Queueing and patient flow at a Soweto polyclinic.

We studied all 265 adult patients who came to a Soweto polyclinic on 18 March 1980. The objectives were: (i) to determine the flow of patients and the time spent in the polyclinic; (ii) to use computer models to predict the effects of altering numbers of staff and/or the introduction of an appointment system; and (iii) to elicit information relating to the feasibility of introducing an appointment system. The results show that of the 265 patients, 80% arrived before 10h00 and 1% arrived after 13h00. Forty-one per cent of these patients waited in 5 or more queues. Of the 245 patients for whom the amount of time spent in the clinic was available the mean time spent in the clinic was 171 minutes, with a range of 16 - 375 minutes. The mean time spent receiving attention was 24 minutes. IBM's GPSS/360 programme was not found to be useful for running computer-simulated flow models. Of 241 patients who returned questionnaires, 65% said they would like the introduction of an appointment system and 70% would be able to make appointments relatively easily. An appointment system might considerably reduce time being wasted. The practicalities of such a system in terms of the functioning of the clinic must still be carefully investigated. We suggest that a feasible appointment system be introduced and its effect on patient satisfaction and flow carefully monitored.