Angkor Hospital for Children

Faculty Development Course

SWOT Analysis of Outpatient Teaching

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What are the goals (

) of the outpatient department?
Treat patients and provide education for the doctors/nurses/patients/families
Treating patients is the primary goal; education is second

Strengths (PaBxaMg):

What do we do well?

Database/documentation
Triage nurses (2-3) help with patient flow
Good communication with other depts/doctors
Learn together through discussing cases
Internet access for reference/teaching
Friendly environment (between staff)
Respect from patients/families

Weaknesses (PaBexSay):

What do we do poorly?

Patients wait a long time

Patients overlap
Sometimes doctors/nurses talk too long
Over-diagnosis/too many tests/over-medicate
Not enough information recorded in the chart, illegible
Sometimes doctors lazy/low motivation
Not enough staff
Not as much direct teaching
Poor English skills
Poor chart review

Opportunities (PaBGacnWgceRmInrugerOg):

Where can we do better?

Review charts
Daily: review10 charts (maybe need to review all undergrad charts and some of graduate charts)
Weekly: review 4-5 charts with juniors (7-7:30am) Discuss what they did well and areas that they could
improve
Role of nursing staff in chart review (Quality control nurse)
Review interesting cases together
Chief needs to manage time well (prep patient ahead of time, keep learning focused)
Chiefs need to encourage juniors encourage questions, be good role models, motivate them
Between each patient, ask a different junior, Are you doing okay? Do you have any questions? Have you seen
anything interesting?
OPD Handbook idea
1. Schedule
4. Physical Examination (components)
2. The Junior Doctor
Progress Notes
o Appearance
o Standard
o Responsibilities
o Disease-specific
o Attitudes
Clinical Skills they should learn
o Confidentiality
Common Conditions algorithms
3. Patient Interview (components)
Feedback & Evaluations

Threats (GVIEdlKMramkMEhg):

What may cause us to fail?

Noisy room/no privacy

Cannot control for good quality

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What can we do to help the outpatient department better reach its goals? (
)
OPD vice-chiefs can get together and discuss a policy for outpatient teaching focusing on the
opportunities discussed.
Ive just put together a quick example of an outpatient template it makes things quicker, easier to
read, and hopefully reminds the provider what to examine. They dont have to examine everything
just whatever systems are relevant to the illness.

Angkor Hospital for Children

Faculty Development Course

Progress Note Template Example

Date: _______________ Provider: __________________

Patient name / birth date

Chief Complaint: _________________________________

imprint

Meds: ____________________ Allergies: _____________

Temp: ___ Pulse: ___ Resp: ___ BP: ___ Wt: ___ Ht: ___ HC: ___

(triage completes this section)

Circle indicates a normal exam finding. Write abnormal findings in space provided
Gen: A&R, NAD ________________________________________________________________________
HEENT: PERRL, EOMI, +RR, TMs, NP, nodes, neck ___________________________________________
Lungs: CTAB ___________________________________________________________________________
CV: Rate, rhythm, no murmur, no gallop, no rubs _______________________________________________
Abdomen: Flat, soft, NT, nl BS, no hepatosplenomegaly _________________________________________
GU: CVA non-tender, normal ext. genitalia, testes, no hernia ___________________________________
Extremities: no cyanosis, no clubbing, no edema, FROM _________________________________________
Neuro: DTR nl, non-focal exam _____________________________________________________________
Skin: no rashes, no jaundice ________________________________________________________________
Developmental: age appropriate (write exam) _________________________________________________
A/P: __________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
RTC in ___ days/weeks/months

________________________________
Provider signature

Explanation of abbreviations:
Gen: A&R alert and responsive, NAD no apparent distress. HEENT: PERRL pupil equal, round,
reactive to light, EOMI extraocular movement intact, +RR red reflex, TMs tympanic membranes, NP
nasopharynx. Lungs: CTAB clear to auscultation bilaterally. Abdomen: NT non-tender, nl BS bowel
sounds. GU: CVA costovertebral angle. Extremities: FROM full range of motion. Neuro: DTR deep
tendon reflexes.
RTC return to clinic