Using the Total Quality Management (TQM) tool in solving the problem of delays during the emergency eye care consultation process in Kaduna, Nigeria

Abstract

Aim: To demonstrate the usability of the total quality management (TQM) tool in studying the problem of delays during the emergency eye care consultation process in a government-owned eye hospital in Kaduna, Nigeria, with a view to identifying appropriate solutions. Materials and methods: Twenty-five consecutive patients presenting for emergency eye care were surreptitiously observed and the time taken at various stations during the consultation process recorded. The maximal duration expected at each station had been worked out, and overall, the whole consultation process should have been completed within an hour. By calculating the mean of the excess times utilized at the stations, areas of delays were then identified. The causes of the delays encountered at the worst affected station were then identified and appropriate solutions proffered. Result: Nineteen patients out of the total of 25 (76%) did not conclude the consultation process within the stipulated one-hour period. Most of the delays (64% of the total mean excess times spent) occurred at the station where patients saw the emergency duty doctor. The causes of delay included lack of orientation, support and supervision of junior doctors by their senior colleagues; poor hospital support services; poorly circulated doctor duty rosters; and absence of a conducive rest room for the emergency duty doctor. Conclusion: The TQM tool was found useful in studying the problem of delays in the emergency eye care consultation process in the hospital under study. Tackling the identified causes of delays, which were largely within the hospital organizational set-up to solve, will result in a more efficient use of time and personnel, and an increased patronage by satisfied patients. Nigerian Journal of Ophthalmology Vol. 14(1) 2006: 1-4