11: AN EVIDENCE BASED APPROACH TO IMPROVEMENT OF TIME VISIT IN THE BIGGEST UNIVERSITY POLICLINIC TABRIZ UNIVERSITY OF MEDICAL SCIENCES EXPERIENCE

摘要

Abstract Background and aims: Today health systems all around the world have paid more attention to the concept of patient Time visit. This duration is one of the most valuable resources in healthcare and is considered as an important subject in the quality of services. This study has been conducted with evidence based approach in one of the biggest polyclinics of Tabriz University of Medical Sciences (TUMS) aiming in order to increasing patients' visit time. Methods: The first stage of study started with utilization, cost, and satisfaction data review ?￠????environmental analysis ?￠????problem prioritize - systematically searches- focus groups and intervention selection. In the second stage data of visit time (from time of entering to examination room until exit) were gathered and analyzed using simple method of chronometry by secretaries of wards and under supervision of experts in two time intervals of winter 2015 with sample of 850 patients and spring 2016 with sample of 421 patients. Results: Mean visit duration has increased from 6.04 minutes to more than 14.6 minutes and doubled improvement was observed in most of specialties and even in generalists. On the other hand the number of physicians employed in the center shows 4 times increase, where physicians with benefits of visit promotion have increased from 30% to about 50%, so all subsequences have led to increase in satisfaction of people and the number of service receivers has increased from 15000 to 70000 in month, and the center has reached positive financial balance. Conclusion: Following instructions of evolution plan we witnessed doubling of visit duration and qualitative and quantitative promotion of services comparing with the past, where in previous studies of the country we had 4.7, 7.6, and 8 minutes comparing with numbers above 23 minutes in America. Therefore it would not be surprising to expect significant improvements and reach standards (20 minutes) if there are on-time payments for physicians' receivables as well as managerial efforts with evidence based approach.