Abstract Details

Title Task-shifting to Optimize Outpatient Neurological Care in Zambia

Topic Global Health and Neuroepidemiology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-046

Objective

To investigate opportunities for task shifting to decongest an outpatient neurology clinic in Zambia.

Background Zambia has a population of ~ 16.5 million people with 4 full-time adult neurologists –all of whom practice at the only tertiary care hospital in Zambia, the University Teaching Hospital (UTH). As a result of this provider to patient ratio, outpatient neurology clinics is overcrowded and overbooked. Task -shifting programs have shown to improve efficiency, access and quality of care, through the use of less specialized healthcare workers in low- and middle-income countries (LMIC).

Design/Methods We performed a retrospective period prevalence study of outpatients seen by at the neurology clinic between 2014 to 2018 at UTH. We then prospectively collected appointment lag time periods and the total time patients spent waiting in the clinic between July and August 2018. We made recommendations on potential task shifting strategies to help reduce wait times, based on the overview of the clinic patient flow and capacity analysis.

Results From 2014 - 2018, 7822 outpatients were seen in the neurology clinic. On average patients waited 57.8 (73.4) days to be seen by a neurologist. The average wait time in clinic was 4.03 (2.5) hrs. The most common neurological diseases were epilepsy (25.7%), headache (12.2%) and cerebrovascular disease (9.7%). Stable patients in these three diagnostic categories requiring only medication refills were felt to be most amenable to a task shifting intervention that could reduce patient wait times. Clinic nurses could inquire about stability of symptoms and dispense medication refills or refer patients to the neurologists if necessary.

Conclusions Epilepsy, headache, and cerebrovascular disease make up the largest percentage of outpatient neurological illness in Zambia. Stable patients in these diagnostic categories represent a potential target for a task shifting intervention to decrease waiting times in neurology outpatient clinics in Zambia.

Authors/Disclosures
Ana C. Villegas PRESENTER	Ms. Villegas has nothing to disclose.
Michelle P. Kvalsund, DO (University of Rochester)	Dr. Kvalsund has nothing to disclose.
	No disclosure on file
Omar Siddiqi, MD (Beth Israel Deaconess Medical Center)	The institution of Dr. Siddiqi has received research support from NIH.

��ɫ��

��ɫ��