Improving Patient flow in Outpatient Department At Apollo Main Hospital, Chennai
EXECUTIVE SUMMARY
The Orthopedic Department at Apollo Main Hospitals, Chennai has been facing problems in patient flow due to increased delays in other processes like registration, waiting time, other diagnosis etc. This has led to patient flow delays, disruptions and inefficiencies, and it has caused dissatisfaction among some patients and employees resulting in a loss of potential revenue and safety concerns for these patients. In order to combat these challenges, we analyzed data and conducted interviews to establish a comprehensive understanding of the hospital’s orthopedic department, strengthened the existing processes and protocol through verification and validation, and suggested improvements in the system to increase the flow rate of the patient throughout the stay.
Table of Contents
ACKNOWLEDGEMENT 2
EXECUTIVE SUMMARY 3
HEALTHCARE 5
LEAN IN HEALTHCARE 5
OUTPATIENT DEPARTMENT AT APOLLO MAIN HOSPITAL, CHENNAI 6
OBJECTIVE OF THE STUDY 7
SCOPE OF THE STUDY 7
PROCESS STUDY 7
PROCEDURE AT OP DEPARTMENT (OUT PATIENT DEPARTMENT) 8
PROCEDURE AT RADIOLOGY DEPARTMENT (X-RAY) 9
SOURCES OF WASTE 9
DATA COLLECTION 11
DATA ANALYSIS AND INTERPRETATION 11
RECOMMENDATIONS 14
PATIENT FLOW PROCESS 15
SPAGHETTI ANALYSIS 15
LIMITATIONS OF THE STUDY 19
FURTHER SCOPE OF THE STUDY 19
HEALTHCARE
Healthcare is essential to the general welfare of society. It provides for the prevention...
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Blood Collection Centre
The Television showing the token number is to be placed near the blood collection Centre. This would help in smoothening the patient flow.
LIMITATIONS OF THE STUDY
The limitations of this study is that only the granularity level that was kept was keeping in mind the feasibility of data collection and time constraints. The processes are much more detailed and the more depth we go, the better will be the insights. To further optimize the processes of a Hospital, all other departments must be considered.
FURTHER SCOPE OF THE STUDY
As an extension to the study, more granular level data for a greater number of patients can be collected so as to derive better insights. This could be implemented using the RFID tags on the patients. Also we can cover other departments of the hospital so as to expand the scope of the study.
In order to maintain its reputation, Homeland must thoroughly evaluate its processes and operations which indirectly or directly result in greater customer satisfaction and thus a promotion of the ideal reputation. Homeland can use Enterprise Performance Management analytic techniques to ultimately bolster is business persona. The company as whole as well as each individual department have key areas that must be critically evaluated. Inventory tracking within each department is important for financial savings as well as having what you need when you need especially as the dietary department is concerned. The dietary department undertook a challenge this past year to reduce its food budget. A great deal of food waste (ex. foods which expired before they could be cooked, cooking more food than necessary for a particular meal, purchase of unnecessary food items, lack of a price comparison being completed between competing suppliers, etc.) had been identified last year. The dietary department also must constantly track and react to any significant resident weight loss. Weight loss is a desirable outcome for many in the general population, but significant weight loss in an elder population receiving health care signals a red flag. This red flag can lead to resident family member concerns about the effectiveness of Homeland care, and its overall reputation as one of the best facilities in Central Pennsylvania. The nursing department is concerned with the presence of resident bed sores, falls, urinary tract infections, pressure ulcers, etc. In an article titled The Value of Analytics in Healthcare, the writer states The increasing regulatory presence of government places additional focus on accountability, governance and oversight on the industry. (The Value,
Because of the lack of organization with the health care providers in Canada, the wait times are too long and can cause serious complications to any condition the patient went in for in the first place. This situation of how the health care system can resolve wait times was brought to the government but they continue to ignore the proposals brought to them. It is possible to resolve the problems of wait times without extreme change and expenses in the health care system. The solution is to be found in the reorganization of the health care providers. Lack of assistance in the emergency room can make ones illness to become worse, therefore, causes the patient to be forced to wait in emergency rooms for an extended period of time and when they are finally seen by a health care provider, the outcome is very poor due to lack of registered staff, physicians and proper assessment(Goldman & Macpherson, 2005, p.40). The objective of this paper is to discuss and critically analyze the conditions of emergency waiting rooms. The specific issue this paper intends to explore is extensive and prolonged waiting times for patients accessing health care, patients who need urgent treatment and the vulnerability of elderly patients and children. With an in-depth critique of the barriers to health care and shortcomings of emergency rooms, strategies will be provided to enhance a health care system that makes it more accessible and efficient.
The users of London NHS hospital are more concerned with having quality service from the hospital. In case of an emergency they prefer to check in and register and get treated as soon as possible and get treated for emergency with much care. And according to the case study it means that the patient survey was positive.
