Factors Affecting Delivery of Interventional Radiology Services at Kenyatta National Hospital

Abstract

Background The provision of radiological services needs to be examined from the point of customer-oriented delivery. This, in the business sense, would put into consideration various factors among them being customer satisfaction, quality and efficiency of service. To reach high repute standards of a service the provider must have well equipped and laid out radiology department set up. This is particularly important for interventional radiological services given that they are highly specialized and require sophisticated and often high capital tools as well as minimal suite standards. Additionally, interventional radiology services require highly specialized, continuously trained and motivated staff that are able to operate in a multidisciplinary setting. Objective To determine factors affecting the practice of Interventional Radiology at Kenyatta national hospital. Materials and methods This cross-sectional study employed the purposive sampling approach where all employees working at the KNH IR department, including UON IR fellows as well as the heads of technical unit and head of finance were targeted. Between 2nd May 2022 to 17th June 2022 the respondents were administered with a closed and open-ended questionnaire. Results Of the 27 targeted interviewees, 19 responses were returned (70% response rate). The data obtained was analyzed using excel quantitative computer analytics tool. One nurse (..%), and one interventionist (50%) were on annual leave during the study period. There are more female staff (52.63%) than males; while majority of IR workers are aged between 31 and 40years. While majority of personnel (89.48%) are registered with a professional body all of which require annual licensor based on prove of attendance of continuous professional development (CPD) learning; a comparatively high number of staffs (86.67%) had attended at least one CPD event in the six months preceding the study. There was noted to be a low number of workers trained in non-core supportive management skills, with IR nursing, Radiation safety and Advanced intervention work being highly demanded competences. 78.95% of respondents were emphatic that the department is ill equipped for the current work load and 68.42% indicated that erratic consumable material supply in the IR department curtailed service delivery. xii 88.24% of respondents hailed the existing referral system as encouraging inter-disciplinary consultation and a further 70.59% as promoting feedback to referring clinicians. Nonetheless, Unclear IR policy, Late patient referrals, Ignorance of available IR scope by referring clinicians and a Manual health management system were among the identified gaps bedeviling the department. The mode of total radiology turnaround time in the IR department was estimated at one week with multiple factors contributing to prolonged waiting time. These include, delays in clients raising procedure fees, machine breakdown and high workload, among others. Majority (53.33%) of the respondents felt that the current service charges of the IR services should be reduced while 20% think the prices are exorbitant. Conclusion The findings of this study demonstrate that the delivery of IR services at the Kenyatta National Hospital are affected by the training and qualification of IR staff, the department’s physical infrastructure, the patient referral system in place, the total radiology waiting time in the IR department and the cost of IR services. Several growth and improvement areas are identified which addresses the need for IR policy formulation and implementation as well as the improvement of the department’s existing processes for optimal service delivery(28)