The Royal Melbourne Hospital (RMH) like other facilities across Australia running outpatient clinics usually find it difficult dealing with long patient queues and the confusion that comes with it. Patients are also concerned with the long waiting time at the reception and at the waiting bay. There is thus need for a solution and as a recommendation in this presentation; the facility should install a digital electronic queue management system at both its RMH City Campus and RMH Royal Park Campus outpatient clinics. This presentation thus involves the description of the system, best practices using the technology, related barriers and enablers of the project, methodology for choosing participants in related focus groups and further, the ethical considerations in rolling out the project.
According to the management and the workers at the Royal Melbourne Hospital, long patient waiting time at the outpatient section has become a serious concern. A thorough research established that there are different factors that contribute to the long waiting menace at the RMH’s outpatient clinics. These include first, long queues at different reception desks and waiting rooms that are very crowded. Secondly incorrect details of patients in the facility’s administration that then needs clarification and challenges in pronouncing patient name by clinic staff also increase waiting time. A number of patients have continuously also raised concerns over their privacy in regard to name-calling at the waiting bays within the outpatient unit. Further, where clinical staff members have been unaware whether a patient had already checked in or whether they are ready to be served, the confusion has ever been leading to clarifications that are a waste of time.
Best Practice & Recommendation
Best practice requires that hospitals develop strategies which can accelerate the flow of clients/patients at crowded units especially in outpatient clinics and improve service integration. It also provides practical approaches which can be used to reduce the wait times at the clinic. One of the most effective methods to solve this particular problem is to use a self-check-in and electronic calling system (Ibanez et al, 2015). Since this system is specifically for hospitals, it will enable patients to automatically check in without queuing at the outpatient reception. The patients can also leave the waiting bay and reduce the usual congestion but called back remotely before their appointments. The system will also be important in facilitating the capturing and verification of individual patient’s data automatically. Research indicates that queue management systems allow hospitals to create a criterion for improving services ((Ibanez et al, 2015). Since calling of patients will be done automatically, the system captures both call and complete time stamps for reference. The facility can then evaluate their performance in regard to the maximum time a patient needs to take at a particular section. This can also inform decision making on the need to improve service speed among healthcare workers (Xie, 2013). The system will capture the arrival time of each patient, their call, time taken for consultation and in-clinic wait time.
Hospitals using the electronic queue system which I also recommend for the RMH, have reported shorter and/or no queues at outpatient reception desks. They have also reported reduced crowding at the waiting rooms with staff giving a positive feedback. It helps solve the patient name pronunciation problem and provides a visual display of the flow of patients within the outpatient unit. Automation of queuing management increases the workers rate of compliance with maximum time for patient call and completion during consultations (Xie, 2013). Statistically, the system is reported to be able to thus reduce the wait time at clinics to below 20 minutes for each patient. As a result, I highly recommend the installation of the electronic queue management system at the ABCD hospital’s outpatient care unit in order to solve the problem of long waits for patients.
Enablers & Barriers
Among the enablers should first be that the facility will serve patients with posters indicating how the electronic queue management system works. Secondly, the workers are likely to be willing to embrace the technology understanding well that it will reduce their work burden. Further, it is also easy and logical to have assistant to direct those patients who might not be aware of how the system works and those with disabilities. In terms of barriers, it will take some time for both patients and workers to get used to using the electronic system. Secondly, the system is relatively expensive and needs a technician to run maintenance procedures often for quality functionality. The RMH will thus have to incur costs for training its staff and clientele on the use of the technology through focus groups.
There are different factors that must be considered when selecting participants in focus groups in the clinical setting for low risk projects like putting up an electronic queue management system. Institutions which intend to embrace the electronic queue management technology should first use focus groups to train workers and clients visiting the facility on the technology. Effective focus groups need to have between 6 and 10 participants (Redmond & Curtis, 2009). While the outpatient clientele should participate on a voluntary basis, healthcare providers within the facility should all take part in the focus groups. There should however be separate focus groups; one for the volunteering clients and others involving healthcare providers within the hospital. Focus groups in hospital setting can include representatives from different departments that will be directly affected by the operations and data captured by the electronic queue management system (Zwaanswij & Dulmen, 2014). The different focus groups should have facilitators and observers to run the discussion and training on the use of the technology. Effective focus groups should usually not take more than an hour’s time.
Separating the two groups including healthcare workers and outpatient clients is crucial in preventing unexpected conflicts and/or power struggles. The facilitators should however make the ground neutral in that shy participants are not intimidated by those that are more assertive. The moderators should be experts in the technology and skilled in handling groups. The venues chosen according to the Nonprofit Business Advisor Journal (2016) should also be appropriate as the environment influences responses and reactions to the conversation especially for the groups that involves outpatient clients. It is paramount to ensure that participants who form the outpatient clientele must have an informed consent before being included in the focus group (Anderson, 2011). While the focus group for health workers at the facility may be held a few times , there is need for repeated focus group sessions with other volunteers who would like to give their views on the technology even after implementation is on-going. This will be crucial in informing decision on making necessary improvements at the outpatient section of the hospital.
Ethical Considerations in Participating in Focus Groups & Using the Technology
First, tension is likely to emerge if health workers at the outpatient section are put in the same focus groups due to the obvious imbalance of power and potential power struggle (Item 12 of Part C). The facilitators should thus separate focus for healthcare providers from those involving volunteer patients. Secondly considering that majority of Australians speak English, any patient who does not understand English including the deaf and blind will always be assisted by an assistant who will be regular at the reception (item 14 of Part C). Their bookings on the digital electronic queue management system will be done by the assistant who can show them when to get into any room once the system calls out their numbers.
Thirdly in line with item 13 of Part C, the focus groups should only involve adult volunteers mainly above 18 years (Anderson, 2011). However, parents who are willing to bring their children who are not below 16 years to take part in the focus group under their watch will be free to do so. Considering section 3 part B of the ethics form, this project can involve children but not those aged 16 years and below. They can however, only be included in focus group discussion with parental consent (Moore & Richardson, 2013). As indicated earlier, the focus group will not include the deaf and the blind since it is basically includes audio sounds and a visual display. Further in line with item 3 Part B Section 3 on participant vulnerability, those with impaired ability to consent will be assisted to book their place on the queue by an assistant. Even so, parents and or people with the responsibility to give consent on their behalf can be asked to take part in the focus group and/or use the electronic queue management system.
The presentation above involves the description an electronic queue management system recommended for the RMH hospital’s RMH City Campus and RMH Royal Park Campus outpatient clinics. The presentation cites best practice aspects of the technology in reducing waiting time in health facilities. It also includes related barriers and enablers of the project implementation and the methodology for choosing participants in focus groups to discuss its use and importance. Further, the ethical considerations in rolling out the project have also been outlined to ensure that it meets the threshold of a low-risk project.
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