Optimization of service process of hospital outpatient pharmacies based on PDCA / 现代医院

Objective To explore the application of Plan-Do-Check-Act(PDCA)cycle management to continuously im-prove the service quality of outpatient pharmacy and enhance patient satisfaction.Methods To address the problem of long wait-ing time for patients in outpatient pharmacy,we applied PDCA cycle to investigate the factors affecting patients'waiting time in the process of medicine collection,analyze the current situation,determine the expected goals,formulate the service quality im-provement plan of outpatient pharmacy,implement the improvement plan,follow up and supervise,and summarize and analyse the problems regularly until it was solved.Results After implementing the PDCA cycle in the management,the service quality of outpatient pharmacy was improved,the waiting time was significantly shortened and the satisfaction of medical treatment was in-creased.Conclusion The application of PDCA cycle method is effective in improving the service quality of outpatient pharmacy.Therefore,it is recommended for broader implementation.

Improving the Waiting Time in Outpatient Clinics Using Lean Approach in Hospital: A Systematic Review

@#Introduction: The use of the lean approach in healthcare has rapidly gained popularity globally, although this approach was more routinely used in the manufacturing sector as opposed to health. Besides, recent studies confirm the suitability of the lean approach applications for improving the quality of medical care. This study aimed to determine the Lean approach’s capacity to improve the waiting time in outpatient clinics in hospitals. Methods: The systematic review approach was employed to help in the research procedures. Search databases used included Ovid, Google scholar, PubMed, MEDLINE, and archive. Besides, search terminologies such as the Lean approach, Hospital-implementation, waiting time, and patient flow were used to help identify sources that best suited the investigation process. Results: The review revealed that the lean approach is suitable for the reduction of waiting times as well as for improving efficiency in the clinic. The outcomes provide a basis for reducing the average waiting time within the hospital. Conclusion: This study recommended that healthcare facilities and departments should take a keen interest in implementing the Lean approaches, as they are crucial for reducing waiting time.

Effects of prolonged waiting time on visual outcomes of patients with pediatric cataract in a Tertiary Public Hospital

Background@#Pediatric cataract is one of the most common preventable cause of childhood blindness worldwide. Early and timely intervention of pediatric cataract is important to maximize the visual outcomes and start prompt visual rehabilitation.@*Objectives@#This study aimed to determine the average time from the day of initial consult at the outpatient clinic to the day of the cataract surgery and compare the effects of delayed surgery on visual outcomes of patients.@*Methods@#This is a retrospective chart review of medical records from January 2015 to June 2022. The dates of the different steps in the process up to the day of intervention were noted and the average interval duration and the total waiting time were determined. Patients operated on within 2 weeks from initial consult was defined as no delay while those operated >2 weeks had delayed surgery. Pre-operative and post-operative best corrected log MAR visual acuity were compared within each group to determine if delay in surgical intervention has a significant effect on the visual outcomes of patients.@*Results@#Median age at initial consult was 4.9 years while median age at surgery was 5.2 years. Ninety-nine (99) patients had developmental cataract and 123 patients had bilateral cataract. Leukocoria was the most common chief complaint (63.45%). Pre-operatively, 94 patients had strabismus, 49 had eye preference, 48 had nystagmus, and 43 had amblyopia in the diagnosis. There was significantly faster admission to cataract surgery during the pandemic compared to pre-pandemic period but there was no difference in the total waiting time. Patients with congenital cataract had the least total waiting time followed by developmental, and rubella cataract. There is no significant difference in visual outcomes between patients operated without delay and with delay.@*Conclusion@#There is delayed age at diagnosis and surgery of pediatric cataract patients in the Philippine General Hospital. Early surgery did not reflect better visual outcomes compared to delayed surgery probably due to delay in consultation of patients.

