Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar

Ghadeer Mustafa; Almunzer Zakaria; Muna Atrash; Sara Kazkaz; Ayman Tardi; Ayman Ghanem

doi:doi:10.11648/j.wjph.20210604.16

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Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar

Ghadeer Mustafa, Almunzer Zakaria, Muna Atrash, Sara Kazkaz, Ayman Tardi, Ayman Ghanem

Published in World Journal of Public Health (Volume 6, Issue 4)

Received: 30 August 2021 Accepted: 14 September 2021 Published: 24 November 2021

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Abstract

Waiting times for clinic appointments constitute a key indicator of an outpatient department performance for access to care and patient satisfaction. This is particularly relevant for pediatric population. The Ministry of Public Health in Qatar set a waiting time of 28 days for patients to get new appointment in General Outpatient Department (GOPD). The current average waiting time to get a new appointment in the general pediatric clinic (GPC) at AWH is 57 days. As the aim is to decrease the average waiting time to get a new clinic appointment from 57 days to 28 days by the end of December 2018, and to meet the national targets set by the Ministry of Public Health. Using the Model for Improvement (MFI) will make it a Quality Improvement (QI) project. The MFI framework is designed to support organizations answering fundamental questions before agreeing on drivers for change. The implementation of change was be facilitated by the Plan-Do-Study-Act (PDSA) cycles methodology. The QI project team performed a root cause analysis using the Ishikawa diagram and identified the key contributing factors to the long waiting times to get a new appointment. Twenty-seven PDSA cycle ramps were designed with support of predictive tool to test innovative changes in current operational processes in an attempt to improve waiting time in the general pediatric clinic at Al Wakra Hospital. As a result, the monthly average number of referrals for GPC increased by 200% between the pre and post implementation periods. The average triage waiting time improved from 6 to 2.6 days in 2018 and the average become 1 day in 2019. Post-implementation the average waiting time for patients to get new appointment improved from 57 days to 28 days in 2018 and the average waiting time improved to 16 days in 2019. In conclusion The quality improvement project for the AWH general pediatric clinic demonstrates significant improvement in waiting times for new appointments, the recommendation for the hospital leadership would be to rollout the improvement methodology to other clinics that suffer from similar challenges.

Published in	World Journal of Public Health (Volume 6, Issue 4)
DOI	10.11648/j.wjph.20210604.16
Page(s)	171-180
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Pediatric Clinic, Quality Improvement Project, Outpatient Department, Reducing Waiting Time

References

[1]	Mardiah, F. P., & Basri, M. H. (2013). The Analysis of Appointment system to reduce outpatient waiting time at Indonesia’s public hospital. Human Resource Management Research, 3 (1), 27-33.
[2]	Harper, P. R., & Gamlin, H. (2003). Reduced outpatient waiting times with improved appointment scheduling: a simulation modelling approach. Or Spectrum, 25 (2), 207-222.
[3]	Rinder, M. M., Weckman, G., Schwerha, D., Snow, A., Dreher, P. A., Park, N.,... Young, W. (2012). Healthcare Scheduling by Data Mining: Literature Review and Future Directions. Journal of Healthcare Engineering, 3 (3). doi: 10.1260/2040-2295.3.3.477.
[4]	Mohamed, K., Mustafa, A., Tahtamouni, S., Taha, E., & Hassan, R. (2016b). A quality improvement project to reduce the ‘No Show’rate in a paediatric neurology clinic. BMJ Open Quality, 5 (1), u209266. w203789.
[5]	Rose, K. D., Ross, J. S., & Horwitz, L. I. (2011). Advanced access scheduling outcomes: A systematic review. Archives of Internal Medicine, 171 (13), 1150-1159. doi: 10.1001/archinternmed.2011.168.
[6]	Daggy, J., Lawley, M., Willis, D., Thayer, D., Suelzer, C., DeLaurentis, P.-C.,... Sands, L. (2010). Using no-show modeling to improve clinic performance. Health Informatics Journal, 16 (4), 246-259.
[7]	Lynn, J., Baily, M. A., Bottrell, M., Jennings, B., Levine, R. J., Davidoff, F.,... James, B. (2007). The ethics of using quality improvement methods in health care. Ann Intern Med, 146 (9), 666-673.
[8]	Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2^nd edition).
[9]	Courtlandt, C. D., Noonan, L., & Feld, L. G. (2009). Model for improvement-Part 1: A framework for health care quality. Pediatric Clinics, 56 (4), 757-778.
[10]	Mohamed, K., Mustafa, A., Tahtamouni, S., Taha, E., & Hassan, R. (2016a). A Quality Improvement Project to Reduce the ‘No Show’ rate in a Paediatric Neurology Clinic. BMJ Quality Improvement Reports, 5 (1). doi: 10.1136/bmjquality.u209266.w3789.
[11]	Knight, V., & McNulty, A. (2006). Triage in a public outpatient sexual health clinic. Sexual health, 3 (2), 87-90.
[12]	Tan, J. H. T., Rajendra, B., Shahdadpuri, R., Loke, C. Y., Ng, S. S.-L., Jaafar, N.,... Arkachaisri, T. (2017). A quality improvement project to reduce waiting time for pediatric outpatient referral clinics in Singapore. Proceedings of Singapore Healthcare, 26 (4), 224-229.
[13]	Rohleder, T. R., Lewkonia, P., Bischak, D. P., Duffy, P., & Hendijani, R. (2011). Using simulation modeling to improve patient flow at an outpatient orthopedic clinic. Health care management science, 14 (2), 135-145.
[14]	Alkuwaiti, A., Maruthamuthu, T., & Akgun, S. (2018). Factors associated with the quality of outpatient service: The application of factor analysis – A case study. International Journal of Healthcare Management, 1-6. doi: 10.1080/20479700.2017.1422910.
[15]	Bielen, F., & Demoulin, N. (2007). Waiting time influence on the satisfaction-loyalty relationship in services. Managing Service Quality: An International Journal, 17 (2), 174-193.
[16]	Chen, B.-l., Li, E.-d., Yamawuchi, K., Kato, K., Naganawa, S., & Miao, W.-j. (2010). Impact of adjustment measures on reducing outpatient waiting time in a community hospital: application of a computer simulation. Chinese Medical Journal (English Edition), 123 (5), 574.
[17]	Mohebbifar, R., Hasanpoor, E., Mohseni, M., Sokhanvar, M., Khosravizadeh, O., & Isfahani, H. M. (2014). Outpatient waiting time in health services and teaching hospitals: a case study in Iran. Global journal of health science, 6 (1), 172.

