Authors (including presenting author) :
Yeung SY(1) , Chan W(1) , Ho HM(1) , Chow MY(1) , Wong KL(1) , Huang J (1), Wong CS (1)
Affiliation :
(1) Department of Clinical Oncology, Tuen Mun Hospital
Introduction :
The rapid advances in cancer therapy and prolonged patient survival translates into soaring workload in outpatient clinic (OPD) of department of clinical oncology. The annual outpatient chemotherapy attendance has risen from 19427 (year2016) to 24215 (year2019) . The average over time in OPD has increased from 35minutes in 2017 to 46 minutes in 2019. Measures to increase efficiency and to boost staff morale at the outpatient clinic is desperately needed. An experimental incentive system was introduced in August 2020. 2 doctors were allocated to the incentive system each afternoon and would be granted clinical freedom after achieving a weighted output score which is equivalent to 110% of expected output per session. The incentive system runs simultaneously with the conventional OPD.
Objectives :
The incentive system aims to increase doctor’s efficiency in OPD and to improve staff morale. Being run simultaneously with the conventional outpatient clinic, our incentive system provides a good opportunity to study the magnitude of benefit a clinic quota system could bring. The primary endpoint of our project is output per clinic session, secondary endpoint would be clinic overtime and staff satisfaction level.
Methodology :
Output and duration of each OPD session (both in incentive system and conventional OPD system) were prospectively recorded for each doctor. A weight adjusted score (to adjust for complexity of each clinic type) was calculated for each session. Data from September to November 2020 were used. OPD Sessions shorter than 2 hours were excluded. The matched output (in terms of weight adjusted score) for each doctor at the conventional OPD and in the incentive system were compared using paired t test.
Mean clinic finish time from September to November 2020 with and without incentive system were compared by t test.
Questionnaire surveying on the overall satisfaction and comments on the incentive system were sent.
Result & Outcome :
Mean output score per session in incentive system and in conventional OPD were 16.2 and 12.9 respectively (p< 0.001).
Clinic in the incentive system finishes 40 minutes earlier than conventional OPD on average (p< 0.001).
60% of the participants of the incentive system replied to the questionnaire. 100% are satisfied with the system and agreed that the incentive system can promote efficiency of the participating doctors as well as the overall efficiency of OPD. 100% agreed that the incentive system should continue to run and to be expanded to other areas of OPD.
Conclusion: The incentive system can enhance efficiency, decrease clinic overtime and has a high degree of user satisfaction.
