1. The data taken from appointment office shows that more than 43% patients were not attended the clinic with their appointment and the evidence is that there are many patients suffering to get appointment due to full showing by computer, so many patients are coming without appointment or asking favor from administration to reach the clinic.. LEADER: Mr. Mubarak Aerym (OPD Director) FACILITATOR: Mr. Eid Al Bakar (Quality Director) MEMBERS: Dr. Muhammad Younus (Deputy Quality Director) Dr. Ahmed Hussein (Medical Specialist) Sis. Nighat Yasmin (OPD Head Nurse) Sis. Ajna Ajas Mohammed (Nurse Educator)  To increase physician and patient satisfaction by proper appointment.  Decrease work load in medical record department.  Decrease Unexpected Patients Coming To OPD.  To provide opportunity for other patient to get appointment  To create smooth appointment process Human Human Machine Material Environment Method INCREASED NUMBER OF PATIENTS NOT ATTENDING THE OPD Appointment status Send the patient to the clinic Confirm Appointment in Appointment Office File available in the clinic PATIENT CAME TO HOSPITAL CONSULTING THE DOCTOR FORWARD THE APPOINTMENT CARD FROM OPD OBTAIN APPOINTMENT FROM APPOINTMENTOFFICE NO MEETING THE OPD DIRECTOR YES AVAILABILITY OF APPOINTMENT IN THE SAME DAY Send the patient to OPD waiting area DISCHARGE NEED OTHER APPOINTMENT YES NO WHITE PAPER- no enough supply to print the appointment APPOINTMENT LIST-not ready earlier due to increased workload and shortage of staff in the appointment office WHITE PAPER- no enough supply to print the appointment APPOINTMENT LIST-not ready earlier due to increased workload and shortage of staff in the appointment office COMPUTER-no enough computers TELEPHONE- sometimes not properly working to inform the appointments from PHC PRINTER-no enough printers PHOTOSTAT MACHINE-no enough number COMPUTER-no enough computers TELEPHONE- sometimes not properly working to inform the appointments from PHC PRINTER-no enough printers PHOTOSTAT MACHINE-no enough number APPOINTMENT OFFICE STAFF- shortage of the staff. DOCTORS- ER and PHC doctors are not guiding the patient to appointment office. NURSES- not registering in the system and not guiding the patient to appointment office. PATIENTS- not responsible enough to come in the appointment time. ADMINISTRATION- helping the patients to meet the doctors without appointment. APPOINTMENT OFFICE STAFF- shortage of the staff. DOCTORS- ER and PHC doctors are not guiding the patient to appointment office. NURSES- not registering in the system and not guiding the patient to appointment office. PATIENTS- not responsible enough to come in the appointment time. ADMINISTRATION- helping the patients to meet the doctors without appointment. CULTURE OF THE REGION - patients are used for not attending the appointment APPOINTMENT OFFICE IS WORKING ONLY ON OPD TIME-making difficulty in obtaining appointment in non OPD time. UNNECESSARY APPOINTMENTS FROM PHC-more appointments from PHC is without valid reasons CULTURE OF THE REGION - patients are used for not attending the appointment APPOINTMENT OFFICE IS WORKING ONLY ON OPD TIME-making difficulty in obtaining appointment in non OPD time. UNNECESSARY APPOINTMENTS FROM PHC-more appointments from PHC is without valid reasons POLICY- is not clear PROTOCOL-no protocol to remind the patient before the day of appointment LACKS OF MINISTRY APPOINTMENT SYSTEM- 5 PHC s have no ministry appointment system POLICY- is not clear PROTOCOL-no protocol to remind the patient before the day of appointment LACKS OF MINISTRY APPOINTMENT SYSTEM- 5 PHC s have no ministry appointment system ActivityResponsibilityTarget DateResourceOutcome 1.Formation of a check sheet for data collection from each clinic Quality departmentOne week Computer and printer Accurate data will be available 2. Data Collection for the patient coming in clinics with or without appointment Nurses in each clinic. Every day for 6 month - check sheet -OPD register Get the knowledge about the unregistered patient coming to the clinic daily 3. Data collection for the patient not attending the clinic Reception staff Every day for 6 month Appointment list in the computer Get knowledge about the wasting of appointment 4. Send memo to the PHCs to follow the proper appointment system Team leaderOne weekMemo Decrease unnecessary appointment 5. Appointment list should send to Medical record prior one day Appointment office staff Every day for 6 month Appointment list Required file will be ready in the clinic 6. File will send to all clinics according to the appointment list provided Medical record department staffs Every day for 6 month Appointment list and medical files Both Physician and patient are satisfied QUALITY IMPROVEMENT REPORT OF THE RATE OF PATIENTS NOT ATTENDING THEIR OPD MONTH 1-MONTH 10 /1435 Year 1435 Total No. of Appointments Patients Attended The Clinics Patients Not Attended The Clinics Patient Came Without Appointment % of patients not attending the clinic Month 12621208453787320.5% Month 22686189179597729.6% Month 325191857662102426.3% Month 42587201557294922.11% Month 52420199142971029.33% Month 63537304249576314% Month 72950240254868623.35% Month 83588271387536424.38% Month 92272195087533920.1% Month 103152256561551019.5% TOTAL28332225106403719522.6% COMPARISON OF NUMBER OF PATIENTS NOT ATTENDED THEIR CLINIC BEFORE AND AFTER THE START OF PERFORMANCE IMPROVEMENT PROJECT. Future Plan: