Authors (including presenting author) :
Mary Ho(1,2), Ka Yee Ng(1), Patrick Chow(1), Angeline Tong(1), Wilson WK Yip(1,2), Alvin L Young (1,2)
Affiliation :
1. Department of Ophthalmology and Visual Sciences, NTEC 2. Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong
Introduction :
General eye outpatient clinic, among one of the busiest clinics in our hospital, requires multiple pre-consultation assessments before seeing doctors. These fundamental problem makes pre-consultation time long. On average, patients have to wait for 85 minutes before entering doctor consultation room. Hence, it is important to streamline the pre-consultation workflow in order to shorten the waiting time of eye patients.
Objectives :
1. To streamline the pre-consultation assessment model with the aim to smoothen the process.
2. To cut repeated visual acuity (VA) examination in order to reduce the overall pre-consultation waiting time.
Methodology :
The general model of pre-consultation work flow was investigated. A team was formed to assess the average pre-consultation waiting time. A lean management model was applied and areas of potential wastes with repeated procedures were identified. A pilot study was performed with 15% patients, who met the inclusion criteria as stable cases, enrolled into the new model of pre-consultation workflow—“fast track assessment”. The average waiting time were re-evaluated after application of new workflow model.
Result & Outcome :
At baseline, the average pre-consultation waiting time was 65-85 minutes. A selection criteria was applied to patients who were considered as stable cases with frequent follow up at 2- 4 months period. Their last visual acuities were considered as reliable and visual acuity examinations were omitted in the next follow up. These patients could undergo "fast track assessment” by entering only one station for combined intraocular pressure assessment and dilating eye drops application. Their pre-consultation waiting time was reduced by 60%. The overall waiting time of the other patients were also reduced as the process channelled more manpower for those in need for full visual acuity assessment. Conclusions: It is advisable to modify the current work flow of pre-consultation assessment in selected cases. Manpower resources generated from this can be re-directed to other value-added ophthalmic services. The authors advised to continue identify areas for modification in our workflow in order to face the challenge of expanding workload.
