Improving HIV clinic efficiency through reducing client waiting time in Virika Hospital HIV Clinic | Uganda



Holy Family Virika Hospital is a PNFP (Private Not for profit) hospital owned by the Catholic Diocese of Fort-Portal and located 2 kms away from Fort-Portal town, on the Fort-Portal Kasese road. The Hospital offer a wide range of services to address the different health service needs of the population amongst which is HIV care. By November 2011 2998 were receiving chronic HIV care at this facility with 2336 of them on ART. To ensured continued quality service provision to HIV clients, quality improvement (QI) has been implemented at the HIV clinic with support from USAID-HCI project since 2005.

As part of quality improvement  implementation at the  HIV clinic we assessed the average time client spent at the HIV clinic in June 2011 after receiving patient complaints from the suggestion box and  found this to be about 7hours . Problem analysis revealed that;
  • No clear system was in place to guide patients bookings for clinic appointments.
  • Having two dispensing points one in clinic pharmacy for OI treatment and the other in the main hospital pharmacy for ARVs. This meant clients had to queue for ARV and OI medicines separately contributing to longer time spent at the clinic.
  • Lack of a clear clinic flow chart to help guide the daily course of events brought about disorganization and delayed the clients
  • Difficulties in retrieval of files and patients cards due to the inappropriate file storage system.

Role clarification was done for HIV clinic staff before the start of each clinic day.

A comprehensive clinic flow chart was generated revised and established which eased the service delivery.

The two dispensing points were harmonized into one to eliminate multiple patients’ queuing.  

Initiated the storage patient files in an orderly manner on shelves with clear labels for easy file retrieval.

Finally in late July 2011, the appointment register was put in place and a trained care giver was assigned a task to harmonize the appointment system with minimum daily client number determined.


Eight patients were randomly selected on two clinic days a week and their clinic time determined. The average client clinic was determined at the end of each month by calculating the mean time in minutes that the sampled patients during the month spent at the HIV clinic. With the above interventions a steady reduction in the time noted over the next six months of running the QI project from about 420 minutes(7hours) in June to 180 minutes (3hours)in December 2011.



Organization of your work place environment can boost or improve your results  
HIV care provision is liable to several but efforts to solve one problem can help you identify another underlying problem.
Involving clients into care can improve the quality care and increase client satisfaction.


Report Author(s): 
Ankwatiriire Shem
Holy Family Virika Hospital
ASSIST publication: 
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