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APA Style

Ghadeer Mustafa, Almunzer Zakaria, Muna Atrash, Sara Kazkaz, Ayman Tardi, et al. (2021). Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar. World Journal of Public Health, 6(4), 171-180. https://doi.org/10.11648/j.wjph.20210604.16

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ACS Style

Ghadeer Mustafa; Almunzer Zakaria; Muna Atrash; Sara Kazkaz; Ayman Tardi, et al. Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar. World J. Public Health 2021, 6(4), 171-180. doi: 10.11648/j.wjph.20210604.16

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AMA Style

Ghadeer Mustafa, Almunzer Zakaria, Muna Atrash, Sara Kazkaz, Ayman Tardi, et al. Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar. World J Public Health. 2021;6(4):171-180. doi: 10.11648/j.wjph.20210604.16

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@article{10.11648/j.wjph.20210604.16,
  author = {Ghadeer Mustafa and Almunzer Zakaria and Muna Atrash and Sara Kazkaz and Ayman Tardi and Ayman Ghanem},
  title = {Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar},
  journal = {World Journal of Public Health},
  volume = {6},
  number = {4},
  pages = {171-180},
  doi = {10.11648/j.wjph.20210604.16},
  url = {https://doi.org/10.11648/j.wjph.20210604.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20210604.16},
  abstract = {Waiting times for clinic appointments constitute a key indicator of an outpatient department performance for access to care and patient satisfaction. This is particularly relevant for pediatric population. The Ministry of Public Health in Qatar set a waiting time of 28 days for patients to get new appointment in General Outpatient Department (GOPD). The current average waiting time to get a new appointment in the general pediatric clinic (GPC) at AWH is 57 days. As the aim is to decrease the average waiting time to get a new clinic appointment from 57 days to 28 days by the end of December 2018, and to meet the national targets set by the Ministry of Public Health. Using the Model for Improvement (MFI) will make it a Quality Improvement (QI) project. The MFI framework is designed to support organizations answering fundamental questions before agreeing on drivers for change. The implementation of change was be facilitated by the Plan-Do-Study-Act (PDSA) cycles methodology. The QI project team performed a root cause analysis using the Ishikawa diagram and identified the key contributing factors to the long waiting times to get a new appointment. Twenty-seven PDSA cycle ramps were designed with support of predictive tool to test innovative changes in current operational processes in an attempt to improve waiting time in the general pediatric clinic at Al Wakra Hospital. As a result, the monthly average number of referrals for GPC increased by 200% between the pre and post implementation periods. The average triage waiting time improved from 6 to 2.6 days in 2018 and the average become 1 day in 2019. Post-implementation the average waiting time for patients to get new appointment improved from 57 days to 28 days in 2018 and the average waiting time improved to 16 days in 2019. In conclusion The quality improvement project for the AWH general pediatric clinic demonstrates significant improvement in waiting times for new appointments, the recommendation for the hospital leadership would be to rollout the improvement methodology to other clinics that suffer from similar challenges.},
 year = {2021}
}

