Reducing Waiting-time of Preterm Babies at a Retinopathy of Prematurity Clinic: A Quality Improvement Project

ABSTRACT

Objective: To decrease the waiting time for preterm babiesvisiting the Retinopathy of prematurity clinic in a tertiary eyehospital.Design: Interventional study.Setting: Tertiary eye care hospital.Patients All preterm babies reporting for screening and follow upat Retinopathy of prematurity clinic.Intervention/Procedure A quality improvement teamcomprising of a faculty (team leader), two senior residents, twojunior residents, one nursing officer, and a registration staff wasconstituted.Fish bone analysis was done to understand variousreasons for the high waiting time for preterm babies. Baseline datawas collected followed by multiple Plan-Do-Study- Act (PDSA)cycles.Main outcome measures: Average waiting-time, maximumwaiting-time, and last baby entry-time were measured.Results: The median average waiting-time, maximum waiting-time and last baby entry-time at baseline were 90.5 min (range74.1 to 118.8 min), 177.5 min (range 160 to 190 min) and 111 min(90 to 118 min), respectively. At the end of 3rd PDSA cycle, thesereduced to 77.6 min (range 55.2 to 94.3 min), 122 min (range 110to 135 min), and 60 min (range 45 to 80 min), respectively andwere sustained; the decrease from baseline being 14.3%, 31.2%,and 46%, respectively.Conclusion: The time spent in the waiting area at theRetinopathy of Prematurity clinic was significantly reduced bysimple changes in the process flow.