scholarly journals Assessment of Diabetic Patient Waiting Time in A Primary Healthcare Clinic

2020 ◽  
Vol 19 (2) ◽  
Author(s):  
Shalihin SE ◽  
Firzada I ◽  
Din MH
Keyword(s):  
Diabetic Patient ◽  
Waiting Time ◽  
Sampling Method ◽  
Primary Care Clinic ◽  
Early Morning ◽  
Health Clinic ◽  
Diabetic Patients ◽  
Care Clinic ◽  
Patient Waiting Time ◽  
Consultation Time

Introduction: Long waiting time is a common issue complained by diabetic patients that came for an early morning appointment in a health clinic. Therefore, an audit was conducted among diabetic patients in a primary care clinic with the aim to assess the patients’ waiting time and to formulate strategies for improvement. Methods: This audit was conducted for four weeks using a universal sampling method in November 2017. All diabetic patients who attended the clinic during this period were included except those who required longer period such as critically ill patients or those who came for repeat medication or procedures. The arrival and departure time for each station was captured using the modified waiting time slip, which is manually filled at every station. The waiting and consultation time for registration, screening, laboratory investigation, diabetic educator, doctor and pharmacy were recorded. The data were entered into the statistical software SPSS version 17 for analysis. Results: Results showed that all patients were registered within 11.0 minutes (SD=2.52min). Average total waiting time to see a diabetic educator and a doctor was 20.9 minutes (SD=15.53min) and 33.23 minutes (SD=27.85min), respectively. Average waiting time for other stations was less than 10 minutes. Average total time spend in the clinic for a diabetic patient was 107.58 minutes, which is comparable to a non-diabetic patient. The identified problems were due to the poor tracing and filing system. Conclusion: Improvement strategies recommended include enforcing early file tracing prior to appointment and providing a checklist for consultation by doctors and diabetic educators.

scholarly journals The Impact of Longer Consultation Time: A Simulation-Based Approach

2020 ◽  
Vol 11 (05) ◽  
pp. 857-864
Author(s):  
Abdulrahman M. Jabour
Keyword(s):  
Waiting Time ◽  
Quality Care ◽  
Working Hours ◽  
Discrete Events ◽  
Simulation Based ◽  
Patient Waiting Time ◽  
Free Environment ◽  
The Impact ◽  
Consultation Time ◽  
Patient Waiting

Abstract Background Maintaining a sufficient consultation length in primary health care (PHC) is a fundamental part of providing quality care that results in patient safety and satisfaction. Many facilities have limited capacity and increasing consultation time could result in a longer waiting time for patients and longer working hours for physicians. The use of simulation can be practical for quantifying the impact of workflow scenarios and guide the decision-making. Objective To examine the impact of increasing consultation time on patient waiting time and physician working hours. Methods Using discrete events simulation, we modeled the existing workflow and tested five different scenarios with a longer consultation time. In each scenario, we examined the impact of consultation time on patient waiting time, physician hours, and rate of staff utilization. Results At baseline scenarios (5-minute consultation time), the average waiting time was 9.87 minutes and gradually increased to 89.93 minutes in scenario five (10 minutes consultation time). However, the impact of increasing consultation time on patients waiting time did not impact all patients evenly where patients who arrive later tend to wait longer. Scenarios with a longer consultation time were more sensitive to the patients' order of arrival than those with a shorter consultation time. Conclusion By using simulation, we assessed the impact of increasing the consultation time in a risk-free environment. The increase in patients waiting time was somewhat gradual, and patients who arrive later in the day are more likely to wait longer than those who arrive earlier in the day. Increasing consultation time was more sensitive to the patients' order of arrival than those with a shorter consultation time.

scholarly journals A Rare Form of Melanoma Masquerading as a Diabetic Foot Ulcer: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Susan Thomas ◽  
Yuan-Xiang Meng ◽  
Vijaykumar G. Patel ◽  
Gregory Strayhorn
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Primary Care Clinic ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Patients ◽  
Care Clinic ◽  
Acral Lentiginous Melanoma ◽  
Diabetic Ulcer ◽  
Formidable Challenge

Background. Acral lentiginous melanoma (ALM) is a less-common form of melanoma in US, and it accounts for about 5% of all diagnosed melanomas in US. ALM is often overlooked until it is well advanced because of the lesion’s location and its atypical appearance in the early stages. We present a case of ALM initially presented as a diabetic foot ulcer.Case Report. An 81-year-old man initially presented to the primary care clinic with a right foot diabetic ulcer. There was a large plantar, dark-colored ulcer that bled easy. Initial excision biopsy revealed Clark’s Level IV ALM. Subsequent definitive wide excision and sentinel node biopsy confirmed ALM with metastasis to inguinal lymph nodes (stage IIIb). The treatment included wide margin excision of the lesion with en bloc amputations of 4th and 5th toes, followed by adjuvant chemotherapy.Discussion. The development of ALM may potentially relate to diabetes as a reported higher prevalence of diabetes with ALM patients.Conclusion. The difficulty in early diagnosing of ALM remains as a formidable challenge particularly in diabetic patients who commonly develop plantar foot ulcers due to the diabetic neuropathy. This case reiterates the importance of a thorough foot exam in such patients.

