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  • Annelie Wessels

Outpatient flow at a state clinic

This year I had the privilege of doing my honours research project for at a state clinic in the cape winelands district. As I am fortunate enough to afford private care, I did not quite know what to expect at the clinic. I went “undercover” and visited the clinic to experience it myself. That day I waited five and a half hours before I could see the nurse. Luckily I was “doing research” so I was, unlike the other patients, quite calm and patient. I was also pleasantly surprise with the friendliness, patience and helpfulness of the clinic staff.

After my initial visit I went back to introduce myself properly and visited the clinic quite often during my June holidays. I used that days to collect my data. I gathered arrival times, service times and waiting times of the patients. One day we tracked the patients through the clinic to determine the paths patients follow in the clinic. I also spoke to the staff frequently to understand the flow of the patients as well as the administration in the clinic.

I built a discrete event simulation model in AnyLogic to model the patient flow in the clinic. After a lot of experiments I concluded that an appointment system would decrease the patients’ waiting time, currently almost four hours, with 40%. Currently, patients seeing the doctor has an appointment scheduled for 08:00. Patients seeing the nurses get appointments on the hour. Patients usually get helped in the order that they arrive and therefor patients start arriving at the clinic as early as 06:00. The whole aptitude and culture at the clinic needs to change, starting at the clinic staff and following through to the patients.

After my time spent at the clinic I realised that there is an urgent need for structure at state clinics and a lot of their problems can be either solved or improved on with a little bit of effort from government’s side. The clinic staff were more than willing to adapt and even provided me with ideas and suggestions, they just need external and internal support to guide them through the process.

I enjoyed my time at the clinic tremendously, mostly because of the people. Their support, friendliness, caring personalities and open minded attitude towards my findings were heartwarming and made my research process so much easier.

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