Assessment of the patient satisfaction level with outpatient department services in a tertiary care hospital of Jammu region

Background: Outpatient department (OPD) is that section of the hospital which is staffed and equipped to provide diagnostic, therapeutic and rehabilitative care to those patients who are not registered as inpatients while receiving the services during scheduled working hours. Objective of the study was to assess the patient satisfaction level with OPD services in a tertiary-care hospital of Jammu region. Methods: A cross-sectional study was conducted among patients visiting the OPD of the SMGS hospital GMC Jammu from January to March 2023. Exit interviews were conducted using a semi-structured questionnaire among patients availing the services from OPD. Results: Average percentage of total satisfaction score among sampled OPD patients has come out to be 68.13% whereas total average dissatisfaction score was 20.87% and the total average mild dissatisfaction score as 11.00%. Conclusions: This study suggests that patients were satisfied to a larger extent with OPD services except a few which are least satisfied especially with waiting time at registration counter.

Association between waiting time, service time and patient satisfaction in the out-patient department of a tertiary care hospital in Maharashtra

Background: Quality patient care is controlled by various factors - degree of fulfilment of patients' needs being one of them. Lesser waiting times, empathetic doctors and availability of medications yield more satisfied patients. Methods: A descriptive cross-sectional study was carried out among 80 patients attending the OPD of a tertiary care hospital from 9 am to 1 pm, Monday to Saturday from 8th February 2021 to 8th April 2021. Consenting patients were shadowed and observed until they completed their visit. Actual waiting time, consultation time and overall visit duration were calculated. An exit interview was conducted to assess satisfaction with waiting time, infrastructure and doctor-patient interaction. Results: The mean waiting time in one visit was 59.025±39.497 minutes. The mean consultation time with the doctor was 6.925±7.688 minutes. Statistical analysis showed that patients with lesser waiting time were significantly more satisfied with hospital services (p=0.004). Domains of dissatisfaction were waiting time at the registration desk, outside the OPD, seating arrangement, cleanliness and availability of medications. Doctor-patient interaction and consultation time were rated highly. Conclusions: The results showed that significant changes are required in the queueing system and hospital infrastructure. The positive response received in case of doctor-patient interaction is a step in the right direction. Regular surveys can help us rectify oversights in the present healthcare system.

Teorías subjetivas sobre el tiempo de espera y experiencias de la parentalidad adoptiva / Subjective theories about waiting time and experiences from adoptive parenting

Resumen El proceso de adopción comprende cambios importantes en las familias adoptivas, pues implica una reestructuración y adaptación a una nueva organización del sistema familiar. Durante este proceso los padres elaboran expectativas y creencias respecto a cómo comportarse frente a los cambios y adaptarse a sus hijos, desde donde dirigen sus prácticas de crianza. La percepción del tiempo que tenga cada persona posee un papel en cómo se desarrolla la identidad tanto individual como familiar, pues las experiencias pasadas, vivencias actuales y expectativas del futuro influyen en sus acciones. Por lo tanto, es posible decir que los padres adoptivos elaboran teorías subjetivas sobre este proceso y especialmente en relación con el tiempo de espera de la adopción, explicaciones que podrían incidir en la forma en que enfrentan este nuevo desafío y se preparan para la parentalidad. El presente estudio tuvo por objetivo comprender las teorías subjetivas sobre el tiempo de espera y las experiencias de la parentalidad adoptiva. Participaron diez madres y padres adoptivos mediante entrevistas episódicas individuales. Se analizaron los datos obtenidos utilizando técnicas de tres procedimientos de análisis: de contenido basado en la Teoría Fundamentada, específico para las teorías subjetivas y de la perspectiva temporal. De los hallazgos se destacan teorías subjetivas de contenido emocional ansioso durante el proceso de adopción. Además, contar con una red de apoyo, compartir experiencias con otros padres y el uso de estrategias personales son las principales estrategias de adaptación de los padres adoptivos que les permiten sobrellevar los sentimientos negativos durante el proceso.

