Pre-post Intervention Study on Overcrowding and Waiting time at Outpatient Department in Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
Creators: name: Yalew, Tamiru
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2013

description: Overcrowding is one of the major problems that impede quality of services at Amanuel Mental Specialized Hospital, especially at outpatient department. Overcrowding at outpatient department deters easy movement of both staff and patient which hinders appropriate use of available space in the hospital. Outpatient overcrowding influences quality and efficiency of service provision. The objective of this intervention research was to assess impediments of overcrowding to improve patient flow and ease service provision at outpatient department in Amanuel Mental Specialized Hospital by end of October 30, 2013. An intervention study comparing the status of overcrowding before and after the appropriate procedures to ease free movement and quality service was placed in the Outpatient Department of Amanuel Mental Health Specialized Hospital. All possible factors that cause overcrowding at outpatient department in Amanuel Mental Specialized Hospital were explored at the baseline (at pretest). These factors would be related to the characteristics of patients, care takers, providers and the physical and logistics setup in the department. Appropriate interventions were developed by the principal investigator in collaboration with the hospital leadership. Ultimately changes brought about by the proposed intervention was measured and documented. From a total of 250 health care professionals, 41 health care providers were serving in regular outpatient department of Amanuel Mental Specialized Hospital. All health care providers who are working at OPD are selected by purposive sampling method. A total of 8,791 clients visit Amanuel mental specialized hospital per month. Three hundred eight four clients were selected by simple random sampling technique for survey. Pre-intervention- Intervention–Post-Intervention study was conducted. In each phase, analysis was performed using SPSS software version 20 and Excel spreadsheet. Two sample proportion test (pre and post) statistical tests was used to test factors contributing to overcrowding for clients, staff and two mean comparison test (T-test) was used for waiting time study. This project work was done from December 2012 to August 2013. The total cost required to conduct and implement the project was 12,240 Ethiopian Birr. After the implementation of appropriate interventions, overcrowding in most outpatient department units was significantly reduced, quality of services was enhanced, and there was low waiting time to get outpatient services. After implementing selected strategies (Appropriate appointment system and recruiting adequate staff) the proportion of outpatient load among treatment session was significantly reduced from 76.82% at morning session to 57.49% and increased from 23.18% at afternoon to 42.51% with p=0.0001 which is significant proportion difference between the two tests. And similarly the overall time taken to complete all the services were 112 minutes (SD+58) in pre- and post intervention the result was 54.53 minutes (SD+9.86) with p=0.0001 which is significant mean difference between the two test means.