A Deep Dive into Mulago Cancer Patients’ Missing Files and the Navigation Process

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Didas Opolot,   a 58-year-old cancer patient and resident of Mukono district who was diagnosed in 2020 with Cancer, revealed that his medical file went missing late Dec 2022, and attempts to recover it have been futile.

According to Opolot, he was advised by the medical personnel to start the Navigation process afresh. A process every cancer patient at Mulago has to undergo leading to medical care.

“Starting the navigation process is so tiring and with my deteriorating health, I don’t know if I will make it, the process is quite tedious since you have to book appointments at every stage of the way,” said Opolot.

Opolot says the process can take a period of close to two months to complete.

Another patient who preferred anonymity revealed that a lot of files get misplaced or go missing, since files move from one point to another in a span of two months under different medical personnel.

Some patients attribute these acts of carelessness in handling patient files to poor remuneration and delayed pay of the workers by the institute.

“With unpaid workers anything is possible, how do they think work will go on smoothly with a poorly motivated worker,” patients revealed.

Earlier last week, medical workers at the Cancer institute went on strike for delayed pay, though they later called it off.

The Navigation process

The Navigation program was launched on 09th march at Uganda cancer institute and Uganda cancer society with the aim of providing three types of navigation

  • Physical navigation to improve access to care by moving patients from one care point to another or wheeling them and providing guidance and information about services and their locations in national languages.
  • Clinical navigation to increase patients understanding of the disease and their treatment plan and to coordinate patients’ care.
  • Resource navigation to mobilize local resources to meet the psychosocial, spiritual, and economic needs of patients.

The steps undertaken to complete the navigation process

Registration process;

This is the beginning of the whole navigation, where the patient arrives at the institute and is issued with a file and number.

Checking;

Stage 2, where physical checking is done and a patient makes an appointment for the next visit.

Non- specialized checkup;

Where the patient’s samples are picked and sent to the laboratory, then book another appointment for the laboratory to take the patient’s vitals.

Laboratory appointment;

The patient returns after two weeks, from the time of removal of samples to have their vitals’ taken, after this stage another appointment is set for the patient to meet with the specialist.

Specialist;

The patient is required to wait for close to four days after vitals were taken to meet the specialist. It is not automatic that the report will be reviewed on that day.

Disclosure, counseling and treatment day;

The specialist requests the patient for more time like two weeks to review the results than another date is set for disclosure of the outcome from the report, counseling and treatment commencement if necessary.

At the end of the navigation process, a patient will have waited a minimum of two months to get treatment.

The top management at Uganda Cancer Institute acknowledged that it is true they have received a number of complaints about the misplaced files and management has taken interest and is looking into it.

“I get many complaints about this, and management has swung into action already, they need to bring this to management while still at the institute,” said one of the top managers at UCI.

Could the solution to misplaced files be in timeliness and shortening the whole navigation process?

 

 

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