Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
It is apparent that there is variance in the modus operandi between the various Antenatal/ Gynaecological Outpatients' Sessions at Mater Dei Hospital. In some outpatients sessions, waiting times are reasonable and there is minimal patient overcrowding. Conversely in other outpatients' sessions, the nature of these outpatient characteristics suggest otherwise. Outpatients' sessions are characterised in the main two forms of referral. These forms of patient referral may be delineated as new case appointments and follow-up appointments. Both forms of appointments are regulated by quotas as determined by the firms' consultants. System overload of both forms of appointments may and frequently occur. In the circumstance of new case appointments, unscheduled appointments, denoted as “walk-ins”, may overwhelm the outpatient new case system. Inappropriate referral has been noted in a number of new cases and “walk-ins”. In the instance of follow-up appointments, system overload may arise due to unscheduled reviews. Moreover there may be circumstances where unnecessary follow-up appointments have been scheduled out of habit and not out of clinical need. Excessive waiting time at the outpatients department is detrimental to the service. Patient and doctor frustration rates skyrocket. Many members of the nursing and medical staff feel exhausted after some outpatient sessions impacting morale. The environment is not congenial to efficacious consultation. Locally it has been noted that patients actually left the outpatients department frustrated at having to wait several hours for the consultation. On a positive note the waiting lists are minimal. This undoubtedly is due to the stamina and hard-working character of the nursing/midwifery and medical personnel of the Department of Obstetrics and Gynaecology. It appears that the current imbalance due the excessive workload has to be addressed. In the case of many of unnecessary follow-up appointments, there are firms at Mater Dei Hospital that have successfully resorted to telephone interviews. During the telephone interview the investigation results and future follow- up is explained to the patient. This process is backed up by a posted hard copy and occasionally where appropriate by e-mail. Another strategy to deal with excessive numbers of new case and follow-up appointments may involve increasing the number of simultaneous outpatients' reviews by increasing the number of consulting rooms. Capping of walk-ins both as new cases and followups has to be instituted to curtail the excessive number of unscheduled appointments. More efficient implementation of the consultation process should be applied so as to avoid unnecessary prolongation of consultations.