The world of healthcare changes every day. Technology, as we know it evolves and changes the actual care that patients receive and even post care as well. It has been determined that most faults are caused by system failures. When a break in the system has occurred it must then be decided where the,” inefficiencies, ineffective care and preventable errors” to then influence changes within the broken system (Hughes, 2008). Improvements sometimes can begin with measurements and benchmarks which in turn will allow organizations to assess the trouble spots and broken areas within the system. Many times those broken areas within the system will be owned by the humans who operate within these systems. According to the Institute of Medicine (IOM)
To resolve the problem of patient dissatisfaction, patient falls, increase use in nurse call light and interruptions; 8 West Orthopedics would need to implement hourly rounding into their patient care and preform patient rounding every hour. Implementation of hourly rounding can be a difficult process but with the adequate nursing staff and leadership it can be an uncomplicated
The Centers for Medicare and Medicaid Services (CMS) have recently begun requiring hospitals to report to the public how they are doing on patient care. Brown, Donaldson and Storer Brown (2008) introduce and explain how facilities can use quartile dashboards to transform large amounts of data into easy to read and understandable tool to be used for reporting as well as to determine areas in need of improvement. By looking at a sample dashboard for an inpatient rehab unit a greater understanding of dashboards and their benefits can be seen. The sample dashboard includes four general areas, including nurse sensitive service line/unit specific indicators, general indicators, patient satisfaction survey indicators and NDNQI data. The overall performance was found to improve over time. There were areas with greater improvement such as length of stay, than others including RN care hours and pressure ulcers. The areas of pressure ulcers and falls did worse the final quarter and can be grouped under the general heading of patient centered nursing care. The area of patient satisfaction saw a steady improvement over the first three quarters only to report the worst numbers the final quarter. A facility then takes the data gathered and uses it to form nursing plan...
With consolidation among hospital systems over the last few years there has been a trend toward ways to streamline processes. By having “shared services” such as laundry services, human resources and radiology and diagnostic services it’s possible to lower costs and have common processes. The advent of health care reform and the Affordable Care Act (ACA) with its Information Technology (IT) incentives has led to greater interest in risk management and IT solutions. While there was a decrease in 2012 on outsourcing IT services the finalization by the Supreme Court of the ACA and President Obama’s re-election cemented the need for an IT solution (Kutscher, 2012)
The topic chosen is blood transfusion. Blood transfusion is one of the most common procedures that are performed in the hospital setting to save lives and help improve one’s health. People who have serious injuries may need blood transfusions to replace the lost of blood. Some of the injuries are more critical than others and require an enormous amount of blood. In addition, many people have illnesses that prevent their body from making blood properly. Blood circulates in the body providing oxygen and nutrients and collects waste so it can be eliminated by the body; therefore, it is an important factor for everyone’s lives (Lewis Medical surgical nursing). Blood should be carefully transfused. Although it is a lifesaver, nurses should follow the proper procedure and strict guidelines to safely transfuse the blood. One sample error during transfusion can cause someone life.These situations can lead to death, especially in serious cases. So nurses must have knowledge and understand the purpose of blood transfusion.
We market the orthopedic center as a world class center providing high quality services and recruit a physician orthopedic group with satisfaction rate of 90%. This data would be used to target patients that require total joint services, inpatient and outpatient services. We will also include those physicians who may not be directly adjacent to the Trinity campus, but because they have privileges at Trinity, we can provide referral services and they will in-turn refer patients to Trinity and our orthopedic center. The new PT rehab center, expansion of radiology services and purchase of MRI machines will all serve as support systems for the new orthopedic center and a requirement point for the orthopedic group placing emphasis on support services, ensuring that patients will not require traveling far for rehabilitation services.
Due to WellStar being a multi facility health system, its organizational design is constantly being reviewed for simpler and more efficient processes. WellStar’s two smallest hospitals, WellStar Paulding and WellStar Douglas, previously under went reconstruction with regards to their hierarchical structure in Patient Access Services (PAS). WellStar Paulding, the smallest facility of the five hospitals, renovated their managerial chain of command in PAS. WellStar Paulding’s patient volume is less than half in comparison to the 4 additional hospitals. As a result, their staff is smaller and only requires minimal supervision. In the past WellStar Administrators requested supervisors for every department, a manager of the entire department, and a director that managed PAS’ management directly and PAS staff indirectly. Recent cuts ...
Nevertheless, when patients arrive at the A&E Department, a trained triage nurse will help determine the relative priority due to the patient's condition. There are five categories for nurses to classify, such as critical (immediate treatment), emergency (waiting time within 15 minutes), urgent (waiting time within a half hour), semi-urgent and non-urgent. Yet, it trend to treat the triage nurse as a McDonald’s Customer Service Ambassador in charge of the system carries out smoothly and conveniently. Apart from that, specialist out-patient clinics also have the same problem. In general, patients visit general out-patient clinics or private family doctors which make referrals due to special cases.
In the social service system such as in the healthcare services, the queuing theory is a helpful analytical tool that can measure the access to health care of patients that in this case are considered customers. With this tool healthcare providers can analyze the adequate service capacity needed to cover the patient demand, balancing system utilization, and the patient’s waiting time. In a study in a hospital setting in Singapore in the Emergency Department, tried to demonstrate four factors and methods of the queuing analysis that can help to manage delivery the healthcare service to the patients in the four common waiting times in a healthcare system that are seeing an ED (Emergency Department) patient waiting for triage, consult, and tests,
Systematic Conglomerate Sdn. Bhd. (2013, June). Malaysia Hospital Information System: MYHIS. Retrieved from Malaysia Hospital Information System: http://www.sc.net.my/v2/sc/downloads/myhis_pamplet.pdf
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Operations management is an important aspect of the health care industry. Without operations managers, no organization would run smoothly and successfully. Studying pre-existing models of operations management may be a smart approach to truly understand this field. But since technology is advancing by the minute, new concepts, and tools should be adapted for operations management. The book titled Operations Management strategically explains the different concepts, divisions, and approaches of operations management.