Abstract The adoption process includes important changes in adoptive families, since it implies a restructuring and adaptation to a new organization of the family system. The path to parenthood entails changes at levels of mental, physical and social health, which in the case of adoptive parents, the challenges are greater or are altered in some way due to the unique characteristics of their experiences and the obstacles they face. To these challenges are added the usual stressors that parents face, such as changes in roles, increased stress, lack of sleep, alterations in the relationship and intimacy of the couple and difficulties that arise in raising their children. On the other hand, time is configured as a concrete dimension through which life develop. The relationship between objective time and subjective or psychological time will shape the perception of time that each person has, which has a role in how both individual and family identity develops. This is because people´s actions are influenced by past experiences, current experiences and future expectations. One of the areas of the adoption process that has not yet been deepened is the waiting time, the period of time between obtaining the suitability and assignment of the minor to the adoptive family, which can be considered important for the future family depending on how adoptive parents face it, this because the way in which the adoption process is experienced impacts both the path to parenthood and post-adoption adaptation. In fact, it confirms that waiting time influences the psychological well-being of adoptive parents. Therefore, it is possible to say that adoptive parents elaborate subjective theories about this process and especially in relation to the waiting time for adoption, explanations that could influence the way in which they face this new challenge and prepare for parenthood. The present study aimed to understand subjective theories about the waiting time and experiences of adoptive parenting. Ten adoptive mothers and fathers participated in this study through individual episodic interviews. The data obtained were analyzed using techniques of three analysis procedures: content based on Grounded Theory, specific for subjective theories and time perspective.

Patients’ perception of quality of tuberculosis healthcare service in South West Nigeria

Background: Nigeria has the highest burden of tuberculosis (TB) in Africa and is among the 14 countries in all the 3 world health organization global high-burden countries for TB, TB/HIV and MDR-TB. The aim of this study was to assess patients’ perception of the quality of TB healthcare in Southwest Nigeria Methods: The study utilized the cross-sectional design, and data was collected from drug-sensitive TB clients receiving care at health facilities providing TB healthcare services Results: The average time clients spent to get to TB facilities from home was 23 minutes, the average waiting time was 6.7 minutes, and the average medical visit time was 17 minutes. Sixty-seven percent of respondents strongly agreed that doctors explained medical test result with them and 68.7% strongly agree that they wanted the medical doctors to spend more time with them. The mean score for convenience of accessing drugs was 4.8±0.5 mins, mean score for convenience of accessing laboratory test was 4.7±0.6 mins and mean score for convenience of accessing chest x-ray was 3.8±1.4 mins. Overall, the quality of TB care was perceived to be good. Conclusions: Overall, the quality of TB services is very good from the perspectives of the patient, however, there is need to improve integrated patient-centered TB healthcare services by medical doctors. In addition, access to chest x-ray services should be improved to enhance quality of TB services.

Technical expertise and behavior of the doctor- a major determinant of waiting time of OPD patients

Background: The study was conducted to understand various factors affecting waiting time spent by the patients in outpatient department (OPD) and to provide recommendations for reducing the waiting time in OPD of the selected hospital. Methods: It was a descriptive cross-sectional pretested questionnaire-based study involving all new 100 consenting patients at OPD recruited into the study using a systematic sampling technique after calculating the sampling interval. Results: The study indicates that 70% of patients were satisfied and only 30% were dissatisfied with the attention given by the OPD staff, cleanliness, attentiveness of doctor but shows great dissatisfaction regarding the waiting time spent by them in the outpatient department. Most of the subjects gave the reason for their satisfaction despite more time because of expertise of the doctor, behavior of the doctor, association of hospital with non-government organizations and insurance companies for free medicine and surgery. The dissatisfaction was not because of lack of administration but because of low level of awareness amongst patients attending the OPD about internet booking of appointment, COVID protocols, priorities given to recommendations given by other doctors/VIPs and walk in OPDs attended without prior appointment. Conclusions: A very important observation which evolved from the study was the version of patients that waiting time does not matter because they want to be treated from same doctor due to his/her expertise. Second important observation was that the addressing and greeting of patient by his/her name gave a great satisfaction and level of comfort to patients and affects the waiting time.

