Strategies for optimizing clinic efficiency in a community-based antiretroviral treatment programme in Uganda

S.T. Alamo, G.J. Wagner, J. Ouma, P. Sunday, M. Laga, R. Colebunders, F. Wabwire-Mangen

Research output: Contribution to journalA1: Web of Science-article

Abstract

We address a critical aspect of antiretroviral therapy (ART) scale-up: poor clinic organization leading to long waiting times and reduced patient retention. Using a before and after study design, time and motion studies and qualitative methods we evaluated the impact of triage and longer clinic appointment intervals (triage) on clinic efficiency in a community-based program in Uganda. We compared time waiting to see and time spent with providers for various patient categories and examined patient and provider satisfaction with the triage. Overall, median time spent at the clinic reduced from 206 to 83 min. Total median time waiting to see providers for stable-ART patients reduced from 102 to 20 min while that for patients undergoing ART preparation reduced 88-37 min. Improved patient flow, patient and provider satisfaction and reduced waiting times allowed for service delivery to more patients using the same staff following the implementation of triage.
Original languageEnglish
JournalAIDS and Behavior
Volume17
Issue number1
Pages (from-to)274-283
Number of pages10
ISSN1090-7165
DOIs
Publication statusPublished - 2013

Keywords

  • Viral diseases
  • HIV
  • AIDS
  • HAART
  • Antiretrovirals
  • Programs
  • Community-based treatment
  • Efficiency
  • Organization
  • Health care delivery
  • Health services-needs and demand
  • Waiting times
  • Retention
  • Triage
  • Patient satisfaction
  • Hospitals
  • Uganda
  • Africa-East

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