AUTHOR BIOGRAPHIES
Reynan S. Bautista, BSN, RN, Continuous Quality Improvement & Patient Safety , Armed Forces Hospital
Roles: Writing – original draft, Writing – review & editing, Data curation, Methodology, Formal Analysis, Investigation, Resources
Reynan Subahani Bautista (bautistascfhs87@gmail.com) is a registered nurse and a Continuous Quality Improvement and Patient Safety workforce member. He earned his Bachelor of Science in nursing in 2007 at Western Mindanao State University. Currently, he is pursuing a master’s degree in nursing with specialization in nursing administration at the Philippine Women’s University.
*Corresponding author
Muhammad H. Abid, MBBS, MHQS, EMBA, Continuous Quality Improvement and Patient Safety Department, Armed Forces Hospital, Fellow and Mentor, Institute for Healthcare Improvement,
Roles: Writing – review & editing, Formal Analysis, Resources
Muhammad Hasan Abid is the regional head of Patient Experience & Continuous Quality Improvement and patient safety specialist at the Armed Forces Hospitals Taif Region (AFHTR). He is also an Institute for Healthcare Improvement Fellow and Mentor. He provides leadership and strategic alignment of the quality improvement and patient safety projects with the strategic goals for patient experience at the AFHTR.
Lamiaa Elmasry, MBBS, Continuous Quality Improvement and Patient Safety Department, Armed Forces Hospital,
Roles: Project administration, Methodology, Formal Analysis, Resources
Lamiaa Elmasry is the head of the Quality Improvement Division at Al Hada Armed Forces Hospital in Taif Region, Saudi Arabia. She is in the medical profession with a total quality management diploma and hospital management diploma from the American University in Cairo. Additionally, Dr. Elmasry has Lean Six Sigma Green and Lean Specialized qualification from ASQ (American Society for Quality). Moreover, she is an improvement advisor candidate at the Institute for Healthcare Improvement.
Abdulaziz S. Almalki, MBBS, Continuous Quality Improvement and Patient Safety Department, Armed Forces Hospital
Roles: Project administration, Resources
Abdulaziz Saleh Alamalki is currently a physician at Al Hada Armed Forces Hospital and the head of the Medical Violation Department. He was the Outpatient Department Director from 2020–2021. He was part of the Healthcare Quality Management Program by the Ministry of Defense for Health Services in 2022.
Marynette De Vera, MSN, BSN, RN, Outpatient Department,, Armed Forces Hospital
Roles: Data curation, Methodology
Marynette De Vera is the Outpatient Department head nurse at Al Hada Armed Forces Hospital. She earned her Master of Science in nursing degree at University of La Salette in the Philippines.
Jean B. De Asis, MAN, BSN, RN, BSBio, Continuous Quality Improvement and Patient Safety Department, Armed Forces Hospital
Roles: Methodology, Resources
Jean Barriento De Asis is a registered nurse specializing in emergency nursing and a Continuous Quality Improvement and Patient Safety workforce member. She earned her Master of Arts in nursing in 2015 at Urdaneta City University in the Philippines. She is a certified professional in healthcare quality and a certified Lean Six Sigma Master Black Belt and has worked in several improvement projects at Al Hada Armed Forces Hospital.
Jamal Al Nofeye, MBBS, EMBA, MHQS, Continuous Quality Improvement and Patient Safety Department, Armed Forces Hospital
Roles: Conceptualization, Project administration, Resources
Jamal Al Nofeye is the regional director of Continuous Quality Improvement and Patient Safety in Taif Region, Saudi Arabia. He is a current board member of the Taif Health Cluster. He is a physician with double master Executive Master of Business Administration (Hon) Master of Healthcare Quality and Safety (Harvard Medical School) and a certified project manager.
Abstract
Background
The Outpatient Department (OPD) of Al Hada Armed Forces Hospital - Taif Region (AHAFH) plays a critical role in providing specialized medical services to a diverse population in Taif region, Saudi Arabia. The hospital faces the challenge of ensuring timely access to a comprehensive array of 40 specialized services and subspecialties, supported by 120 rooms in the OPD. This article outlines a significant understanding of the patient flow process and queuing mechanism in the context of the OPD and the dynamics of supply and demand.
Local Problem
Our project was initiated during the last few weeks of fourth quarter 2020, which revealed a concerning trend of increasing the third next available appointment (TNAA), surpassing the optimal target of <14 days.
Methods
The study used pre-test and post-test monitoring of the TNAA. Patients’ categories of referral were identified as urgent and routine. We also established a referral and discharge criteria for each clinic specialty and reminder messages on patient appointments 24 hours and 48 hours prior to their actual appointment.
Interventions
The Plan-Do-Study-Act (PDSA) model for improvement was utilized to implement action plans and interventions to address the increase of TNAA (in days) in the OPD. Weekly huddles were conducted to monitor project progress, action plans, data, and challenges.
Results
During the intervention phase, notable changes were observed in the control chart, including shifts in TNAA mean decreasing from 9.4 days to 5.6 days after the implementation of four PDSA cycles. Moreover, the average TNAA in each quarter showed consistent reduction in TNAA, with an average of six days in Q1 2022.
Conclusions
The study sheds light on the complexity of managing the patient flow and access in an outpatient setting. By implementing effective strategies and continuous and vigilant monitoring of the outcomes, outpatient departments can strive to ensure that patients receive specialized care in a timely manner.