Correlation between the waiting time for radiotherapy and prognosis after induction chemotherapy for locally intermediate and advanced nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To investigate the correlation between the waiting time for radiotherapy after induction chemotherapy and the prognosis of locally intermediate and advanced nasopharyngeal carcinoma, as well as its optimal time.Methods:Retrospective analysis of 101 patients with locally intermediate and advanced nasopharyngeal carcinoma admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from 2017 to 2020 was performed. All patients received at least 2 courses of induction chemotherapy followed by radical radiotherapy. The waiting time for radiotherapy was defined as the time from the end of induction chemotherapy to the start of the first radiotherapy. The relationship between waiting time for radiotherapy and other factors (age, gender and stage, etc.) with progression-free survival (PFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) was analyzed through Cox model. The median waiting time for radiotherapy with 3 weeks was used as the boundary, and all patients were divided into ≤3 weeks and>3 weeks groups. The PFS, LRFS and DMFS between two groups were compared using Kaplan-Meier survival analysis. P<0.05 was considered as statistical significance. Results:Cox-regression analysis showed that the waiting time was correlated with PFS, LRFS, and DMFS (all P<0.05). Kaplan-Meier survival analysis suggested that the PFS, LRFS and DMFS in the ≤3 weeks group were significantly better than those in the >3 weeks group (all P<0.05). Under the premises of the T 3 stage, N 2 stage and the increased EB virus DNA replication levels before treatment, the PFS, LRFS and DMFS in the ≤3 weeks group were significantly better than those in the >3 weeks group (all P<0.05). Conclusions:The waiting time for radiotherapy is one of the factors affecting clinical prognosis of locally intermediate and advanced nasopharyngeal carcinoma. The earlier the time, the better the prognosis. Radiotherapy should be delivered within 3 weeks.

Queuing Dynamics and Beneficiary Satisfaction in The OPD Of a Tertiary Care Centre in Bankura, West Bengal

Context/Background: Queuing, a major problem faced by beneficiaries availing services in public health care system, may also have influence on the level of satisfaction among beneficiaries. Aims/Objectives: To describe the queuing dynamics in the OPD, to explore different factors influencing the level of satisfaction among the beneficiaries and their perception regarding possible ways to improve the queuing situation. Methodology: A hospital-based analytical study was conducted in an OPD of Bankura Sammilani Medi-cal College and Hospital, West Bengal, among 202 beneficiaries. Data were collected from subjects, se-lected from random queue in total 30 shifts (30 minutes each) on different working days, using prede-signed, pretested, questionnaire.Results: Queuing dynamics revealed utilization factor of 75%, while 25% probability of the system be-ing idle. Only 39.1% of the subjects were satisfied with the service in Paediatric OPD, in context of wait-ing in queue. MLR revealed subjects waiting in queue for a duration ≤ 1 hour and those with > 4 minutes consultation time were found to be more satisfied. Conclusions: Considering variable consultation time, arrival and service rates at the OPDs and re-sources, a well-planned system can minimize the waiting time and thus improve the level of satisfaction among the beneficiaries.

Tiempos de espera de pacientes programados en un servicio de ecografía de consulta externa / Scheduled patient waiting times in an outpatient ultrasound service

INTRODUCCIÓN: la seguridad social se encarga de la atención médica de los trabajadores asalariados. OBJETIVOS: determinar los tiempos de espera en las programaciones de ecografía y conocer el nivel de satisfacción de pacientes asegurados en el Policonsultorio 20 de octubre de la Caja Petrolera de Salud. MÉTODOS: estudio descriptivo de corte transversal y cuantitativo. Se seleccionaron 1110 solicitudes de las gestiones 2012 ­ 2014 y 1110 pacientes que tenían su solicitud de ecografía en programación actual. Se revisó los expedientes clínicos y archivos de ecografía y se realizó cuestionarios estandarizados con escala Likert a los pacientes para medir el nivel de satisfacción. RESULTADOS: el 26% de los pacientes esperaron de 4.1 a 5.1 semanas (29-35 días), existieron 2.2 solicitudes de ecografía por cada paciente, el 93% de los pacientes no está nada o poco satisfecho con los periodos de espera y el 58% considera aceptable esperar entre 1.1 a 2.0 semanas (2-14 días) para la realización del estudio. DISCUSIÓN: se deben realizar acciones que mejoren la calidad de atención y satisfacción del paciente, una de ellas es disminuir los periodos de espera en las programaciones de ecografía.

