International Journal of Research Foundation of Hospital and Healthcare Administration

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VOLUME 6 , ISSUE 2 ( July-December, 2018 ) > List of Articles

ORIGINAL ARTICLE

Improving the Efficiency of Refraction Services at a Tertiary Care Eye Hospital Using an Action Research Methodology

Shakti K Gupta, Innayath Kabir, Meeta Tyagi

Keywords : Refraction services, Uncertainty in appointment,Action research

Citation Information : Gupta SK, Kabir I, Tyagi M. Improving the Efficiency of Refraction Services at a Tertiary Care Eye Hospital Using an Action Research Methodology. Int J Res Foundation Hosp Healthc Adm 2018; 6 (2):63-67.

DOI: 10.5005/jp-journals-10035-1093

License: CC BY-NC 4.0

Published Online: 00-12-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: The hospital under study is a 300 bedded tertiary care eye hospital in New Delhi, India. The hospital being the apex tertiary care eye institute of the country faces a constant issue of demand-supply mismatch. Due to the demand-supply, the appointment system for refraction posed problems of uncertainty and non-availability of appointments for the same resulting in delay in diagnosis and hence patient dissatisfaction. Objective: The main aim of the exercise was to ascertain the cause and to find an amicable solution for the uncertainty in the appointment system for refraction. Methodology: Action research methodology was applied to the process in the form of planning, implementation and evaluation in 2 cycles. The existing registration process was analysed in the first phase and the problems identified. In the first cycle, the detailed workflow process analysis and capacity calculation of Refraction services was carried out following which the problems were identified and actions were planned in a collaborative manner. The planned actions were implemented and evaluated. Based on the evaluation of the cycle 1 changes were planned for cycle 2 and implemented. Results: The problems identified in cycle 1 were absence of knowledge about the present capacity, slow registration process, uncertainty of appointment for refraction and lack of display of timings for registration and confirmation of appointments. The calculated capacity for refraction varied between 156 and 120 due to variation in the availability of consultation chambers. The changes planned were sensitisation of staff to the changes, increasing the capping limit of appointments to 160 in the morning and 80 in the afternoon (which included 33% above the capacity to cater to no shows). The results of cycle 1 were evaluated and the problems were identified. The corrective actions were planned for cycle 2 and planned actions were implemented. The capping limit for appointments was increased to 200 in the morning and 100 in the evening Conclusion: The main objective of the study was to address the patient grievance with regard to uncertainty in appointment by the participatory approach of action research methodology. In conclusion, action research is socially oriented and the intended outcome will therefore be evidenced through changes in social situations, systems and conditions.


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