Improving productivity for outpatient clinics using task-shifting

Wesselius, Sybren (2014) Improving productivity for outpatient clinics using task-shifting. thesis, Other studies (UMCG).

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Abstract

Introduction: The objective of this research is to identify and assess opportunities for reallocating tasks from physicians to non-physicians in order to improve an outpatient clinics productivity. With constraints on budgets and the scare availability of resources like physicians and a growing number of patients, outpatient clinics face serious capacity problems. Therefore a challenge for the clinic manager is to improve the productivity of the outpatient clinic. In this research we consider the possibility to increase productivity by shifting workload from physicians to non-physicians Method: To achieve the research objective, a design approach is used for the Inflammatory bowel disease (IBD) clinic at the University Medical Center in Groningen, which serves as a case example. Findings from literature, observations, interviews with managers, physicians and nurses and company data are used to set up the system description, analysis and task redesign. Results: IBD patients can experience a disease in different phases. The main part of these patients experience a disease in remission. Consults are relatively standardized and performed by physicians. Part of these consults may also be performed by a nurse practitioner. During the analysis of the tasks performed in consulting an IBD patient, we found that the task of explaining the effects or use of medicine may be shifted from physician to nurse. We found that 229 out of 1521 consults with patients in remission, on a yearly bases, can be shifted to a nurse practitioner. This comes down to 15% of the workload spend on IBD consults. Shifting the task of explaining the effects or use of medicine to a nurse results in decreasing the physicians’ workload by 8,1%. Conclusion: Concluding, task-shifting may be a beneficial solution for the capacity problem IBD clinics face. A large part of IBD patients experience a disease in remission and standard procedures, fitting the competences of nurse practitioners are available. This creates opportunities for task-shifting from physicians to non-physicians. The most important barrier for implementing task-shifting may be the acceptability of patients. Ultimately, patients have to accept that they may have less contact with highly specialized personal. We recommend IBD clinics to seriously consider the involvement of a NP in the process of consulting IBD patients. While nurses may also be helpful to the outpatient clinic process, there are not a lot of task that may be shifted to nurse without creating duplicated work.

Item Type:	Thesis (Thesis)
Supervisor name:	Borgers, mr. R. P.
Supervisor name:	Zee, dr. ir. D.J. van der
Faculty:	Economics and Business
Keywords:	outpatient clinic, productivity, task analysis, task-shifting, nurse practitioner
Date Deposited:	25 Jun 2020 10:51
Last Modified:	25 Jun 2020 10:51
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1224

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