Evaluation of efficiency in the adult cystic fibrosis clinic at the Halifax Infirmary

The adult cystic fibrosis clinic in Halifax provides team-based care. Appointments are lengthy with high truancy. Our two-part efficiency study examined clinic flow, appointment length, and identified inefficiencies. A follow-up study was conducted to assess for improvements. Variables included total clinic time for each patient and total time spent alone waiting. Attempts to rectify problems were made after the first study. Outcomes were compared using analysis of variance. We found that patients wait significantly longer on Fridays (p 0.05), and patients with known methicillin-resistant Staphylococcus aureus wait significantly longer (p < 0.05). Patients who arrive earlier wait significantly longer (p < 0.05), while patients who arrive late wait less overall. No significant difference was found after the second study. Despite changing scheduling, procedures and notifying patients, no significant improvements in efficiency were found. Further measures may be required.