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Patient friendly OPD

Patient friendly OPD

Outpatient Department (OPD) is the place in a hospital where all patients visit for a wide range of consultations, treatment, diagnostic tests and day surgeries.  Long queues are often seen in front of the registration counters, cash clerks, clinics, laboratories, pharmacy and report collection centers. Eliminating queues in OPD is the most important patient- friendly step that hospitals should take. Also the counters to receive Ladies, Gents, Senior Citizens and Physically Challenged should be separate. Large turnout of patients is not the only reason that makes people wait. Incompetent and inadequate helpers, cumbersome and time consuming procedures and forms, unhelpful and apathetic attitude of staffs and  poor design are some of the processes that contribute to this malady. This often turns visible when the patient gets agitated and shouts at the staff for the delay or favoritism, sometimes taking an ugly turn. This also leaves a room for greasing palm of the menial staff and interference by big wigs of the hospital or other bureaucrats and politicians.

The areas to be taken care of include problem free parking, wait less registration and attendance by the doctor, hassle free payment of dues and prompt availability of the investigation report. Happily all these can be achieved.

Since patient spends a considerable amount of time waiting in the OPD, it is necessary to provide a pleasing ambience and present a warm, cheerful and pleasant atmosphere with emphasis on patient comfort. Suitable paintings, indoor plants go a long way in making interior cheerful. Imaginative use of color and lighting is equally important. Aphorisms displayed artistically on the walls can be educative. Advanced eye centre at PGI is a good example to emulate in this regard.

What can be done?

Patients with uncomplicated conditions can be cared for by their Family Physician or by GDMOs in the civil dispensary or general OPD screening centers that can be set up specially by institutes like PGI/AIIMS  , away from the  tertiary hospital and refer only complicated conditions to the main hospital. Move to set up OPD blocks at New Chandigarh to screen and refer cases to main hospital at PGI will be able to reduce chaos to a great extent. A Family Physician in the  private GP clinic or government polyclinic is the best person to help you deal with most of the simple medical problems and determine where and who should patient go to for the next level of care, if required. Their referral will also help you avoid problems that arise if you see the wrong type of specialist, on your own.

Defective parking system as prevalent now has choked the campus of various hospitals and this has resulted in a nightmarish experience to its visitors, resulting in frequent brawls and verbal duals. If the vehicles are used only for drop and pick up and parked at a designated multi story parking elsewhere as is the case in Singapore general hospital, the place will become more hospitable.

Use of internet for Pre-registration can take away most of the irritants and eliminate queues. The patients can get pre-registered in the comfort of their own homes by filling an on line form and generate a token. This will show their serial number, name of the consultant, room number and the time of appointment.  This also entails keeping an electronic record of patients from the point of first consultation to admission, acceptance in the wards, transfer from one ward to another, until their discharge. In case the doctor is unavailable or there is change in schedule, intimation by SMS can be sent to the patient concerned and appointments rescheduled. As the pre-registered patients come with their self generated tokens to the hospital, the staff will keep. OPD cards and record files ready. This requires sending the list one day in advance by the tele-centre of all patients scheduled for visit on a given day. The most important requirement is the will and initiative of the hospital in having it implemented

This can be done by the IT cell of the hospital or through call centre’s assistance. Although Call-centers are common in commercial industries like telecom, the concept has been alien to hospitals. An integrated call-centre can manage extensive backend administrative chores and services besides providing a host of patient related activities on a common platform. Mobile number is captured in the EMR and verified by the Call-centre while giving appointment. Call centre can collate all data, integrates with mobile application and acts as a ‘human middleware’ to the masses. Majority of the members of public may be skeptical but such a simple initiative could transform healthcare delivery in the OPD setting.

The hassle of making payments at centralized cash counters situated at far flung areas can also be sorted by computerization, where the sister in-charge of the section or ward can receive payments and issue computer generated receipts, saving a lot of time and effort of the patient/attendants. Where possible, cash handling can be avoided by payments through cash cards/debit cards/Credit cards etc.

The troubles in collection of reports from different departments can be avoided by posting the report on the web. SMS facility can be introduced for informing patients when their reports are ready to be accessed from the web. In addition hospital can connect all radio-diagnosis machines to the network in order to give access to MRI and CT scan images in OPDs on computers or smart phones, of the doctors. Our vision is to have mobiles as enabling devices for the empowerment of society so that appropriate information is available without barriers to the masses.

These few measures can eliminate queues and make hospital OPDs patient friendly.

 

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