Doctors of Jigme Dorji Wangchuck National Referral Hospital in Thimphu have been informed to report and leave on time, Medical Superintendent Dr Gosar Pemba said.
The Royal Audit Authority (RAA) found that doctors on-duty arrived late and left as early as two hours before the closing time.
Average waiting time for patients at medical outpatient department (OPD) was observed to be about 1 hour 38 minutes and 45 minutes for general OPD. The RAA’s performance audit of the hospital’s OPD services revealed that some patients had to wait for more than two hours.
Waiting time refers to the time a patient waits in the clinic before being seen by one of the clinical medical staff.
“The doctors have case presentation and discussions around 8:30am. Some doctors are at the hospital by 8am,” Dr Gosar Pemba said. “The hospital is now a teaching hospital. Some doctors have to teach and come by 9:30am from the ward.”
The working hour is from 9am to 3pm. Teaching has to be done before 9am and after 3pm, he added.
The report for 2014- 2016 states that the doctors’ services were also called for other services when they were engaged in OPD chambers, affecting smooth delivery of consultation services and increasing the waiting time for OPD patients.
Dr Gosar Pemba said that usually in the afternoons if there are no patients, doctors walk out and come back later. “Sometimes we have meetings after 2pm. That is when there is less patient at the hospital. But we make sure that at least a doctor is there in a chamber to see the patients who visit the hospital in the afternoon.”
He said that doctors sometimes have to meet patients they know. “This could also result in the increase in waiting time. But this happens only sometimes. On the whole, we are trying to streamline things.”
Acknowledging the RAA’s findings, Dr Gosar Pemba said the doctors have been informed that as far as possible, they have to come and leave on time unless they are engaged in other activities like teaching or meeting. “But we need to keep a record.”
The study was carried out to ascertain the turnaround time, adequacy and optimal utilisation of human resource and equipment, and to assess the existence and effectiveness of supervision and monitoring mechanism in delivery of OPD services
The RAA made nine recommendations to the hospital to enhance greater accountability, improved decision-making and efficiency in the delivery of healthcare services.