Design and Investigation of Consultation and Referral System in Tikur Anbessa Hospital
Creators: name: Ijo, Desta
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2016

description: Introduction: Referral is a process by which a health worker at one level of the health care system having insufficient resources (drugs, equipment and skills) to manage a clinical condition seeks the assistance of a better or differently resourced facility at the same or higher level to assist in or take over the management of the client's case. In tertiary hospital such as Tikur Anbessa teaching Hospitals which receives patients from all over the country, the referral system is lengthy and complicated. It is therefore imperative that information should be managed in the most effective way possible in order to ensure a high quality service delivery. Objective: This project, therefore, aimed to describe challenge that affects patient referral and consultation system and to design web based consultation and referral information management for Tikur Anbessa Hospital referral center Hospital. Methodology: Mixed method research was conducted by combining patient survey, document review, in-depth interviews of staff and object oriented analysis as the same time done. It was a cross-sectional study design. The quantitative data were analyzed using SPSS and the qualitative data were analyzed thematically and complemented the quantitative findings. Result: A total of 295 patients participated in the quantitative survey while 19 health workers took part in the qualitative a study. Majority of patients participants 165 (55.9%) were males as in the health workers group where there were male participants. Most patients 238(80.7%) reported to have been referred from other health facilities. For most patients280 (94.4%, reason for referral to Tikur Anbessa Hospital was, to get better treatment and diagnosis .2/3, 199(67.5)want to have feedback to their referring health facility for their follow-ups at the end of their treatment at Tikur Anbessa Hospital to nearest health facility at the end of care. Waiting time was one of the major problems reported by 266 (90.2%) where 59(20.0%) reported to have been waiting for 4-5hrs without being seen by a specialist. Qualitative research participants also acknowledged the long waiting time before patients received the required care. More than 3 in 4 patients 234(79.3%) reported that there was a huge delay in consultation communications processes with specialists. Health worker participated in the qualitative research also indicated poor communication, between receiving and referring health facilities, unnecessary referrals, and patients coming without important documentation as a source of delay in care and patient overcrowding. The designed WC&amp;RIM system registration, validation patient, generate report and re direct communication between health institutions. Conclusion: Problems of coordination, inappropriate referral, and hospital over loading, late response of specialist, poor feedback, and utilization problems are seen and this problems cause waiting time in hospital. To fulfill this gap web based consultation and referral information management was designed and evaluated. Recommendation: The hospital should coordinate, Communicate /consult/ the referring patient before referral for available service and retain the patient if possible to the nearest health facility. After assessing the referral system, we designed a web based system to decrease waiting time. This could enhance accessibility of services and information. Fast, and redirect/fed back/ communication is possible through web based. Key term: referral and consultation system, web based consultation and referral information management system