VilaHealthPatientFlow.pdf

9/24/22, 2:54 PMVila Health: Patient Flow

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Vila Health: Patient Flow Introduction Quality Assurance The Emergency Room The Fishbone Diagram Conclusion Credits

Introduction The physical delivery of health care is a complicated process, and one which can have implications for the organization’s finances and its patients’ health. For those reasons, organizations try to make their delivery as efficient as possible. For example, hospitals routinely analyze how patients flow from one department to another – such as from the ER to a room in one of the units, or from Surgery to Med-Surg to discharge. The goal is to make sure that patients get treatment in a timely fashion and then discharged or moved to a more appropriate floor as soon as possible.

In this activity, you will observe the flow of patients in an ER.

Email From Quality Assurance Independence Medical Center is a critical access hospital in Independence, Iowa. You are a recently hired project manager in the hospital’s Quality Assurance department, and you’ve been given an assignment: Find out why patient satisfaction has been going down in recent months.

9/24/22, 2:54 PMVila Health: Patient Flow

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!"#$% Chad Williams, Director of Quality Assurance

&'()*+,% Survey Numbers

Hey there! I’m in charge of Quality Assurance and I hear from Albert Lynton that you’re in charge of the project to figure out our problem with patient satisfaction. Albert (he’s our director of operations) asked me to send you the survey numbers so you know what we’re seeing.

So here’s the scoop: In the last 8 months, our patient sat has tanked. We’re talking 93 percent satisfaction at the beginning of that time to 79 percent now. Ouch!

We’re still at 90 percent satisfaction with treatment outcomes, so at least there’s that. And we’re at 85 percent with the quality of the environment – beds, food, that sort of thing.

But here’s where we’re hurting: communication and wait times. We’re at 65 percent for communication (by providers, that is, our docs and nurses), and 49 percent for wait times.

Now, here’s a breakdown of those who said they were dissatisfied with their wait time:

• 47 percent of those who completed the survey were treated in the ER.

• 38 percent were admitted from the ER to the floor (to Med-Surg, the ICU, and other departments).

• 15 percent of the patients who completed the survey were parents of pediatric patients.

Other facts you might want to keep in mind: 73 percent of the hospital’s admissions come through the Emergency Room, and nearly half (46 percent) of these admissions occur between 6 p.m. and 4 a.m.

Good luck, and let me know if you need anything!

–– Chad

The Emergency Room

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You decide to use a common technique for figuring out problems in patient flow: shadowing patients as they come through the ER.

Converstaion between Ruby Martindale, Linda Mueller, and Stephanie Foster.

-'(./01",23415*% We’re going to have to divert all ambulances to Buchanan County. We are at capacity, and by that I mean we are beyond capacity.

62341/0'*55*"% When can I see a doctor?

-'(./01",23415*% Any time now! (to another nurse) Who’s attending today? Aren’t there any doctors we can pull in?

&,*78132*/!#9,*"% No, they’re still doing rounds.

-'(./01",23415*% What? It’s 3:00! How many patients do we have still here who could have been moved?

&,*78132*/!#9,*"% I don’t know, but Med-Surg is under capacity. So probably several.

Message over the hospital PA system:

Dr. Fabiola, please call the ER. Dr. Fabiola, please call the ER.

Conversation between Debra Green and Beverly Marshall.

:*("1/;"**3% That’s his third page. I wonder where he is?

<*=*"5./01"98155% I don’t know, but Mr. Tensleep, the one with the confusing lab results, isn’t going anywhere until we can consult with him.

Converstaion between Winston Sutherland and Heather Taylor.

>239,#3/&',8*"5134% Let’s get an EKG on Ms. Mueller.

?*1,8*"/@1.5#"% But she’s not showing any cardiac risk factors.

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>239,#3/&',8*"5134% Let’s get one anyway. She’s driving me nuts and I’m not giving her a single excuse to sue us. Besides, the last patient who didn’t have any risk factors went home on my okay, and he was back here three hours later.

?*1,8*"/@1.5#"% Well, it will have to wait. There are quite a few elective surgeries today, and several of the patients needed a preoperative EKG.

>239,#3/&',8*"5134% Oh, right. It’s Monday. I should have known we’d get backed up. Remind me again why they don’t spread those out?

?*1,8*"/@1.5#"% Don’t get me started.

The Fishbone Diagram !"#$% Chad Williams, Director of Quality Assurance

&'()*+,% Template for You

How did your observations go? I hope you learned what you needed to. Meanwhile, here’s a template for you to use as you pull together your ideas for improving patient satisfaction. I think this is a useful tool, and I use it myself regularly.

A,,1+8$*3,% The Fishbone Diagram.docx (https://media.capella.edu/CourseMedia/VilaHealth/BHA4110/patientFlow/docs/The Fishbone Diagram.docx).

–– Chad

Conclusion Conclusion: Activity complete!

What did you learn about Independence Medical Center’s patient flow? What would you do to improve the situation?

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Fill out the Fishbone Diagram template and submit it along with your assignment in this unit.

Credits !"#$%&'()*''%+(,-.%+'/ B'521/<*"*9C#"4 01'%+*&'23%(4%5261/ :132*55*/D11"415/0*.*" 01'%+*&'23%(4%3%78.%+/ 01,,/@1.5#" 015'+"&'281*7(4%5261/ E*5231/<*.*"9 )%92*(015'+"&'281*7(4%5261/ ?#55./:#5*F15*G :+8$%&'()*1*6%;%1'/ A513/E1$7(*55

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