4. Send memo to the PHCs to follow the proper appointment system

Team leader One week Memo Decrease unnecessary appointment

5. Appointment list should send to Medical record prior one day

Appointment office staff

Every day for 6 month

Appointment list Required file will be ready in the clinic

6. File will send to all clinics according to the appointment list provided

Medical record department staffs

Every day for 6 month

Appointment list and medical files

Both Physician and patient are satisfied

QUALITY IMPROVEMENT REPORT OF THE RATE OF PATIENTS NOT ATTENDING THEIR OPD MONTH 1-MONTH 10 /1435

Year 1435 Total No. of Appointments

Patients Attended The Clinics

Patients Not Attended The Clinics

Patient Came Without

Appointment

%of patients not attending the clinic

Month 1 2621 2084 537 873 20.5%Month 2 2686 1891 795 977 29.6%Month 3 2519 1857 662 1024 26.3%Month 4 2587 2015 572 949 22.11%Month 5 2420 1991 429 710 29.33%Month 6 3537 3042 495 763 14%Month 7 2950 2402 548 686 23.35%Month 8 3588 2713 875 364 24.38%Month 9 2272 1950 875 339 20.1%

Month 10 3152 2565 615 510 19.5%

TOTAL 28332 22510 6403 7195 22.6%

COMPARISON OF NUMBER OF PATIENTS NOT ATTENDED THEIR CLINIC BEFORE AND AFTER THE START OF PERFORMANCE IMPROVEMENT PROJECT .

CURRENT ACTIONS

DENTAL

OB-GYNAE

PEDIATRICS

PEDIA SURGERY

SURGERY

MEDICAL

DERMATOLO

GY

PSYCHIATRY

ORTHOPEDICS

OPHTHALMOLO

GY

CARDIOLO

GYENT

UROLOGY

NEUROSURGERY05

10152025303540

17.79

29.8224.53

28.3622.09

15.51

34.7530.08

14.112 15.856

30.47725.515

20.05514.79

COMPARISON OF PERCENTAGE OF PATIENTS NOT ATTENDED THE OPD FROM MONTH1 TO MONTH10 1435

OPD

PERC

ENTA

GE

MONTH

8 1434M

ONTH 9 1434

MONTH

10 1434M

ONTH 11 1434

MONTH

12 1434 M

ONTH 1 1435

MONTH

2 1435 M

ONTH 3 1435

MONTH

4 1435M

ONTH 5 1435

MONTH

6 1435M

ONTH 7 1435

MONTH

8 1435M

ONTH 9 1435

MONTH

10 1435

0

10

20

30

40

50 46.842.7 40.3

45.441.8

20.5

29.626.3

22.1129.33

14

23.35 24.3820.1 19.5

PERC

ENTA

GE

BEFORE THE PIP

AFTER THE PIP

Patients are getting appointment properly

The administration not allowing any patients without appointment

The files are providing according to the appointment list prior to

start the clinic Requested to administration to increase manpower in medical

record and appointment office Future Plan:

Computerize electronic medical record with paper less system in the Hospital and all primary health care centers with intra net facility .