Clinic Appointment Systems Explained

• In health records, an appointment is more than just a booking.

Definition of Appointment System

• Allocates a day, date, and time for outpatients to see consultants or doctors conveniently in a suitable environment.

Aims of Appointment System

• Regulates patient flow in special consultative clinics to best serve patients, doctors, and hospitals.

Patients benefit by:

• Having time to plan hospital visits.
• Ensured privacy during examinations.
• Reduced waiting times.
• Receiving the best medical attention.
• Making transportation arrangements.
• Having sufficient time for examination and treatment.

Doctors benefit by:

• Having a fixed clinic time suitable for their purpose.
• Definite knowledge of their workload.
• Giving the best medical attention.
• Planning investigations and treatments ahead.

Hospitals Benefit by:

• Reduced overcrowding in the waiting area.
• Reduced delays in registration and tracing of folders.
• Maximum utilization of consultant services.
• Maximum utilization of hospital equipment and facilities.
• Avoiding cross-infection among patients.
• Enhanced reputation through consultant services at clinics.

Types of Appointment Systems

• Centralized system: a central office handles new and follow-up appointments for all consultant clinics.
• Decentralized system: appointments are made at each clinic level, usually by physicians or nurses, with the Health Information Manager updating patient records.
• Combination system: new appointments are made centrally, while follow-ups are scheduled at individual consultation clinics, common in most hospitals.

Details for Booking

• Health Record Officers arrange appointments with medical staff, deciding the number of patients and the type of appointment.
• Health Records Officer and hospital administrators coordinate new clinics and staff movements.

Timed/Scattered Method

• Patient is given a specific time to see the physician.
• Patients know their appointment time in advance, aiding in planning.
• Advantage:
  • Patients can plan their schedules.
  • Reduced waiting times.
  • Reduced hospital cross-infection.
• Disadvantage:
  • Patients may miss appointments due to emergencies.
  • Lacks flexibility.

Block Method

• Patients arrive at the same time and are seen one after another.
• No specific time is given to patients.

Advantage:

• Patients can be seen anytime.
• Offers flexibility.

Disadvantage:

• Increases patient waiting times.

• Can lead to overcrowding.

• Increases the spread of hospital-acquired infections.

• With any method, the clinic works with doctors and Nursing staff in the clinics who may make adjustments or reviews.

Benefits of Appointment System

• Reduces patient waiting times.
• Reduces the risk of cross-infection.
• Reduces crowding.
• better time management for patients and physicians.
• Reduces physician workload.
• Effective utilization of hospital equipment and facilities.
• Guaranteed utilization review.
• Better attention from physicians.

Challenges

• Inadequate appointment equipment.
• Patient illiteracy.
• Ignorance.
• High transportation costs.
• Bad roads and traffic.
• Overbooking.
• Laziness of health workers.
• Bias among health workers.
• Poor government policies.
• Staff-to-patient ratio issues.
• Cultural background and diversity considerations.

Equipment for Booking

• Visible card tray.
• Loose leaves register.
• Ordinary diary or register.
• Kalamazoon binder.
• Computers.
• Patient Reference Card.
• Visible card trays are good but expensive, with patient names and hospital numbers filed for easy retrieval.
• Loose leaf registers act as diaries for booking new and follow-up patients, using carbon or NCR paper to avoid photocopying, but pages can tear and the system lacks flexibility.
• Ordinary diaries have space for daily entries.
• Kalamazoon binders work with triplicate copies for the consultant, administration, and health records library.

Sources for Appointments

• A request can be for a first visit or a follow-up
• First visits:
  • Referrals from family doctors or doctors in large organization
  • Referrals from private practitioners
  • Referrals from General Out-Patient Department (GOPD)
  • Referrals from the Accident and Emergency unit of the same Hospital for further management
  • Referrals from other clinics and hospitals for further management
• Follow-Up Appointments:
  • Requests after clinic consultation.
  • Internal requests from other departments.
  • Requests after discharge from the ward.