Lotus - web

Refining clinic processes to reduce patient wait times


A public facility of the Western Cape Department of Health, Lotus River Clinic serves 13,000 low-income patients per month, including many with chronic diseases, in a Cape Flats neighborhood of Cape Town.


Faced with high-levels of patient demand and limited resources, Lotus River needed to find innovative ways to improve operational efficiency and reduce patient wait times.

Drawing on data collected on site, the GlobalHealth Lab student team analyzed the movement of patient folders throughout the day to generate ideas and questions to explore on site. At the clinic, an early discovery was that every day some patient folders were lost, resulting in wasted time for receptionists, nurses, and even doctors—and patients. By identifying the main causes for lost folders and implementing a simple change in clinical rooms of the doctors and nurses, the team quickly reduced the frequency of lost folders by over 50%. Other changes were designed to improve patient and document flows.

The student team designed their intervention processes to model for the staff a set of practical methods for identifying problems, developing solutions, and implementing them. A goal was to help show Lotus River that they already possessed many ideas for potential improvements, but that there was neither a mechanism for bringing these ideas to light nor an institutional culture encouraging internal critique. To maintain the momentum, the team helped form a steering committee to build enthusiasm for improvement and serve as a clearinghouse for new ideas.