MPH / Department of Public Health / Post-apartheid South Africa’s healthcare system improved with many community members being able to easily access basic health care services. However, patient waiting time has remained a critical issue. Patients are well-known for arriving at healthcare facilities very early for the reason of avoiding lengthy queues. This, however, does not solve their problem. The purpose of the study was to explore factors influencing patient waiting time in Nthabiseng clinic in the Capricorn district of the Limpopo Province. The study was conducted at Nthabiseng clinic in the Capricorn District. A qualitative approach was adopted, and a sample was chosen from a targeted population through purposive sampling. Data were collected through a one-to-one semi-structured interview and analysed through the Thematic Data Analysis approach. The study found out that the Department of Health does not have a patient waiting time specific policy or legislative framework and/or a guiding document. It also showed that healthcare professionals define and calculate patient waiting time differently. Moreover, what is an acceptable waiting time to one is an unacceptable waiting time to another. The study recommended that a policy and Standard Operation Procedure be drafted to guide healthcare professionals on how to improve waiting time in their specific facilities.

<p>The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively.</p>

<p>The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively.</p>

Magister Public Health - MPH / The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively. / South Africa

Emergency department (ED) overcrowding has been a common complaint in Emergency Medicine in Canada for many years. Its adverse effects of prolonged waiting times cause patient dissatisfaction and unsafety. Previous studies indicate that adding a physician in triage (PIT) can increase accuracy and efficiency in the initial process of patient evaluation. However, the scientific evidence of the PIT impact on ED is far away from sufficient before its widespread implementation. This research is to search solutions using PIT to identify areas of improvement for the ED patient flow, based upon a validated discrete-event simulation (DES) model. As an efficient decision-making tool, the DES model also helps to develop an understanding of the current ED performance and quantitatively test various design alternatives for ED operations. / February 2017

Today great efforts are made to record and reduce waiting times in cancer care. Long and variable turnaround times (TATs) delay the start of treatment and waiting contributes to mental anguish. The purposes of the QI intervention were to establish an effective and streamlined histopathology process with shorter TATs, to extend customer collaboration and to build knowledge of internal processes in order to lay the foundation for a learning environment. The goal was to raise the proportion of reported tissue samples from 50% to 90% within a 15 day period, ending 31th December 2014. The study of the QI intervention intended to identify factors that affect the introduction of novel working methods. Both quantitative and qualitative methods were used to achieve the goals. Improvement knowledge was combined with lean-inspired methods, and two focus groups were arranged in which data were analysed using qualitative content analysis. The goal to report 90% of tissue samples within 15 days was not achieved for all sample types, but improved TATs were clearly noted. Customer collaboration and visualisation of the processes had a positive effect on staff. The study resulted in six key factors important working with QI interventions; competence, compliance, feedback, interaction, patient- and customer focus and resources. Having motivated and dedicated staff is a key success factor for improvement work, in contrast to a lack of resources, and people that oppose change. To achieve future ambitious goals requires continuous improvement initiatives that involve optimisation of both human resources and equipment. / Stort fokus riktas idag på att kartlägga och reducera väntetider inom cancervården. För långa och variabla svarstider fördröjer behandlingsstart och väntan innebär dessutom psykiskt lidande. Syftet med förbättringsarbetet var att etablera en effektiv och stabil patologiprocess med kortare svarstider, utöka kundsamverkan samt bygga kunskap om interna processer för att lägga grunden till en lärandemiljö. Målet var att senast den 31 december 2014 höja andelen besvarade vävnadsprover från 50 % till 90 % inom 15 dagar. Studien av förbättringsarbetet syftade till att identifiera faktorer som påverkar införandet av nya arbetssätt. Såväl kvantitativa som kvalitativa metoder användes för att uppnå målen; förbättringskunskap kombinerades med lean-inspirerade metoder och två fokusgrupper där data analyserades med kvalitativ innehållsanalys. Målet att höja andelen vävnadsprover som besvarades inom 15 dagar på 90 % uppnåddes inte för samtliga provtyper, men tydligt förbättrade svarstider noterades. Kundsamverkan och visualisering av processerna hade en positiv effekt på personalen. Studien resulterade i sex viktiga faktorer; kompetens, inställning, återkoppling/feedback, interaktion, patient- och kundfokus och resurser. Motiverad och engagerad personal är nyckelframgångsfaktorer i förbättringsarbeten i motsats till resursbrist och människor som motsätter sig förändring. För att på sikt uppnå högt uppsatta mål krävs fortsatta förbättringsinitiativ som involverar optimering av både personalresurser och instrumentering.