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TY - JOUR
T1 - Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar
AU - Ghadeer Mustafa
AU - Almunzer Zakaria
AU - Muna Atrash
AU - Sara Kazkaz
AU - Ayman Tardi
AU - Ayman Ghanem
Y1 - 2021/11/24
PY - 2021
N1 - https://doi.org/10.11648/j.wjph.20210604.16
DO - 10.11648/j.wjph.20210604.16
T2 - World Journal of Public Health
JF - World Journal of Public Health
JO - World Journal of Public Health
SP - 171
EP - 180
PB - Science Publishing Group
SN - 2637-6059
UR - https://doi.org/10.11648/j.wjph.20210604.16
AB - Waiting times for clinic appointments constitute a key indicator of an outpatient department performance for access to care and patient satisfaction. This is particularly relevant for pediatric population. The Ministry of Public Health in Qatar set a waiting time of 28 days for patients to get new appointment in General Outpatient Department (GOPD). The current average waiting time to get a new appointment in the general pediatric clinic (GPC) at AWH is 57 days. As the aim is to decrease the average waiting time to get a new clinic appointment from 57 days to 28 days by the end of December 2018, and to meet the national targets set by the Ministry of Public Health. Using the Model for Improvement (MFI) will make it a Quality Improvement (QI) project. The MFI framework is designed to support organizations answering fundamental questions before agreeing on drivers for change. The implementation of change was be facilitated by the Plan-Do-Study-Act (PDSA) cycles methodology. The QI project team performed a root cause analysis using the Ishikawa diagram and identified the key contributing factors to the long waiting times to get a new appointment. Twenty-seven PDSA cycle ramps were designed with support of predictive tool to test innovative changes in current operational processes in an attempt to improve waiting time in the general pediatric clinic at Al Wakra Hospital. As a result, the monthly average number of referrals for GPC increased by 200% between the pre and post implementation periods. The average triage waiting time improved from 6 to 2.6 days in 2018 and the average become 1 day in 2019. Post-implementation the average waiting time for patients to get new appointment improved from 57 days to 28 days in 2018 and the average waiting time improved to 16 days in 2019. In conclusion The quality improvement project for the AWH general pediatric clinic demonstrates significant improvement in waiting times for new appointments, the recommendation for the hospital leadership would be to rollout the improvement methodology to other clinics that suffer from similar challenges.
VL - 6
IS - 4
ER -

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Author Information

Ghadeer Mustafa

Pediatric Division, Hamad Medical Corporation, Doha, Qatar
Almunzer Zakaria

Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
Muna Atrash

Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
Sara Kazkaz

Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
Ayman Tardi

Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
Ayman Ghanem

Outpatient Department, Hamad Medical Corporation, Doha, Qatar

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APA Style

Ghadeer Mustafa, Almunzer Zakaria, Muna Atrash, Sara Kazkaz, Ayman Tardi, et al. (2021). Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar. World Journal of Public Health, 6(4), 171-180. https://doi.org/10.11648/j.wjph.20210604.16

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ACS Style

Ghadeer Mustafa; Almunzer Zakaria; Muna Atrash; Sara Kazkaz; Ayman Tardi, et al. Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar. World J. Public Health 2021, 6(4), 171-180. doi: 10.11648/j.wjph.20210604.16

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AMA Style

Ghadeer Mustafa, Almunzer Zakaria, Muna Atrash, Sara Kazkaz, Ayman Tardi, et al. Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar. World J Public Health. 2021;6(4):171-180. doi: 10.11648/j.wjph.20210604.16

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@article{10.11648/j.wjph.20210604.16,
  author = {Ghadeer Mustafa and Almunzer Zakaria and Muna Atrash and Sara Kazkaz and Ayman Tardi and Ayman Ghanem},
  title = {Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar},
  journal = {World Journal of Public Health},
  volume = {6},
  number = {4},
  pages = {171-180},
  doi = {10.11648/j.wjph.20210604.16},
  url = {https://doi.org/10.11648/j.wjph.20210604.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjph.20210604.16},
  abstract = {Waiting times for clinic appointments constitute a key indicator of an outpatient department performance for access to care and patient satisfaction. This is particularly relevant for pediatric population. The Ministry of Public Health in Qatar set a waiting time of 28 days for patients to get new appointment in General Outpatient Department (GOPD). The current average waiting time to get a new appointment in the general pediatric clinic (GPC) at AWH is 57 days. As the aim is to decrease the average waiting time to get a new clinic appointment from 57 days to 28 days by the end of December 2018, and to meet the national targets set by the Ministry of Public Health. Using the Model for Improvement (MFI) will make it a Quality Improvement (QI) project. The MFI framework is designed to support organizations answering fundamental questions before agreeing on drivers for change. The implementation of change was be facilitated by the Plan-Do-Study-Act (PDSA) cycles methodology. The QI project team performed a root cause analysis using the Ishikawa diagram and identified the key contributing factors to the long waiting times to get a new appointment. Twenty-seven PDSA cycle ramps were designed with support of predictive tool to test innovative changes in current operational processes in an attempt to improve waiting time in the general pediatric clinic at Al Wakra Hospital. As a result, the monthly average number of referrals for GPC increased by 200% between the pre and post implementation periods. The average triage waiting time improved from 6 to 2.6 days in 2018 and the average become 1 day in 2019. Post-implementation the average waiting time for patients to get new appointment improved from 57 days to 28 days in 2018 and the average waiting time improved to 16 days in 2019. In conclusion The quality improvement project for the AWH general pediatric clinic demonstrates significant improvement in waiting times for new appointments, the recommendation for the hospital leadership would be to rollout the improvement methodology to other clinics that suffer from similar challenges.},
 year = {2021}
}

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