Patient flow analysis in a general medical outpatient clinic

The aim of this work was to determine the waiting times of patients at some of the stations in the general medical clinics in the outpatient department of the University Hospital in Ismailia and to determine the duration of consultations with interns and specialists. It was a cross-sectional study. The study population consisted of all patients attended the clinics during one month [706 patients]. The data were collected using a specially designed check-list: Entry and exit times for every patient at each service station were recorded in the check-list. The total patient time spent in the clinic ranged from 26 minutes to 276 minutes [4.6 hours] and the mean was 90.33 +/- 46.37 minutes. This total time was divided into 3 components. The first one [time from arrival till reaching the clinic] ranged from 3 minutes to 55 minutes [mean = 17.60 +/- 10.06 minutes]. The second component was the waiting time. Average waiting time for the intern was 42.88 +/- 25.06 minutes, for the specialist was 109.93 +/- 49.89 minutes, and for the intern then the specialist was 89.22 +/- 43.69 minutes. The third component was the duration of consultation. Average duration of consultation with the intern was 10.90 +/- 3.38 minutes, with the specialist was 14.16 +/- 5.25 minutes, and with the intern then the specialist was 24.78 +/- 5.71 minutes. The average waiting time constituted 60.7% of the total time for patients examined by intern only, 76.5% for patients examined by specialist only, and 67.2% for patients examined by intern then by specialist. The time spent by the patients in the clinic was long. Most of this time was the waiting time for doctors. The average waiting time constituted from about 60% to about 75% of the average total time spent at the clinic

Effect of patient and center characteristics on medical complications of hemodialysis [HD] patients in Alexandria

The study included all patients [724 patients] on HD for more than one year in different HD centers in Alexandria [21 centers, 181 machines] during the year 1994. Patient characteristics [PCH] included age, sex, cause of end-stage renal disease [ESRD], duration of HD in years, and number of sessions per week. Center characteristics [CCH] included administrative authority, teaching status, ownership, hospital affiliation, center's age, and numbers of machines, patients, patients per machine, shifts per day, consultants, specialists, residents, qualified nurses, and nurses. Results revealed that, the mean total complications increased with patient's age, HD duration, center's age, and numbers of consultants, specialists, and nurses. It was higher with schistosomal hepatic fibrosis, 3 HD sessions per week, in centers of health insurance organization, teaching and governmental hospitals, and centers not affiliated to hospital. Out of the 19 patients and center characteristics studied using logistic regression analysis in 3 models, 14 characteristics were significant predictors of occurrence of complications to HD patients. These were all PCH [age, sex, duration of HD, number of sessions per week, and presence of diabetes mellitus] and 9 of CCH [teaching status, authority, hospital affiliation, ownership, center's age, and numbers of patients per machine, patients, qualified nurses and shifts per day