INTRODUCTION: social security provides medical care for salaried workers. OBJECTIVES: to determine waiting times for scheduled ultrasound appointments and the level of satisfaction of insured patients at Policonsultorio 20 octubre, Caja Petrolera the Salud. METHODS: this is a descriptive, cross sectional, quantitative study. One thousand one hundred and ten ultrasounds orders from the 2012 ­ 2014 administration and 1110 patients who had ultrasounds orders currently scheduled were selected for review. Clinical records and ultrasounds files were reviewed and patients answers using a standardized questionnaire using the Likert scale were used to measure their level of satisfaction. RESULTS: twenty-six percent of the patients waited 4.1 to 5.1 weeks (29-35 days), there were 2.2 ultrasounds orders per patient, 93% of the patients are somewhat or completely dissatisfied with the waiting times, and 58% consider it acceptable to wait from 1.1 to 2.0 weeks (2-14 days) to undergo the study. DISCUSSION: Actions are needed to improve the quality of care and patient satisfaction, one of which is to shorten waiting times for scheduled ultrasound.

The current situation of teleophthalmology on national telemedicine center from 2015 to 2021 / 中华眼底病杂志

Objective:To observe the demographic data, disease composition and convenience of remote consultation in ophthalmology.Methods:A retrospective study. From 2015 to 2021, the demographic data, changing trends, disease classification of teleconsultation patients, and hospitals participating in teleconsultation, and the waiting time of patients for teleconsultation was analyzed retrospectively; remote consultation physician level composition and other data was analyzed.Results:During the 7-year period, 1 216 patients with remote consultation were obtained through the platform of the telemedicine center. Among them, there were 680 males and 536 females; the average age was 50.8 years. In 2016 and 2017, the number of patients participating in telemedicine consultations reached a peak of 260 and 221 cases, respectively. Among the ophthalmic diseases, there were 490 cases (40.30%, 490/1 216) of retinal and optic nerve-related diseases, 212 cases (17.43%, 212/1 216) of ocular trauma. 678 cases (56.27%, 678/1 205) of remote consultation waiting time were less than 24 hours, 991 cases (82.24%, 991/1 205) were less than 48 hours. Among the physicians who participated in the remote consultation, there were 733 chief physicians (60.3%, 733/1 216) and 466 deputy chief physicians (38.3%, 466/1 216).Conclusions:During the seven-year period from 2015 to 2021, there are relatively few patients with ophthalmology teleconsultation; retinal and optic nerve-related diseases accounted for a high proportion. Remote consultation has high convenience.

Effect of waiting time before colonoscopy on bowel preparation quality in hospitalized elderly patients / 中国实用护理杂志

Objective:To explore the influencing factors of bowel preparation quality in hospitalized elderly patients, and to find the appropriate waiting time from the end of bowel preparation to the beginning of colonoscopy.Methods:Baseline and clinical data of elderly patients over 60 years old who underwent colonoscopy in the Tenth People′s Hospital, Tongji University from February 2021 to August 2021 were collected. Multivariate analysis was used to screen the factors that might affect the quality of bowel preparation in hospitalized elderly patients. Patients were grouped according to waiting time before colonoscopy. After eliminating confounding factors using propensity matching analysis, the difference of bowel preparation quality among groups was compared.Results:251 patients were included in the study. Multivariate analysis revealed that, hypertension ( OR=3.530, 95% CI 1.295-9.618), chronic constipation ( OR=3.302,95% CI 1.132-9.632), dietary compliance ( OR=0.161, 95% CI 0.070-0.371), medication and drinking water compliance ( OR=0.167, 95% CI 0.070-0.397), exercise compliance after medication ( OR=2.245, 95% CI 1.040-4.845), The frequency of defecation after medication ( OR=0.446, 95% CI 0.308-0.647) and waiting time ( OR=0.537, 95% CI 0.387-0.745) were important factors affecting the quality of bowel preparation in hospitalized elderly patients ( P<0.05). There were differences in bowel preparation quality between groups of waiting times. The overall quality of bowel preparation in 120-180 min group was significantly better than that in 241-300 min group, 301-360 min group and>360 min group ( P<0.05). The overall quality of bowel preparation in 181-240 min group was better than that in >360 min group ( P<0.05). There were no significant differences among other groups( P>0.05). The scores of cecum and ascending colon were the best in 120-180 min group, and the cleanliness of descending colon, sigmoid colon and rectum was significantly higher in 241-300 min group, 301-360 min group and > 360 min group. The scores of descending colon, sigmoid colon and rectum showed that the intestinal preparation quality of 181-240 min group was better than that of 301-360 min group and > 360 min group. Conclusions:The best examination time for elderly patients is about 180 minutes after bowelpreparation. Medical workers should flexibly guide the medication time to ensure that patients are in the best clean state of intestinal tract during examination.

