An Integrated Methodology for Process Improvement and Delivery System Visualization at a Multidisciplinary Cancer Center

Singprasong, Rachanee; Eldabi, Tillal

doi:10.1111/j.1945-1474.2011.00174.x

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…The non-value-added items are a waste (Womack and Jones, 2003); they are resources that are the loss to the AEH. Singprasong and Eldabi (2011) proposed a methodology for process improvement and delivery system visualization at a multidisciplinary cancer center to provide a high quality of patient care. Process mapping improves workflows (Middleton and Roberts, 2000).…”

Section: Methodsmentioning

confidence: 99%

From process flows to benchmark in an accident and emergency hospital with PERT approach

Ahmed

Mohammed

2019

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Purpose Accident emergency hospital (AEH) services require cohesive, collective, uninterrupted streamlined medical diagnostic and satisfactory patient care. Medical service efficiency in AEHs is difficult to quantify due to the clinical complexity involved in treatment involving various units, patient conditions, changes in contemporary medical practices and technological developments. This paper aims to show how to measure efficiency by eliminating waste in AEH system, identify service failure points, identify benchmark medical services, identify patient throughput time and measure treatment time when AEH services are nonstandard. The applications shown in this paper are distinct in particular; we the authors use nontraditional and systems engineering approach to collect data as the traditional data collection is difficult in real-time AEHs. Design/methodology/approach The authors show in this study how to measure overall patient treatment time from admission to discharge. Project evaluation and review technique (PERT) captures the inconsistencies involved in measuring treatment time, including measures of variability. The irregular treatment time and complexity involved in the emergency health-care services are usual. The research methodology illustrates how the time function map and service blueprint can improve value-added time in AEHs and benchmark services between similar AEHs. Findings The inconsistency in treatment time between AEH in public and private hospital is found to be in ratio of 1:20. The private hospital suggests variety of treatments and long stays for recovery. The PERT computations show that the average time a patient remains in a government AEH is about 10 days. The standard deviation of the AEH treatment time is about 0.043 per cent of the expected patient care time. The inconsistency is not significant as compared to the expected value. In 89.64 per cent of the cases, a patient may be discharged in less than 10 days’ time. The patient on average is discharged in 13 days in a private hospital. Originality/value The patient treatment time of an AEH is evaluated with PERT project management approach to account for inconsistencies in treatment time. This research makes new contributions in benchmarking AEH throughput time, identify medical service failure points with service blueprint, measure the efficiency with time function map and collect patient data with nontraditional methods. The inherent inconsistencies in a clinical process are identified by PERT analysis with the variance as a characteristic of the treatment time. Improvement of variability implies cost reduction in AEH system.

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Section: Methodsmentioning

confidence: 99%

From process flows to benchmark in an accident and emergency hospital with PERT approach

Ahmed

Mohammed

2019

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“…These result in data being recombined in a number of ways to support decision making throughout the patient journey. The decision-making process typically integrates a coordinated team approach making many process modeling approaches unable to adequately capture the team dynamics and role differentiation [ 66 ]. Health care also has a high level of required documentation.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of Understandability of Patient Journey Models in Mental Health

Percival¹,

McGregor²

2016

JMIR Hum Factors

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BackgroundThere is a significant trend toward implementing health information technology to reduce administrative costs and improve patient care. Unfortunately, little awareness exists of the challenges of integrating information systems with existing clinical practice. The systematic integration of clinical processes with information system and health information technology can benefit the patients, staff, and the delivery of care.ObjectivesThis paper presents a comparison of the degree of understandability of patient journey models. In particular, the authors demonstrate the value of a relatively new patient journey modeling technique called the Patient Journey Modeling Architecture (PaJMa) when compared with traditional manufacturing based process modeling tools. The paper also presents results from a small pilot case study that compared the usability of 5 modeling approaches in a mental health care environment.MethodFive business process modeling techniques were used to represent a selected patient journey. A mix of both qualitative and quantitative methods was used to evaluate these models. Techniques included a focus group and survey to measure usability of the various models.ResultsThe preliminary evaluation of the usability of the 5 modeling techniques has shown increased staff understanding of the representation of their processes and activities when presented with the models. Improved individual role identification throughout the models was also observed. The extended version of the PaJMa methodology provided the most clarity of information flows for clinicians.ConclusionsThe extended version of PaJMa provided a significant improvement in the ease of interpretation for clinicians and increased the engagement with the modeling process. The use of color and its effectiveness in distinguishing the representation of roles was a key feature of the framework not present in other modeling approaches. Future research should focus on extending the pilot case study to a more diversified group of clinicians and health care support workers.

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The Impact of Receiving Treatment for Cancer at a Large Metropolitan Teaching Hospital as Recorded by Patients Using Unstructured Journals

et al. 2012

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The aim was to obtain patients' experiences of the cancer treatment pathway at a tertiary teaching hospital using unstructured journals to enable health care professionals to be educated on how to improve patient care. Most of 38 patients (22 females and 16 males), average age of 58 (range 29-80), who returned diaries were starting chemotherapy for a range of cancers. Data entries were transcribed and entered into the NVIVO software to facilitate thematic analysis. Women wrote more, and more often than men, and disclosed more. For most, physical side effects dominated, comprising 25-75 % of diary entries. The most commonly mentioned were fatigue (74 %), pain (63 %), sleep disturbances (50 %), nausea (45 %) and changes in appetite (45 %). Collectively, 22 patients reported 261 separate emotional reactions including depression, anger, guilt, shame, grief, panic and confusion. The treatment environment, including personnel, impacted upon patients. Where survival is unpredictable, evidence of consistency of practitioners' approaches attains heightened significance.

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An Integrated Methodology for Process Improvement and Delivery System Visualization at a Multidisciplinary Cancer Center

Cited by 5 publications

References 12 publications

From process flows to benchmark in an accident and emergency hospital with PERT approach

From process flows to benchmark in an accident and emergency hospital with PERT approach

An Evaluation of Understandability of Patient Journey Models in Mental Health

The Impact of Receiving Treatment for Cancer at a Large Metropolitan Teaching Hospital as Recorded by Patients Using Unstructured Journals

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