“No queues, by appointment only”

I welcome the inclusion in the Philippine Health Agenda 2016-2022 the policy of “no queues, by appointment only” as I have been advocating for this since February 2015.duterte_queues_roj_16oct6

 

phil_health_agenda_poor_quality_long_waiting_time_roj_16oct6

 

As I have said, I have been advocating for this since February 2015.  I have been developing the system in my private clinic.

See the following:

 

https://sites.google.com/site/rojosonmedicalclinic/consultation-with-appointment-time

https://sites.google.com/site/rojosonmedicalclinic/booked-appointment-performance—september-2016

Latest update:

October 2016 Resolution:

I can now reduce the target to no waiting time for more than 60 minutes from booked appointment time starting October 2016 (from the 75-minutes target in May to September 2016).

From July 2016 to September 2016, the longest waiting times were down to 52, 49, and 40 minutes respectively.  The overall means were 7, 10 and 10 minutes respectively.

It used to be no waiting time for more than 90 minutes from booked appointment when I started in February 2016. I reduced it to 75 minutes in May, 2016.  Now, it will be 60 minutes starting October 2016.

I like to share my experience on how I develop the system (note it is still under continuous improvement) by giving some tips.

Consider time and length of patient consultation hours

Example: 4 hours (8 am to 12 noon)

Consider the types of patients consulting (new, follow-up) and estimate the average time one will allot for new and follow-up patients. (Note: patient consultation time only. Do not include treatment procedure time. Treatment procedure as a matter of policy should be treated separately using a different  booking schedule.)

Then, make patient consultation time blocks. 

For example: average 15 minutes for follow-up patients and 30 minutes for new patients).

Make time blocks by 15 minutes.  Allot 15 minutes for follow-up patients who book for appointment.  Allot 30 minutes for new patients who book for appointment.

Ask them to be at the clinic 30 minutes before the booked appointment time.  Ask them to confirm the day before.  Ask them to call when there is a sudden cancellation so that there will be contingent adjustment.

Start on time.  Ready to adjust accordingly based on the situations.  Some follow-up patients can be seen in less than 15 minutes; some longer.  Some new patients can be seen in less than 30 minutes; some longer.

Always coordinate with the secretary or clerk on the time being consumed for each patient; waiting time of the next patients; etc.  Always keep the pledged target of patient waiting time in mind.

Don’t make a promise that all patients can be seen on time on the booked appointment time, particularly after the first patient.  Make a pledge such as there will be no waiting time for more than 60 minutes after a booked appointment.  If there is a break in the pledge, apologize right away and do continual improvement.

May accept walk-in patients but priority is on those with booked appointment.  Walk-in patients whether follow-up patients or new can be seen after all the booked patients have been seen (if time is available or the policy allows this).  Or, one can make a strict policy, no prior booking, no patient consultation.

Educate the patient on arriving on time and calling when there is sudden cancellation.

Continually evaluate and review the booking system.  

Review the patient consultation time, particularly the average.  See if there is a need to adjust.

Calculate and report at least monthly the waiting times (counting from the booked appointment up to the start of consultation) of the patients.  Get the range and average. The range should be zero to a figure pledged (for example, not more than 60 minutes). The average should be within 60 minutes.   It will be hard to get a zero waiting time all the time.  But, sometimes, it can be achieved.  What is acceptable (make sure to have the patient agree on this) that the average waiting time is within 60 minutes.

ROJ@16oct6

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