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Full Project – Design and implementation of patient appointment scheduling system

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CHAPTER ONE

INTRODUCTION

1.0 INTRODUCTION

Appointment or scheduling refer to the period of time allocated in the schedule to a particular patient’s visit and “service time” refer to the amount of time the physician actually spends with the patient (which may be shorter or longer than the appointment duration. According to Cayirli&Veral (2017), appointment scheduling can be classified into two broad categories: static and dynamic. In static appointment scheduling all decisions must be made prior to the beginning of a session, which is the most common appointment system in healthcare. In dynamic appointment scheduling the schedule of future arrivals are revised continuously over the course of the day based on the current state of the system. This is applicable when patient arrivals to the service area can be regulated dynamically, which generally involves patients already admitted to a hospital or clinic.

The appointment-scheduling process which is either dynamic or static can be viewed as burden in hospitals, which can be eliminated through an efficient online appointment scheduling system. The benefits of implementing this technology touch everyone involved in the scheduling process. Administrators and staff can conduct their tasks more efficiently and accurately, while patients have the ability to book their appointments and reservations quickly and more conveniently.

Medical appointment can be seen as a means of patient booking and securing a particular time with the doctor either for medical checkup or for medical consultation. Online medical appointment scheduling helps to manage and effectively utilize the time spent at the health center in a way that the patient is assigned a time which is visible for both the patient and the doctor. Large waiting times at hospital outpatient clinics are a cause of dissatisfaction to patients, cause additional stress to hospital staff, increase the risk of contagion and add complications for patients with medical conditions. Reducing waiting times and surgeon idle time improves the quality of service and efficiency of a hospital (Strahl, 2015).

Pawlikowska et al. (2016), explained that the medical consultation is a two-way encounter between a doctor and a patient. This may be initiated by a patient when they are ill or by a doctor when instituting preventive medicine or screening. The medical consultation is being done by the patient booking an appointment with the physician by physical appearance of the patient at the health center which at time lead to queue as many might also be waiting to be responded to by the physician.

1.1 BACKGROUND OF THE STUDY

The Delta State University Teaching Hospital (DELSUTH) is a renowned and accredited University teaching hospital to the Delta State University (DELSU), Abraka. Located in Oghara, Ethiope West Local Government Area of Delta State, the hospital was built initially as a 180-bed ultra-modern specialist hospital. An inaugural management board headed by Professor Joseph Otobo was sworn in June 2009 to manage the affairs of the Hospital when it kicked off initially.

The earliest staff of DELSUTH consisted of a team of qualified Nigerian medical professionals drawn from the United Kingdom and the United States. The Hospital was officially commissioned on the 19^th of June, 2010 by the Former President of the Federal Republic of Nigeria, Dr. GoodluckEbele Jonathan. Delta State University Teaching Hospital (DELSUTH) is an affilate of the Delta State University (Abraka). With provision to provide medical care in over 20 Medical Specialties, ensuring we deliver world class services to Patients is our priority (Ejomafuvwe, 2018).

The research on appointment scheduling has a long history, starting with the work of Welch and Bailey in 1952. Their most famous result is the so-called Bailey-Welch appointment schedule, which states that two patients should be planned at the start of the day, and the other patients evenly spaced throughout the day, to offset the bad effects of no-shows and patient lateness. Bailey announced that already announced that an appointment system is a trade-off between doctors’ and patients’ waiting times. Although outpatient clinic’s average internal waiting times are long, doctors frequently have idle time. Patients who do not show up or who are late for their appointments cause idle time for doctors, leading to temporary underutilization of the outpatient clinic’s capacity. Gaps in the appointment schedules also cause underutilization of the doctor’s time (Giome et al., 2017).

1.2 STATEMENT OF PROBLEM

The number of missed appointments in healthcare institutions in Nigeria has caused numerous problems hence, the need for integrated healthcare system to intervene and provide seamless care for patients. Appointment scheduling system lies at the intersection of providing efficiency and timely access to health services. One major problem associated with the operation of hospital patients is the issue of waiting time. Due to the major problem of long waiting time facing by many outpatient in the Nigerian Teaching Hospitals, there is need to develop a web based patient medical appointment booking system to help patients to book appointment and access their medical records online.

1.3 AIM AND OBJECTIVES OF THE STUDY

The main aim of the study is to design a patient appointment scheduling system for Delta State University teaching Hospital, Oghara.

The objectives of this study are as follows:

To reduce the number of missed appointments, unnecessary outpatient queue at the clinics, and long waiting time of NHIS outpatients at the clinics.
To store and retrieve a database file to facilitate the electronic file management system
To eliminate or minimize the system of paper file management system
To explicate the relevance of computerizing the system of appointment scheduling in hospitals

1.4 SCOPE OF THE STUDY

The study is focused on developing a web based database system for the efficient database management practice in the Delta State University teaching Hospital, Oghara.

1.5 SIGNIFICANCE OF THE STUDY

The implementation of this study design will be very impactful on the management of hospital boards, consultants, patients and other health workers as it intends to eliminate unnecessary waiting line with brings stress and pressure on health workers.

1.6 LIMITATIONS OF THE STUDY

This study was affected by insufficient time available to expand on the scope of the study. Financial constraint was also an hindrance to the improvement on the scope of the study.

1.7 DEFINITION OF TERMS

Appointment: an arrangement to meet a person or be at a place at a certain time.

Schedule: a series of things to be done or of events to occur at or during a particular time or period

Hospital information system (HIS): variously also called clinical information system (CIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital.

Patient: A patient is a person who is receiving medical treatment from a doctor or hospital. A patient is also someone who is registered with a particular doctor.

Health care: Basic health services means those health services, including as a minimum, but not limited to, emergency care, inpatient hospital and physician care, ambulatory physician care, and outpatient and preventive medical services.

Medical records: The terms medical record, health record, and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient’s medical history and care across time within one particular health care provider’s jurisdiction.

Medical statistics: Medical statistics is a subdiscipline of statistics. “It is the science of summarizing, collecting, presenting and interpreting data in medical practice, and using them to estimate the magnitude of associations and test hypotheses.

Database: In computing, a database is an organized collection of data stored and accessed electronically from a computer system.

Database management system: A database management system (DBMS) is a software package designed to define, manipulate, retrieve and manage data in a database.

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