Patient Flow, Health Delivery Processes, and Areas for Improvement in the UP Health Service (UPHS) during May to June 2020 of the COVID-19 Pandemic

Abstract

Background. Workplace or employees’ clinics play a vital role in disease outbreaks as there could be an influx of sick personnel. Processes and patient flows during pandemics should be documented to identify good practices and sources of operational inefficiencies.
 Objective. To describe the patient flow, health delivery processes, and areas for improvement at the UPHS during the early phase of the COVID-19 pandemic from May to June 2020.
 Methods. This was a cross-sectional study involving patient flow analysis of processes at the employees’ clinic of the University of the Philippines-Philippine General Hospital. The study was divided into two major components: clinic process time measurement and process flow mapping. Data collection involved time elements and narrative descriptions of good practices and problems in the process flow.
 Results. The UPHS staff attended to 1,514 employees’ visits during the 15 working days from May to June 2020. The total UPHS service time from arrival to end of consultation of an employee with a COVID-19-related concern was an average of 1 hour 3 minutes (SD±39 minutes) with a mean total waiting time of 46 minutes (SD±37 minutes). Good practices identified were personnel flexibility in doing other tasks, good communication, and infection control measures. Areas for improvement included symptom screening, implementation of physical distancing, and disinfection practices.
 Conclusion. The process flows in the UPHS clinic consisted of COVID-19 related consultations, non-COVID-19 related concerns, and swabbing services. Good communication, staff flexibility, infection control measures, and leadership were identified as good practices. Occasional lapses in symptom screening at triage, physical distancing among employees in queuing lines, and inconsistent disinfection practices were the areas for improvement.

Patient Flow Management in Biological Events: A Scoping Review.

“…Staff: maintaining mental health of employees (53), reducing burnout (53), training of employees (30,36), training of skilled workers (36, 54) and exible (55,56), giving incentives to effective employees (53), timely monitoring of performance (15), training other categories (36), employing retired forces (15,36).…”

Turnaround Time of Consults in a Primary Care System in Rural Philippines: A Descriptive Retrospective Cohort Study

“…17 Another study by Laviña et al during the pandemic in 2021 showed a mean turnaround time of 109 minutes with a standard deviation of 39.2 minutes. 18 Using the difference between mean turnaround time in the two studies of 8 minutes, the computed sample size for this study is 342 participants divided equally into the prepandemic and pandemic period (171 participants each).…”

“…A study by Cenizal et al in 2020 set in the pre-pandemic time showed mean turnaround time of 117 minutes while another study done during the pandemic by Laviña et al in 2019 showed a mean turnaround time of 109 minutes. 17,18 This may be attributed to differences in setup, system processes, and variances among physicians and patients. In our study, maintenance medication refills, requests for medical certification, and interpretation of laboratories were the usual reasons for consults with shorter turnaround times.…”

“…The impact of the pandemic was wide-reaching, with changes in physical set-up of the clinics, human resource allocation, and process flows to accommodate influx of patients and enforce infection control measures. 18 Such changes influence turnaround times of consults. A study done in a general practice clinic in Nigeria showed that any changes to the patient flow can increase waiting time, thus affecting the overall turnaround time.…”

“…This may be attributed to additional service areas in the UPHS setting such as swabbing booths and screening tests which were included in their reported turnaround time. 18…”