Flaws in the out-patient flow at a semi-rural hospital in northern Namibia

The aim of this study was to determine the quantity and quality of our service in the out-patient department (OPD). During 2 weeks in November and December 1996 all out-patients were followed throughout their stay. Service times, waiting times, time on arrival, time on departure and completeness of the service were recorded. All in all, 4999 patients, who had 17,436 contacts with healthcare providers were recorded. Approximately 500 out-patients were seen daily with 48.43% follow-ups and 15.24% referrals. Two-thirds (74.79%) of all patients arrived before 1100 h. Between 200 and 300 patients were present in the OPD at any time between 0900 h and 1600 h. Twelve per cent (621 patients) left the hospital with an incomplete service. Of the 1511 patients screened by the nurses only 20 (1.32%) were treated by them. The way the work was organized was inefficient and client unfriendly. Inefficient, because available expertise was not utilized. Client unfriendly, because this leads to situations where patients were denied the service to which they were entitled.