Reducing long waiting time for root canal treatments at the University of Rwanda Polyclinic

Abstract

Background: Reducing the patients’ appointment waiting times has been a concern for healthcare provision, especially in developed countries. Waiting time is an indicator of health system responsiveness and is used to measure of access to health care and the performance monitoring of healthcare institutions in service delivery. Interventions addressing the patient waiting time are scare in sub-Saharan Africa including Rwanda. Objective: Conducted at the Dental Clinic of University of Rwanda Polyclinic, this intervention aimed to reduce long appointment waiting times for the Root Canal Treatments from 20 to seven days between July to December 2018. Methodology: A pre- and post- intervention study was conducted from January 2018 to December 2018. The study analyzed the root causes of the long waiting times for patients undergoing the root canal treatments (RCTs). This analysis was followed by an intervention to reduce the waiting times for the RCTs. The intervention consisted of rescheduling the duty roster with introducing evening shifts. Data were extracted from the Open Clinic Software to Microsoft Excel and SPSS for analysis. Descriptive statistics such as mean, standard deviation, median, IQR and frequency polygons helped to summarize data. We assessed the average or median waiting times, the number of patients attending the UR Polyclinic and the number of RCTs cases during both study periods. Results: Generally, the average appointment waiting times for RCTs significantly decreased from 18.32 (±14.91) days in pre-intervention period to 5.7 (±6.97) days in the post-intervention period (t=13.93, df=626, p<0.001). Furthermore, the monthly median number of patients who attended the UR Polyclinic significantly increased from 1,081.50 (IQR=414) during the preintervention to 2,298 (IQR=441) during the post-intervention period (p=0.002). Finally, the monthly median number of RCTs cases significantly increased from 42 (IQR=53) (preintervention) to 201.5 (IQR=63) for post intervention (p=0.002). Conclusion: Rescheduling the Staff duty roster in the Dental Clinic of the UR Polyclinic significantly reduced the waiting appointment times for the patients undergoing the RCTs. This resulted in the increment of the number of patients attending the clinic in general and the number of RCTs cases in particular. Other dental clinics would embrace this intervention to improve the RCTs services accessibility.