Clinic context, mechanisms and outcome configuration for control clinics
| Clinic name | Context | Mechanisms | Outcomes | ||||||||
| Clinic infrastructure | BP machines | Other materials (files, drugs, packs for drugs) | Clinic management | Visit per nurse per month (% change) | Existing manager, staff and patient relationship | Chronic care processes | Patients adhering to appointments | Chronic care pathway | Other aspects of chronic care | Patient attendance on booked date | |
| Arlington | Modern spacious building | Did not break down | Erratic supply | Strong manager but often absent from clinic | 359–370 (+3%) | Very poor relations among staff and with patients | Better equipment and strong manager but failed to motivate staff because of absenteeism. This led to poor staff relations, lack of support to each other and taking long to attend to patients. | Spacious building facilitated a separate consultation room but poor staff relations led to poor commitment. Patients always complained of poor staff conduct. |
Functional: chronic care pathway, chronic consultation room Did n o t happen: designated vital signs station |
Functional: filing Erratic: appointments Did n o t happen: prepacking of medication | HTN: 62% (n=4618) Other chronic: 58% |
| Yang | Dilapidated building, limited space | Did not break down | Erratic supply | Strong manager replaced by weak manager | 306–342 (+12%) | Good relationship among staff and with patients | Initial strong manager and better equipment motivated staff relations, committed staff and quick services to the satisfaction of patients. Later, weak manager and lack of support to staff. | Dilapidated building led to poor queuing and lack of confidential consultation. Patients’ files often missed and patients were frustrated with the little support they received. | Erratic: chronic consultation room Did n o t happen: chronic care pathway, designated vital signs station | Erratic: appointments, filing and prepacking medication | HTN: 59% (n=4347) Other chronic: 56% |
| Morgan | Dilapidated building, limited space | Did not break down | Erratic supply | Weak clinic manager | 374–447 (+20%) | Good relationship among staff and with patients | Weak manager that failed to discipline and control staff. This led to staff behaving as they wished sometimes, that is, arriving late or leaving work early. | Good relation among staff resulted in effective support to patients. Limited space led to poor queuing with patients often quarrelling. |
Functional: chronic consultation room Erratic: chronic care pathway Did n o t happen: designated vital signs station |
Functional: appointments Erratic: filing Did n o t happen: prepacking of medication | HTN: 58% (n=5039) Other chronic: 56% |
| Faith | Modern spacious building | Frequently broke down | Erratic supply | Weak manager | 372 to 227 (−40%) | Poor relations among staff and with patients | Weak management that resulted in poor relations among staff and between staff and patients. Staff felt unsupported and were not willing to work. Patients were often ignored. | Spacious infrastructure facilitated confidential consultations and designated queue sometimes. Poor filing system led to long waiting time and missing appointments. |
Functional: chronic consultation room, chronic care pathway Did n o t happen: designated vital signs station |
Erratic: filing, appointments D id n o t happen: prepacking of medication | HTN: 40% (n=2061) Other chronic: 37% |
HTN: patients with hypertension; other chronic: patients without hypertension.
BP, blood pressure.