Service time, waiting time, good practices and areas for improvement in the UP Health Service during the 2020 COVID-19 pandemic: A five-day cross-sectional study

Background@#The COVID-19 pandemic has emphasized the critical task of the UP Health Service in recognizing and addressing the primary care needs of health care workers and support staff of the Philippine General Hospital. This helps in effective staff management and engendering trust in the hospital that performs critical functions in the pandemic response.@*Objectives@#To determine the service and waiting time in the facilities of the UPHS and describe good practices and areas for improvement for better service delivery at the UPHS during the COVID-19 pandemic@*Methods@#A cross-sectional study using patient flow analysis of processes in the non-COVID, COVID, and swabbing areas of the UPHS was conducted from June 1 to 5, 2020. All clinic visits by PGH employees and health care workers, including consultations and procedure for swabbing, were included in the study. Average service and waiting time in three areas of the UPHS were measured and analyzed from recorded time points using Microsoft Excel. Daily observations recorded on field notes were transcribed and analyzed using MaxQDA Analytics Pro 2020.@*Results@#A total of 604 PGH employee visits in the three main service areas of the UPHS were recorded during the 5-day study period. The average total service time was 25 (SD±17) minutes in the non-COVID clinic and 12 (SD±5) minutes in the COVID clinic. The mean swabbing time was 2 (SD±3) minutes. The average waiting time was longest in the COVID clinic at 46 (SD±39) minutes, followed by the swabbing area at 33 (SD± 32) minutes, and was shortest in the non-COVID clinic at 10 (SD±17) minutes. Good practices were observed in the areas of communication and coordination among the UPHS team, staff complementation, and application of telehealth solutions. Meanwhile, improvements may be made in identifying a practical and robust queuing system, enforcing firmer infection prevention and control measures and providing clearer patient instructions and cues especially during patient surge.@*Conclusion@#The average service time in the non-COVID, COVID and swabbing areas of the UPHS, were 25, 12 and 2 minutes, respectively. The average waiting time was longest in the COVID clinic, followed by the swabbing and non-COVID areas. Good practices were observed in terms of leadership, communication, staff complementation and feedback process while infection control and prevention measures, queuing system for crowd control and patient instructions can be further improved.

Practice on fine management to shorten outpatient waiting time / 中华医院管理杂志

To solve the problems of long waiting time for outpatients, difficulty on implementation of one patient one room initiative, backward appointment method on examination, and imperfect instruction and guidance, a series of fine management measures have been taken place in a tertiary hospital which included dividing the patient waiting queue reasonably, establishing the patient secondary consultation system, improving the outpatient order of two-way management between doctors and patients, establishing one key appointment system for examinations, building hospital intelligent navigation system, and implementing outpatient payment and self-service drug delivery.The results showed, the waiting time of outpatients was significantly shortened ( P<0.001), and the satisfaction of patients in waiting time, hospital guidance and appointment registration was significantly improved ( P<0.05). Fine management mode combining online and offline can effectively increase the efficiency of outpatient service, improve clinical experience, and facilitate the high-quality development of medical services.

