OPD Outpatient Department

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OPD Outpatient Department

OPD is defined as a part of the hospital with allotted physical facilities and medical and other staffs, with regularly scheduled hours, to provide care for patients who are not registered as inpatients.
A hospital department where patients receive diagnosis and/ or treatment but do not stay overnight.
Ambulatory care is medical care provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care can include advanced medical technology and procedures.
A polyclinic is a clinic that provides both general and specialist examinations and treatments to outpatients and is usually independent of a hospital.
A health center is one of a clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area. Typical services covered are family practice and dental care.
A walk-in clinic accept patients on a walk-in basis and with no appointment required.
A day hospital is an outpatient hospital facility where patients attend for assessment, treatment or rehabilitation during the day and then return home or spend the night at a different facility.
A dispensary is an office in a school, hospital, industrial plant, or other organization that dispenses medications, medical supplies, and in some cases even medical and dental treatment. 
In a traditional dispensary set- up, a pharmacist dispenses medication as per prescription or order form.

Facilities of OPD

The physical facilities of the clinic can be categorized into the following areas;
• Patients Area
• Clinical Area
• Circulation
 

Patients Area

1. Entrance: It should be easily accessible for the patients, with wide door, ramps, facing road.
2. Reception/ Nurses station/Waiting Area: A common waiting area for patients and their attendants.
3. Public Utility Service: Public Toilet for male & female

Clinical Area

1. Consultation Room: Accommodated with doctor’s chair, Visitors chair’s, table, patient’s stool, computer table, almiraiahs,  wash basin, examination couch, equipment for examination. 
2. Day Care Center:  Accommodate at least 2 beds, distance between beds should be 1.25mts, with partition between both beds.
3. Minor OT: Include minor OT table, pendulum light, wash basin, dressing trolley, almiraiahs or cabinets for storing sterile equipment’s, provision for wall mounting fans
4. Dirty utility room: Provision for a waste management room to accommodate 5 bucket sized dust bins

Circulation

1. Stairs

2. Corridors

3. Ambulance Entrance

OPD Process

  1. Arrival at OPD
  2. Reception
  3. Registration  
  4. Issue of Token Number
  5. Waiting Room
  6. Consultation with Doctor
  7. Investigations
  8. Issuance of med Chit OR Referral to Spl
  9. Arrival at Pharmacy
  10. Token Number
  11. Waiting  
  12. Collection of Med  
  13. Departure

SOURCES OF ORIGIN OF OPD

Unreferred Cases
Emergency and Accidents
Discharged cases for fallow up
referred cases

OPD Planning

OPD has functional and administrative links with  the hospital of which it is a part.
It may also be linked with Health Centers,  Satellite Clinics and Dispensaries dependent on it.
Expected demand should be determined basing  on catchment area and population to be served.
Should include curative,preventive and  pro-motive health services.

Problems at OPD

General Problems:

1.Insufficient number of doctors.
2.Inappropriate appointment system.
3.Long waiting time at Medicine room.
4. Shortage of facilities.
5. Insufficient training of medical personnel concerningambulatory care.
6.Fragmentation of care, poor communication and inadequate understanding of their demands.
7.An organizational structure geared to traditional preferences  and needs of the providers.
8. Resistance to change.

Specific Problems:

1. Duties undertaken by the auxiliaries are carried out hurriedly in order to keep pace with consultation of doctors. This creates inappropriate documentation.
2. Auxiliary staffs sometimes misbehave with the patients.
3.In absence of appointment system, patients start accumulating even before office time starts; creating a long queue of patients even before arrival of doctors.
4. Absence of visible serial number of appointment. 
5. Interruption of consultation or investigation.
6. Lack of privacy.
7. Advices are not clearly spelled out.
8. Illegible hand-writing of the doctors.
9. Poly-pharmacy.
10. Prescription of too much antibiotics.
11. Queues are not properly maintained.
12. Prescribed medicines are not always available at pharmacy. 
13.Use of trade-name of medicines by the doctors, create confusion to patients, when different-named medicines of same genera is supplied to the patients.
14.No clear advice about when, how and how long to take the medicines.
15. Sometimes, wrong medicines are given by the pharmacists.
16. Insufficient and un-cleaned toilets.
17. Undue influence of local political leaders.

Records at OPD

OPD Registration Record.
Treatment Record.
Medication Record.
Report of Investigation.
Consent Form.

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