Congestion at the Outpatient Department of Lady Ridgeway Hospital Sri Lanka

Abstract

Lady Ridgeway Hospital for Children is a 125-year-old paediatric hospital with several specialties. There are 1016 beds to accommodate patients. It provides care for children who are less than 14 years old. It is the final referral centre and receives patients from all over the island. It is situated in an easily accessible place. The outpatient department provides consultative service from 07.00 am to 12.00 midnight. It serves 1,500 to 1,800 patients daily and, catered 500 to 600 patients during the COVID-19 pandemic. This case study aims to identify the reasons for congestion at OPD and suggest solutions for them. Observation, key informant interviews, and review of the reports were the data collection methods. Congestion at OPD is due to several factors. Among them, stakeholders identified the need for more guidance for those who attend OPD as the main contributing problem. There were several causes for this problem related to client, staff, environment, process, and information. The OPD is functioning in an old building with other clinics and services. The building is packed with several units. Therefore, the number of clients using these premises is more than those using the OPD service. There needs to be direction boards to guide the patients regarding the available services, even though there are name boards for the rooms. A layout map of the OPD is also not available. The rooms are numbered, not in order. Lack of communication skills, poor attitude, unmotivated staff, inadequate responsiveness, not practicing the satisfaction survey, lack of supportive supervision, and need to have regular training are the other causes. Displaying the direction board and OPD layout will help the clients find their way quickly to reach their destination. In addition, strengthening the staff by providing knowledge and skills, field visits, non-monitory incentives and improving welfare will enhance their communication skills and attitude. Development of the staff will improve the quality of the service. Regular patient satisfaction surveys will help assess the service provision's feedback. The information collected from the survey will help correct the shortcomings and help plan the services in the future. Altogether, these will improve the guidance for the patients who attend the OPD and reduce congestion at OPD. Keywords: Outpatient department, congestion, layout, direction