Effect analysis of the medical treatment for first-visit patients based on Internet technology in a cancer hospital / 中华医院管理杂志

Objective:To analyze the effectiveness of the consultation system for first-visit patients at the breast center during COVID-19 epidemic, and to provide reference for other departments and medical institutions.Methods:4 647 patients who used the consultation system from May 12, 2020 to December 31, 2020 and 4 622 patients who came to the hospital for treatment in the same period of 2019 before the application of the system were used as the research objects. Chi-square test and independent sample t-test were used to compare the patients′ age, source, proportion of patients who actually need treatment, and the waiting time from appointment to treatment. The medical cost saved after the application of the system was calculated. Results:After the application of consultation system, the proportion of elderly patients in first-visit patients increased from 15.9% to 17.9%, the proportion of patients who were not from Beijing increased from 70.2% to 74.3%, the proportion of patients who really need treatment increased from 41.4% to 71.5%, and the waiting time from appointment to treatment decreased from 5.0±4.8 days to 3.9±2.3 days, with significant differences( P<0.05). After the application of the system, a total of 6.177 million yuan was saved for patients, with an average of 3 895 yuan for each patient. Conclusions:The application of the first-visit consultation system is conducive to deepening the content of pre-diagnosis services, improving the accessability to high-quality medical resources, promoting the effective utilization rate of medical resources, shortening the waiting days, and saving medical costs.

Practical exploration of one-stop admission service in a general hospital / 中华医院管理杂志

The authors introduced the construction of one-stop admission service in a large general hospital.Measures were carried out by implementing the measures of one window handling of admission business, building one-stop pre-hospital preparation center, optimizing the operational pattern of pre-hospital examination, strictly controlling the hospitalization time of surgical patients, optimizing the information system according to admission criteria, providing personalized services for clinic and implementing quality monitoring.It effectively improved the pre-hospital examination rate, shortened the waiting time and the average length of stay of the patients undergoing elective surgery, and increased the satisfaction of pre-hospital patients.

Effect of painting intervention based on Mandala-self theory on mood and physiological state in patients in preoperative waiting room / 中南大学学报(医学版)

OBJECTIVES@#The waiting room for surgery is an area set up to improve the surgical turnover rate, but the waiting time for surgery is uncertain. Patients are prone to negative emotions that affect their physiological state during waiting time. This study aims to explore the effect of Mandala painting intervention based on Mandala-self theory on the emotion and physiological state of patients waiting before operation.@*METHODS@#The patients in the control group (@*RESULTS@#Diastolic pressure, heart rate, and happiness and excitement showed no statistical significance in the time effect, intervention effect, and interaction between the 2 factors (all @*CONCLUSIONS@#The application of Mandala painting in the operation waiting room is feasible and can effectively regulate the patients' negative mood and systolic pressure, as well as shorten the waiting time of perception.

Quality of referrals to a rheumatology service before and after implementation of a triage system with telemedicine support

Abstract Purpose: To evaluate the quality of referrals for a first Rheumatology consultation at a tertiary care center in a southern Brazilian capital (Porto Alegre, RS), having as background findings from a similar survey performed in 2007/2008. Since then, our state has implemented referral protocols and a triage system with teleconsulting support exclusively for referrals from locations outside the capital, permitting a comparison between patients screened and not screened by the new system. Methods: Physicians of the Rheumatology Service at Hospital Nossa Senhora da Conceição prospectively collected information regarding first visits over a 6-month period (Oct 2017 to March 2018). We recorded demographic characteristics, diagnostic hypotheses, date of referral, and the municipality of origin (within the state of Rio Grande do Sul). We considered adequate referrals from primary health care when a systemic autoimmune inflammatory disease (SIRD) was suspected at first evaluation by the attending rheumatologist. Results: Three hundred fifty-seven patients/appointments were eligible for analysis (193 from the capital and 164 from small and medium towns). In 2007/2008, suspected SIRD occurred in 76/260 (29.2%) and 73/222 (32.9%) among patients from the capital and outside counties, respectively (P = 0.387). In 2017/2018, suspected SIRD occurred in 75/193 (38.9%) and 111/164 (67.7%) in patients from the capital and outside counties, respectively (difference: 28.8, 95% CI: 19.0 to 38.9, P < 0.001), indicating a marked improvement in referrals submitted to the new triage system. Conclusion: The quality of Rheumatology referrals in our state improved over the 10-year interval under study, particularly among patients from locations submitted to referral protocols and teleconsulting support.

