Mapping patient path in the Pediatric Emergency Department: A workflow model driven approach

Abstract

The workflow models of the patient journey in a Pediatric Emergency Department (PED) seems to be an effective approach to develop an accurate and complete representation of the PED processes. This model can drive the collection of comprehensive quantitative and qualitative service delivery and patient treatment data as an evidence base for the PED service planning. Our objective in this study is to identify crowded situation indicators and bottlenecks that contribute to over-crowding. The greatest source of delay in patient flow is the waiting time from the health care request, and especially the bed request to exit from the PED for hospital admission. It represented 70% of the time that these patients occupied in the PED waiting rooms. The use of real data to construct the workflow model of the patient path is effective in identifying sources of delay in patient flow, and aspects of the PED activity that could be improved. The development of this model was based on accurate visits made in the PED of the Regional University Hospital Center (CHRU) of Lille (France). This modeling, which has to represent most faithfully possible the reality of the PED of CHRU of Lille, is necessary. It must be detailed enough to produce an analysis allowing to identify the dysfunctions of the PED and also to propose and to estimate prevention indicators of crowded situations. Our survey is integrated into the French National Research Agency (ANR) project, titled: "Hospital: Optimization, Simulation and avoidance of strain" (HOST).

Human Factors and Organizational Issues in 2015: The Increasing Complexity of the Healthcare Domain Calls for More Comprehensive Approaches

“…A growing trend is the graphical representation of work processes and/or patient journeys. Ajmi et al [15] analyzed the patient path in a pediatric emergency department through a model-driven approach.…”

Clinical pathway modelling: a literature review

“…The sample of papers are discussed briefly and their relevant categories are indicated in Table 1 Ajmi et al, [3] used Business Process Modelling Notation (BPMN) to model the workflows of the patient journey in a Paediatric Emergency Department. The aim was to identify bottlenecks and crowded situation indicators, with noting that delay occurs in the waiting time from the health care request.…”

“…It is important to note that only 12 papers [3,22,52,60,73,93,96,119,120,124,143,170] state that their research/product was implemented/informed policythis is only 6.9% of the papers surveyed. Previous reviews have found similar results in regards to implementation (e.g.…”

“…Furthermore, six papers [3,14,24,151,164,202] discuss the use of 'Business Process Modeling Notation' (BPMN). BPMN is the use of graphical notation for the purpose of illustrating business processes.…”

“…Obtained Data Driven [5, 7-9, 11, 13, 32, 33, 37, 47-49, 54, 58, 62, 66, 70-72, 74-76, 80, 81, 83, 85-99, 104, 107, 108, 112, 120, 121, 124, 126, 127, 131, 133, 134, 138-140, 143, 144, 147-150, 153, 157, 160, 162, 167, 170, 172, 177-179, 183-185, 191, 192, 195, 197-206, 209-211] Collaboration [3,10,14,17,27,42,51,73,100,114,142,152,163] Both [12,20,35,40,56,101,103,129,136,146,154,166,171,186] Other [19,21,22,24,41,60,79,82,116,128,169] Table A6. Care level considered.…”