2019 News

New filing system cuts patient waiting times from 6 hours to 50 mins

Before February 2019, at Holy Cross Gateway Clinic, everyone was waiting. Nurses were waiting for more than two hours for patients to come to their consulting rooms, while at reception, patients were also waiting – on average five to six hours. But a deceptively simple filing solution, and a lot of hard work, cleared the bottleneck, restoring an efficient workflow to the clinic.

Holy Cross Gateway Clinic, a clinic in South Africa’s Eastern Cape, identified a blockage in their patient flow at their clinic reception. There it could take up to 20 minutes to find a single patient’s file. In addition, 85% of their patients were seen without a facility-held clinical record because of an inadequate filing system, made worse by broken filing cabinets. Files were stored according to ART start month and year and Health Patient Registration System (HPRS) records were not used.

During the ‘February Frenzy’ campaign driven by the Centers for Disease Control and Prevention (CDC), TB HIV Care supported the facility to make the following changes:

  • Old clinical records were converted to new HPRS records – patients were registered on the HPRS system with each patient having an HPRN.
  • A local service provider was hired to repair the broken filling cabinets.
  • Three additional data capturers were hired to fast-track the process of HPRS registrations and filing into the cabinets according to HPRN.
  • Box filers were used to arrange files in the cabinets using the HPRN.
  • Professional nurses started using patient appointment books in each consulting room to record patient appointments. When generating an appointment list there are 3 additional columns to control the flow of files in the facility – (file retrieved, file captured and file filed back). These are ticked off at each step.
  • Allocation of data capturers – one data capturer is allocated as a supervisor on a monthly rotational basis, to oversee all administration department duties. A second data capturer is allocated to capture National Health Laboratory Services results and complete HIV testing services registers. The second data capturer also assists at the registration desk, issuing files to patients who have honoured their appointment dates and those who present themselves without an appointment (retrieving files from the filing room).

The new filing system means that files take less than a minute to retrieve. The average patient waiting time at the clinic reduced from five to six hours to between 40 and 50 minutes. The appointment system has meant patient files can be retrieved the day before their consultation, meaning their file is ready and available when they arrive for their appointment. Nurses can now see patients from early morning with no delays, while the patients’ experience of the clinic has also vastly improved.

TB HIV Care joins World Hepatitis Alliance

On Thursday, 26th September 2019, TB HIV Care was approved as a non-voting member of the World Hepatitis Alliance.

This is part of TB HIV Care’s strategy to broaden its focus to include other major diseases, and viral hepatitis in particular. According to the World Health Organization (WHO), hepatitis B and C cause about 1.3 million deaths per year globally, just less than the 1,6 million caused by TB. However, over 80% of people living with hepatitis lack access to prevention, testing and treatment services.

The World Hepatitis Alliance is a not-for-profit organisation that works with governments, national member organisations and other key partners to raise awareness of viral hepatitis and influence global change. By becoming a member, TB HIV Care raises its international visibility (the World Hepatitis Alliance has an ‘Official Relations’ status with the WHO and ‘Special Consultative Status’ with the United Nations Economic and Social Council.), as well as obtaining access to opportunities to network, attend conferences and capacity-building events and receive support for fundraising and policy work.

TB HIV Care has already begun to contribute towards viral hepatitis work in South Africa. From 2015 to 2018, TB HIV Care led a seven city study (in collaboration with the NCID, UCT, Anova Health Institute, OUT Well-being and funded by the Bristol-Myers Squibb Foundation) to assess the prevalence of viral hepatitis among sex workers, people who use drugs and men who have sex with men, as well as evaluate the feasibility of various diagnostic options.

KidzAlive Training

From the 12th – 16th of August 2019, Zoë-Life provided master training for 18 TB HIV Care and Department of Health (DoH) staff, including professional nurses, social workers and training coordinators.

Zoë-Life is an organisation focused on bringing health, wellness and personal development to children, youth and families. Zoë-Life was contracted by TB HIV Care to conduct implementer training on their KidzAlive programme.

The KidzAlive programme is endorsed by the NDoH and deals with child-friendly HTS, disclosure and adherence with children and their parents or caregivers.

The purpose of the training was to scale-up the implementation of the Kidzalive model in various districts of the Eastern Cape, where TB HIV Care provides support and technical assistance at facility level.

The five-day training covered three modules:

* Foundational skills in working with children and their caregivers
* A child-friendly HTS and disclosure model
* Adherence support (more…)