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.
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.
- Content Type Journal Article
- Category Original Paper
- Pages 1-10
- DOI 10.1007/s10461-012-0199-9
- Authors
- Stella T. Alamo, Medical Department, Reach Out Mbuya HIV/AIDS Initiative, P.O. Box 7303, Kampala, Uganda
- Glenn J. Wagner, Health Unit, RAND Corporation, Santa Monica, CA, USA
- Joseph Ouma, Department of Strategic Planning, Management Sciences for Health, Kampala, Uganda
- Pamela Sunday, Monitoring and Evaluation Department, Reach Out Mbuya Parish HIV/AIDS Initiative, Kampala, Uganda
- Laga Marie, HIV Epidemiology and Control Unit, Institute of Tropical Medicine, Antwerp, Belgium
- Robert Colebunders, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Fred Wabwire-Mangen, Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
- Journal AIDS and Behavior
- Online ISSN 1573-3254
- Print ISSN 1090-7165