Study of frailty prevalence and status of elder diabetic patients in a primary care clinic

2016 ◽  
Vol 120 ◽  
pp. S78
Author(s):  
Yuan-Ching Liu ◽  
Neng-Chun Yu ◽  
Shu-Hua Feng ◽  
Lan-Fen Lin ◽  
Chia-Hui Cheng ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Diabetic Patients ◽  
Care Clinic

scholarly journals A 15 Month Experience with a Primary Care-based Telemedicine Screening Program for Diabetic Retinopathy.

2020 ◽  
Author(s):  
James Benjamin ◽  
Justin Sun ◽  
Devon Cohen ◽  
Joseph Matz ◽  
Angela Barbera ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Screening Program ◽  
Primary Care Clinic ◽  
University Hospital ◽  
Eye Disease ◽  
Diabetic Patients ◽  
Close Monitoring ◽  
Care Clinic ◽  
Retinal Screening

Abstract Background: Using telemedicine for diabetic retinal screening is becoming popular especially amongst at-risk urban communities with poor access to care. The goal of the diabetic telemedicine project at Temple University Hospital is to improve cost-effective access to appropriate retinal care to those in need of close monitoring and/or treatment.Methods: This will be a retrospective review of 15 months of data from March 2016 to May 2017. We will investigate how many patients were screened, how interpretable the photographs were, how often the photographs generated a diagnosis of diabetic retinopathy (DR) based on the screening photo, and how many patients followed-up for an exam in the office, if indicated.Results: Six-hundred eighty-nine (689) digital retinal screening exams on 1377 eyes of diabetic patients were conducted in Temple’s primary care clinic. The majority of the photographs were read to have no retinopathy (755, 54.8%). Among all of the screening exams, 357 (51.8%) triggered a request for a referral to ophthalmology. Four-hundred forty-nine (449, 32.6%) of the photos were felt to be uninterpretable by the clinician. Referrals were meant to be requested for DR found in one or both eyes, inability to assess presence of retinopathy in one or both eyes, or for suspicion of a different ophthalmic diagnosis. Sixty-seven patients (9.7%) were suspected to have another ophthalmic condition based on other findings in the retinal photographs. Among the 34 patients that were successfully completed a referral visit to Temple ophthalmology, there was good concordance between the level of DR detected by their screening fundus photographs and visit diagnosis.Conclusions: Although a little more than half of the patients did not have diabetic eye disease, about half needed a referral to ophthalmology. However, only 9.5% of the referral-warranted exams actually received an eye exam. Mere identification of referral-warranted diabetic retinopathy or other eye disease is not enough. A successful telemedicine screening program must close the communication gap between screening and diagnosis by reviewer to provide timely follow-up by eye care specialists.

scholarly journals “Without the need for a second visit” initiative improves patient satisfaction with updated services of outpatient clinics in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jian Shen ◽  
Jun Zhang ◽  
Qiang He ◽  
Haihui Pan ◽  
Zhiqiang Wu ◽  
...  
Keyword(s):  
Waiting Time ◽  
Health Care Services ◽  
Care Delivery ◽  
Outpatient Clinics ◽  
Outpatient Services ◽  
Patient’S Satisfaction ◽  
Patients Satisfaction ◽  
Patient Waiting Time ◽  
Consultation Time ◽  
Patient Waiting

Abstract Background To implement the “without the need for a second visit” (WNASV) initiative in our hospital by optimizing the outpatient clinic services via an upgraded information system, in order to increase the quality of outpatient medical services and improve patients’ satisfaction. Methods An Internet-based care delivery approach was developed and applied to improve the delivery of health care services, simplify the treatment process, and reduce patient waiting time. The patient waiting time and consultation time in the outpatient clinics of our hospital during the peak service intervals and the proportions of various payment methods for outpatient services during the period from May 2017 to September 2019 were retrospectively analyzed. Also, the patients’ satisfaction with the outpatient process was surveyed. Results The waiting time for consultation was shortened from 32.25 min to 28.42 min; the consultation time was shortened from 6.52 min to 3.15 min; and the waiting time for payment decreased from 7.40 min to 4.31 min. The proportion of payment via a counter was reduced from 86.80 to 21.79%, the proportion of self-service payment increased from 9.99 to 16.05%, and the proportion of payment during a consultation increased from 3.21 to 61.91%. The scores of the patients’ satisfaction with the outpatient services increased from an average of 89.10 points in 2017 to an average of 90.26 points in 2019. Conclusion The continuous improvement of the service process markedly increases the efficiency of the outpatient services, and effectively improves patient’s satisfaction with the outpatient process, this initiative thus deserves further application.

scholarly journals Analysis of continuity of care and related factors in diabetic patients in Korea