Satisfacción del usuario externo en tiempo de espera en el servicio de emergencia del hospital general IESS de milagro ­ ecuador / The external user satisfaction in waiting time in the hospital general IESS emergency service Milagro - Ecuador

En la actualidad, los ser-vicios de emergencias en los pacientes tienden a tener inconvenientes al acceso a la atención médica en distintas áreas del hospital, convirtiéndose en un problema de salud pública. Objetivo: Determinar el nivel de satisfacción del usuario ex-terno en tiempo de espera en la atención del servicio de emergencias del Hospital General IESS Milagro. Método: El diseño de investigación fue cuantitativo, descriptivo de cohorte transversal. La población fueron todos los pacientes que acudieron a emergencia en el periodo septiembre 2019, tomando una muestra de 170 pacientes. Como técnica se seleccionó la encuesta y como instrumento se elaboró un cuestionario con 15 preguntas valida-do por juicios de expertos en salud comprobando validez, pertinencia y coherencia. Resultados: Rango de edad mayor entre 40 a 49 años (38,8%), sexo masculino (70%), día en la semana que asisten frecuentemente; lunes (33,5%), Evaluación al personal médico; Bueno (47,6%), Compresión de la explicación que brindó el médico; Si (84,7%), Realización de examen físico; Si (72,4%), Compresión de la explicación que brindó el personal de enfermería; Si (87,1%), Evaluación al personal de enfermería; Bueno (55,5%), Evaluación al personal administrativo; Bueno (60,6%), Trato con amabilidad y paciencia; Si (88,2%), Brazalete asigna-do; Azul (64,7%), Tiempo de espera; 30 a 60 min (25,3%), Explicación de ruta a seguir; Siempre (82,4%), Señalética de orientación; A veces (37,6%), Personal para orientar en los servicios de emergencia; Nunca (62,4%). Conclusión. Se encontró altos niveles de insatisfacción en señaléticas y orientación en servicios de emergencia. Sin embargo, el tiempo de espera de los usuarios atendidos fue considerable(AU)

Currently, emergency ser-vices for patients tend to have difficulties in accessing medical care in different areas of the hospital, becoming a public health problem. Objective. To determine the external user satisfaction level in wai-ting time, in the General Hospital IESS Milagro emergency service attention. Me-thod. The research design was quantita-tive, descriptive of the cross-sectional co-hort. The population was all the patients who went to the emergency in the period September 2019, taking a sample of 170 patients. As a technique, the survey was selected and as an instrument, a question-naire with 15 questions was prepared, va-lidated by the opinions of health experts, checking validity, relevance and coheren-ce. Results. Older age range between 40 to 49 years (38.8%), male sex (70%), day in the week that they attend frequently; Monday (33.5%), Evaluation to medical personnel; Good (47.6%). Compression of the explanation provided by the doctor; Yes (84.7%), Performing physical exa-mination; Yes (72.4%), Compression of the explanation provided by the nursing staff; Yes (87.1%), Evaluation of nursing staff; Good (55.5%), Evaluation to admi-nistrative staff; Good (60.6%), I treat with kindness and patience; Yes (88.2%), as-signed bracelet; Blue (64.7%), Waiting time; 30 to 60 min (25.3%), Explanation of the route to follow; Always (82.4%), Orientation signage; Sometimes (37.6%), Personnel to guide emergency services; Never (62.4%). Conclusion. High levels of dissatisfaction were found in signs and orientation in emergency services. Howe-ver, the waiting time of the users served was considerable(AU)