Question

The Emergency Department of the Walker Memorial Hospital is setup with first responders to get ready to receive any case, a pager system to announce an incoming case, mobile phones for a faster communication and sharing of information. When a patient is treated at one level and is required to be transferred to another unit to continue treatment, the medical personnel will need confirmation from the receiving unit before transferring the patient. In other words, before a patient is moved from one unit to the other, the protocol requires prior information to the other unit before a move is made. This process has always proven to yield great results and most personnel agree it is the best workflow to maintain. You have been assigned as a Manager/Process improvement specialist, and find this process somewhat ineffective and could be amended to improve outcome. In a detailed write up;

1. How will you start the process of improving the workflow of the Unit?

2. Who will you include in this process?

3. What process will you propose as an improvement to the status quo? Include some faults you have identified in this current setup.

4. How will you test your proposal for improvement?

Answer 1

1. I will first understand the VOC (voice of the customers). Specifically what are the customer feedback on this mechanism of transferring patients with special focus on understanding their pain points. Then I will map the AS IS process starting from initial admission process till the treatment of patient is successfully complete including all formalities. Then I will start collecting data of each major steps through various sampling techniques. Once we have data , I will carry out different techniques like ANOVA (Analysis of variance), correlation analysis or clustering etc. to figure out interactions and dependencies. All this will enable me to identify the root cause for each of the pain points. Then I will start the improvement phase and close the process.
2. I will include all the stakeholders specifically, doctors, nurses, patients , caretakers etc. in this process.
3. I will use DMAIC process i.e. Define, Measure, Analyze, Improve and Control for improving the process. Some of the faults /gaps which I have identified are:
   1. Latency and delay in transferring patients
   2. No Colocation . Colocation of the two units will help in drastically improving communication as well as physical shifting.
   3. Waiting time in case the other unit is full.
4. I will carry out hypothesis testing at a given confidence level (say 95%) to test if there is a statistical support in favor of our assumptions.