2020 ◽  
Author(s):  
Ji Yeh Shin ◽  
Ha Jin Kim ◽  
BeLong Cho ◽  
Yun Jun Yang ◽  
Jae Moon Yun
Keyword(s):  
Primary Care ◽  
Continuity Of Care ◽  
Statistical Significance ◽  
Primary Care Clinic ◽  
Residential Area ◽  
Political Support ◽  
Diabetic Patients ◽  
Care Clinic ◽  
Medical Needs ◽  
Care Index

Abstract Background: Diabetes is one of the fastest growing diseases with approximately 463 million patients worldwide. It is established that to manage diabetes, continuity of care in primary care setting is crucial. We aim to statistically define and analyze factors of continuity that are associated with patient, clinic, and geographical relationship.Methods: We used 2014~2015 claim data from National Health Insurance Service (NHIS), with 39,096 eligible outpatient attendances across 29,912 office-based clinics. We applied multivariable logistic regression to analyze factors that may affect three kinds of continuity of care index for each patient: most frequent provider continuity index (MFPC), modified-modified continuity index (MMCI), and continuity of care index (COC). Results: Mean value of continuity of care indices were MFPC 0.90, MMCI 0.96, COC 0.85. Among patient factors, old age above 80 (MFPC 0.81 [0.74-0.89], MMCI 0.84 [0.76-0.92], COC 0.81 [0.74-0.89]) and disability were strongly associated with lower continuity of care. Another significant factor was residential area: further the patients lived from their primary care clinic, lower the continuity of diabetes care (MFPC 0.74 [0.70–0.78], MMCI 0.70 [0.66–0.73], COC 0.74 [0.70–0.78]). Patients who lived in metropolitan areas had higher continuity of care compared to those of other areas (metropolitan area, MFPC 1.19 [1.17-1.27], MMCI 1.17 [1.10-1.25], COC 1.19 [1.12-1.27]). There was no statistical significance among clinic factors, such as the number of physicians or nurses hired per clinic, between the lower and the higher continuity of care groups.Conclusion: Geographical proximity of patient’s residential area and clinic location showed the strongest correlation as factor of continuity. Political support is necessary to geographically align the imbalance of supply and demand of medical needs.

scholarly journals Prevalence of Depression and Its Associated Factors among Diabetes Mellitus Patients in an Urban Primary Care Clinic

2021 ◽  
pp. 100-106
Author(s):  
M. Miskan ◽  
K. Ambigga
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Formal Education ◽  
Primary Care Clinic ◽  
Depression Scale ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Care Clinic ◽  
Prevalence Of Depression ◽  
Probable Depression

Aims: To determine the prevalence of depression among patients with Diabetes Mellitus and to identify its associated risk factors. Study design:  This is a cross sectional study. Place of study: This study was conducted in an urban primary care clinic in a tertiary hospital in Malaysia. Methodology: This study utilized a self-administered questionnaire, Hospital Anxiety and Depression scale (HADS-D) for the data collection. A total of 358 respondents were eligible to be included in this study. Results:  A total of 382 respondents were recruited in this study using universal sampling method. A total number of 358 eligible respondents were included in the final data analysis. The response rate for this study was 94%. Respondents’ mean age was 60.8 years ± 10.3, 56% females, 38% Malays, 76% were married, 37.7% had Diabetes for more than 5 years and 76.3% had completed secondary school education. This study concluded that 63.7% of participants had poor diabetes control and 26% had probable depression. On multiple logistic regression, respondents who earned income less than RM 500 per month were 2.6 times more likely to have probable depression (aOR: 2.64, 95% CI:1.29 -5.43). Patients who received no formal education were 4.5 times more likely to have probable depression (aOR: 4.51 95% CI:1.74-11.63). Respondents with co-morbid illness were almost 3 times more likely to have probable depression (aOR: 2.92, 95% CI: 0.1-0.8). Conclusion: Prevalence of probable depression was high and there was a significant association between depression with income, education level and co-morbid illness. Thus, there is a need to identify and manage depression accordingly among diabetic patients.

scholarly journals Creating Primary Care Access for Mental Health Care Clients in A Community Mental Health Setting

2008 ◽  
Vol 27 (2) ◽  
pp. 129-138 ◽  
Author(s):  
Tamison Doey ◽  
Pamela Hines ◽  
Bonnie Myslik ◽  
JoAnn Elizabeth Leavey ◽  
Jamie A. Seabrook
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Health Care Services ◽  
Primary Care Clinic ◽  
Health Clinic ◽  
Care Clinic ◽  
Mental Health Association

Successful support of persons living with a mental illness in the community is challenged by the lack of primary care accessible to this population. The Canadian Mental Health Association–Windsor Essex County Branch explored options to provide mental and physical health care, initially creating an integrated primary care clinic and later a larger community health clinic co-located with its mental health care services and staffed by a multidisciplinary team. A retrospective review of 805 charts and a client satisfaction survey were conducted in 2001 to evaluate this service. Findings indicate that access to primary care and mental health care co-located at a community-based clinic has reduced the number of emergency room visits and admissions, and length of stay in hospital, for individuals with moderate to serious mental illness. A client survey in January 2008 supports these preliminary findings.

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