KEYWORDS:
Time study and viral hepatitis integration projects

BACKGROUND:
The Illinois Department of Public Health (IDPH) identified the need to assess the impact of implementing viral hepatitis integration project (VHIP) services on client waiting and staff interaction time periods during sexually transmitted disease (STD) clinics. VHIP pilots led to revised clinic flow procedures in late 2000 that has facilitated VHIP service delivery in 2001

OBJECTIVE(S):
1) Assess client waiting and interaction times at four STD/VHIP clinics before and after integration of viral hepatitis prevention services and 2) Identify best practices to successfully integrate VHIP services into STD clinics without lengthening clinic services.

METHOD(S):
Four STD clinics collected data on time spent delivering services during early 2001. Staff charted time-specific data on 283 client visits occurring during one week in mid-winter 2001 prior to implementing VHIP services (pre-test period) and for 181 client visits from one week in early spring 2001 following integration (post-test period). Quantitative data were forwarded to IDPH for entry and analysis.

RESULT(S):
All staff/client interaction periods were combined into three service types: registration, medical (lab, exam, vaccination and treatment) and counseling. Interaction time during registration and medical processes generally remained stable between pre-test and post-test periods; counseling time and client waiting times showed greatest deviation. The total time spent by clients at each clinic decreased from the pre-test to post-test periods.

CONCLUSIONS(S):
The clinics exhibited the ability to provide VHIP services without increasing client visit times during clinic because staff —
* identified and removed redundant and time-wasting practices; and
* utilized both interaction and waiting periods to deliver STD and hepatitis prevention messages.


LEARNING OBJECTIVES:
Describe how to utilize a “time study” to assess the quantitative features of clinic services and thereby enhance service delivery.