RESUMO
OBJECTIVE: To analyse the factors that affect patients´ wait at a health centre before they enter the doctor´s consulting room (CD). DESIGN: Prospective full evaluative cycle of quality. SETTING: A teaching health centre in the Cartagena Health Area (Murcia). PARTICIPANTS: All those patients seen by the doctor during the weeks of the study (1st stage: 3823; 2nd stage: 4247). MAIN MEASUREMENTS: The dimensions evaluated were accessibility and patient satisfaction, through four criteria. Data were collected from the register of scheduled appointments and by telephone questionnaire. The intervention measures were: a) to create empty spaces without any appointments in the day´s diary in order to avoid delays; b) to create spaces at the end of the day for emergency patients, and c) to avoid interruptions during the consultation. RESULTS: 1st stage: on 48.3% of days there were patients with a delay greater than 20 minutes on entering the CD, with a mean waiting-time of 21.3 minutes per patient. 63.1% of the consulting rooms had over 5% «unavoidable¼ appointments per day, of which 61.3% were «emergencies¼. 72.6% of the consulting rooms had 5 or more interruptions per day. 46.7% of patients thought that the time they waited before going into the consulting room was «a lot or enough¼. 2nd stage: after putting the improvement criteria into practice, the number of consultations with waiting time over 20 minutes dropped (37.1%) (P<.05). The number of unavoidable consultations over 5% of the total fell by 35.7% (P=.001), as did the number of consultations with over 5 interruptions per day (by 58.6%) (P=.001). Fewer patients were dissatisfied with the time they had to wait before going into the CD (40.8%) (P<.05). CONCLUSIONS: Patients' waiting time at the clinic dropped. The number of «unavoidable¼ appointments and interruptions was reduced. Patients´ satisfaction improved with the time they had to wait at the clinic improved. The corrective measures introduced are the right ones for correcting the situation.
