Colebunders R, Bukenya T, Pakker N, Smith O, Boeynaems V, Waldron J, Muganga A Muganzi, Twijukye C, McAdam K, Katabira E
Makerere University, Kampala, Uganda.
AIDS Care. 2007 Feb;19(2):149-51. doi: 10.1080/09540120600762078.
In order to cope with the increasing patient load, a study was performed to identify bottlenecks in patient flow at the Infectious Diseases out-patient clinic in Kampala, Uganda on 10 January 2005. On a standardised questionnaire we recorded for all patients: the time they presented at reception, waiting times for different services and in- and out times for nursing, counselling and doctor visits. 250 patients visited the clinic the study day: 36 (20 per cent) were asymptomatic; 133 (75 per cent) symptomatic but not critically ill and 8 (4.5 per cent) severely ill; 63 (37.5 per cent) were on antiretroviral treatment. The median time spend at the clinic was 157 minutes (range 22-426). The median time from reception to the triage/vital-signs measuring unit was 34 minutes (range 3-92), from triage nurse to doctor 51 minutes (range 1-205), from doctor to pharmacy 24 minutes (range 5-292). The median waiting time at the pharmacy was 30 minutes (range 10-175). Based on these results, organisational changes were proposed. A similar methodology could be used to evaluate and compare health service delivery systems for persons with HIV infection in Africa in order to identify the most efficient models of care.
为应对日益增加的患者数量，2005年1月10日在乌干达坎帕拉的传染病门诊进行了一项研究，以确定患者流程中的瓶颈。我们在一份标准化问卷上记录了所有患者的信息：他们到达接待处的时间、不同服务的等待时间以及护理、咨询和医生问诊的进出时间。研究当天有250名患者就诊：36名（20%）无症状；133名（75%）有症状但病情不严重；8名（4.5%）病情严重；63名（37.5%）正在接受抗逆转录病毒治疗。在诊所花费的中位时间为157分钟（范围22 - 426分钟）。从接待处到分诊/生命体征测量单元的中位时间为34分钟（范围3 - 92分钟），从分诊护士到医生为51分钟（范围1 - 205分钟），从医生到药房为24分钟（范围5 - 292分钟）。在药房的中位等待时间为30分钟（范围10 - 175分钟）。基于这些结果，提出了组织变革措施。类似的方法可用于评估和比较非洲艾滋病毒感染者的卫生服务提供系统，以确定最有效的护理模式。
