Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu discontinued consultation by appointment in the Ophthalmology (eye) department from yesterday.

Officiating chief programme officer with the hospital’s Quality Assurance and Standardisation Division (QASD), Jigme Choden, said that the system was discontinued because of the complex nature of examination and treatment procedure in Ophthalmology.

“Unlike in other departments, in the eye department, patients have to be routed through several other procedures like preliminary vision screening, refraction and cycloplegic refraction as mandatory tests before seeing the consultant,” she said.

Because of this, she said, the patients were not able to reach the consultant’s chamber on time. “We were sceptical before rolling out consultation by appointment in the eye department.”

The management discussed with the head of the department and decided to try it. “We started having problems with the system in the department a month after it was started.”

The system did not work and caused confusion among patients visiting the department.

Jigme Choden said the department felt the same and even for the patients the system was not convenient. The department and QASD so discussed it and decided to discontinue the system.

Because of the complex nature of examination and treatment procedure in Ophthalmology, Jigme Choden said that a token system was also not applicable to consult the doctor at the department. “In the department, the token system is there only for checking the vision.”

The patients stand in a queue to consult a doctor in the department because patients are sent from various examination units to a consultant’s chamber. With the current system in place, it is not possible for all the health staff at the different units in the department to know which patient was given what token number.

Medical Superintendent with the hospital, Dr Gosar Pemba, said that the hospital started the system in the department after piloting in three departments in March. “We tried it but it did not work.”

The consultation by appointment was initiated in the Opthalmology department on September 3, six months after the hospital introduced the appointment system in the Ear, Nose, and Throat (ENT) department.

Jigme Choden said that the system was introduced in the OPDs (out-patient department) at the hospital as a measure to reduce patient waiting time after the studies and reviews on the OPD patient waiting time recommended it.

It was a strategy that the hospital came up with in response to the recommendations and findings of the Royal Audit Authority’s performance audit report and the Royal Civil Service Commission’s design thinking.

Jigme Choden said that ‘no show’ was a problem in all the departments. It was found that most of the patients fail to turn up for their appointment at the OPDs for various reasons wasting the allocated time of the consultant. “On a daily basis, it has been observed that ‘no show’ is about 8-10 cases.”

Dechen Tshomo