Background. In South Africa violence related crimes are frequent, and interpersonal violence is one of the most common causes of injury and death. Violence can be related to social structures, poverty and income inequality. In South Africa 25% of the population live in extreme poverty, and 16% of households in Western Cape live in Informal dwellings. Drug and alcohol miss-use is a big problem. EMS personnel all over the world are exposed to violence. The last couple of years the rate of incidents of violence against the ambulances and EMS personnel in Western Cape and Cape Town has escalated, and a protocol to protect the personnel has been established. The protocol of Red Zones requires an armed escort for the ambulance and EMS personnel when working in certain areas. The red zones are often in low income areas, which makes United Nations’ Sustainable Development Goal of Reduced inequality relevant. The Purpose of this study is to describe how red zones affect patient waiting times and mission times for the ambulance in the Western Cape province of South Africa. Method. Quantitative analysis of priority 1 assignments in one month periods in 2016, 2017 and 2018 to Hanover Park, a suburb of Cape Town. Hanover Park has been considered a red zone since September 2016. Result. Seven different time periods in the missions were analyzed, comparing the City of Cape Town and Hanover park in 2016, 2017 and 2018. Conclusion. The result shows an increase in waiting times for EMS in Hanover Park, even though the precise response time could not be described. Call times and mission times for the entire City of Cape Town seem to have increased, indicating a problem beyond the red zones, potentially affecting everyone in need of an ambulance in the city. Further studies are encouraged. / Bakgrund. I Sydafrika är våldsrelaterade brott vanligt förekommande, och interpersonellt våld är en av de vanligaste orsakerna till skada och död. Våldet kan relateras till sociala strukturer, fattigdom och inkomstskillnad. I Sydafrika lever 25% av befolkningen i extrem fattigdom och 16% av hushållen i Western Cape lever i informella bostäder. Missbruk av droger och alkohol är ett stort problem. Ambulanspersonal över hela världen utsätts för våld. De senaste åren har graden av våldshändelser mot ambulanser och dess personal i Western Cape och Kapstaden eskalerats och ett protokoll för att skydda personalen etablerats. Protokollet för Röda Zoner kräver en beväpnad eskort för ambulans och personal vid arbete i vissa områden. De röda zonerna är ofta i låginkomstområden, vilket gör FN: s hållbara utvecklingsmål för minskad ojämlikhet relevant. Syftet med denna studie är att beskriva hur röda zoner påverkar patienters väntetid och uppdragstider för ambulansen i Western Cape i Sydafrika. Metod. Kvantitativ analys av prio 1-uppdrag under en månadsperiod i 2016, 2017 och 2018 till Hanover Park, en förort till Kapstaden. Hanover Park har ansetts vara en röd zon sedan september 2016. Resultat. Sju olika tidsperioder i uppdragen analyserades, och jämfördes mellan hela Kapstaden och Hanover Park 2016, 2017 och 2018. Slutsats. Resultatet visar ökad väntetid för ambulansvård i Hanover Park, även om den exakta framkörningstiden inte kunde beskrivas. Uppdragstider för hela staden Cape Town verkar ha ökat, vilket indikerar ett problem bortom de röda zonerna, vilket potentiellt kan påverka alla som behöver en ambulans i staden. Ytterligare studier rekommenderas.