Name: Macanlalay, Ralph Elvin R.

Date: February 1, 2024

Section/Group: BSN 4F-D Clinical Instructor: Maám Marilou Banusan

I. TITLE: Service Efficiency Analysis of the Outpatient Department (OPD) of a public hospital in the
Philippines by Service Quality Model and Queuing Theory
AUTHOR/S: Essey Misaki V. Andres, Franz C. Dator, Pamela Rose A. Juan,
Joeyette Therese E. Macato, John Carl R. Mendevil
SOURCE: Proceedings of the International Conference on Industrial Engineering and Operations
Management
DOI: N/A
YEAR OF PUBLICATION: 2023

II. SUMMARY
The research study focuses on the challenges faced by healthcare systems, particularly in the Philippines,
during the COVID-19 pandemic. The strain on healthcare systems, with a rapid shift in demand for inpatient
care, is highlighted. The outpatient department (OPD) is identified as a critical component of hospitals,
serving as the first contact between patients and healthcare staff. With the rise of the pandemic,
challenges in providing immediate responses to patients have become a significant concern, leading to
increased waiting times in outpatient departments, causing frustration and stress for patients. The study
emphasizes the importance of addressing these issues in the OPD, especially in a country like the Philippines,
facing challenges due to its vast population and crowded cities.

The objectives of the study are outlined, focusing on determining service efficiency and existing problems in
the OPD of a public hospital in the Philippines. The study utilizes the SERVQUAL scale, queuing theory, and
Promodel process simulation to assess service quality and queue-related issues. Queuing theory is explained
as a mathematical analysis used to analyze facility scheduling, arrival, and service time, with a focus on its
application in hospitals. The importance of patient satisfaction, service quality, and the use of tools like
SERVQUAL in assessing and improving healthcare systems are highlighted.

The research methodology combines quantitative and qualitative approaches, using a 5-point Likert scale
for the SERVQUAL survey and one-way ANOVA for data analysis. The study includes a literature review
discussing the application of queuing theory and Promodel process simulation in healthcare improvement.
The conclusion of the study reveals that the hospital's OPD did not meet patients' expectations, and the
identified bottleneck is the nurse triage process. Proposed solutions involve a redesigned process layout
and additional healthcare workers, demonstrating potential improvements in patient wait times and overall
system efficiency.

III. Nursing Implications

A. To Nursing Practice
The research study underscores critical implications for nursing practice, particularly in the
outpatient departments (OPDs) of healthcare facilities in the Philippines amid the challenges
posed by the COVID-19 pandemic. Nurses, as frontline healthcare providers in OPDs, need to
adapt to the rapid shifts in demand for inpatient care and address the increased waiting times
that lead to patient frustration and stress. The emphasis on utilizing the SERVQUAL scale, queuing
theory, and Promodel process simulation signifies a need for nurses to enhance their
understanding of these tools, incorporating them into their practice to actively contribute to
improving service quality and patient satisfaction. As the study identifies the nurse triage process
as a bottleneck, nurses should actively engage in the proposed solutions involving process
redesign and the addition of healthcare workers. This necessitates a collaborative approach
within nursing teams and across healthcare disciplines to optimize patient flow, enhance
efficiency, and provide timely and satisfactory care in the dynamic healthcare landscape of
the Philippines. Continuous education and training for nurses in these methodologies are crucial
for their effective participation in improving overall system efficiency and patient outcomes.

B. To Nursing Education
The research study holds significant implications for nursing education, particularly in enhancing
the knowledge and skills of nursing professionals to navigate the evolving challenges within
healthcare systems. As the study emphasizes the application of advanced methodologies such
as the SERVQUAL scale, queuing theory, and Promodel process simulation, nursing education
programs need to incorporate these concepts into their curricula. There is a growing need for
 nurses to develop a comprehensive understanding of service quality assessment, queue
management, and process optimization to actively contribute to improving patient care in
outpatient deppartments (OPDs). The study's focus on the quantitative and qualitative
approaches, including the use of the 5-point Likert scale and one-way ANOVA, highlights the
importance of statistical and research methodologies in nursing education. Training programs
should equip nurses with the skills to conduct and interpret such studies, fostering a culture of
continuous improvement in healthcare delivery. By aligning nursing education with the study's
objectives and methodologies, nursing professionals can be better prepared to address
challenges, contribute to effective solutions, and play a crucial role in optimizing healthcare
services in the Philippines and beyond.

C. To Nursing Research
The research study presents crucial implications for nursing research by shedding light on the
multifaceted challenges within healthcare systems exacerbated by the COVID-19 pandemic,
particularly in the Philippines. The identified strain on healthcare systems and the emphasis on
the outpatient department (OPD) as a pivotal component offer a rich avenue for nursing
researchers to delve into the intricacies of service delivery and patient satisfaction in similar
contexts. The study's incorporation of advanced methodologies, including the SERVQUAL scale,
queuing theory, and Promodel process simulation, provides a framework for nursing researchers
to explore innovative approaches in assessing and improving healthcare systems. The
combination of quantitative and qualitative methods, such as the 5-point Likert scale and one-
way ANOVA, sets a precedent for comprehensive research methodologies in nursing studies.
The research findings, highlighting the dissatisfaction in the OPD and the bottleneck in the nurse
triage process, open avenues for further investigation, enabling nursing researchers to propose,
test, and refine solutions that contribute to the enhancement of patient care, especially during
times of increased healthcare demand and strain.

IV. Personal Insights

The research study provides a poignant insight into the intricate challenges faced by healthcare
systems during the COVID-19 pandemic, particularly in a densely populated country like the
Philippines. It underscores the crucial role of outpatient departments (OPD) as the primary interface
between patients and healthcare staff, elucidating the heightened complexities in delivering
immediate responses amid the pandemic's demands. The emphasis on patient satisfaction, service
quality, and the utilization of advanced tools like SERVQUAL, queuing theory, and Promodel in the
research methodology reflects a forward-thinking approach to addressing healthcare inefficiencies.
As I reflect on the study, it prompts me to recognize the global significance of improving healthcare
systems' responsiveness and service quality, with particular attention to the challenges faced by
countries with vast populations. The proposed solutions, involving a redesigned process layout and
increased healthcare workforce, offer tangible steps towards enhancing patient experiences and
overall system efficiency, urging healthcare practitioners and policymakers to consider innovative
strategies for future healthcare planning and management.