10 May WHICH KEY STAKEHOLDERS ARE LIKELY TO BE AFFECTED BY THE PERFORMANCEIMPROVEMENT EFFORT AND HOW?
Application: Improving Patient Flow in Emergency DepartmentsAs you learned from Chapter 4 of Hospital-Based Emergency Care and from this week’sarticles emergency departments face serious challenges that impact and are impactedby conditions throughout the hospital. Experts emphasize the need to making patientflow more efficient. As noted in the IOM Committee’s report:Patient flow defined as the movement of patients through this system is an importantindicator of the timeliness safety and quality of the care received. Efficient patient flowensures maximum throughput (the number of patients treated and discharged from theED per day) minimizing delays at each point of the delivery process with no decrementin the quality of care. Impaired patient flow on the other hand results in bottlenecks thatprolong delays for patients already in the system as well as those awaiting entry (p.133). For this Application you will interview at least one administrator or manager working ina local emergency department to learn how his or her ED has identified and addressedchallenges involving patient flow. On the basis of this interview you will select one ofthese challenges and do further research about best practices to address this problem.1. Setting Up the Interview Read through the entire Application to gain an overview of this assignment.As soon as possible contact the emergency department at a local hospital andask to set up an interview with an administrator or manager in this ED. This must besomeone who can discuss process improvement efforts in this ED related to patientflow.The interviewee should hold one of the following (or comparable) positions for this ED: o Administrative director of the ED (usually non-physician)Chief of Emergency Services or Emergency Department (physician)Nurse Manager for EDLab Manager or Imaging Manager responsible for supporting EDWhen contacting the department identify yourself as a student in theWalden University MHA program and briefly describe your objective in interviewing theadministrator or manager. Let your interviewee know that you will keep all identifyingdetails (such as his/her name and the name of the hospital) confidential if desired.2. Preparing for and Conducting the InterviewReview the “Input/throughput/output Model” of a patient flow through the ED onpage 134 in Hospital-Based Emergency Care (http://books.nap.edu/openbook.php?record_id=11621&page=134# ). Consider why this is the typical model and what the prosand cons of this process flow are. Make sure you understand how it represents patient flow. Make a list of various issues related to patient flow as identified in Chapter 4of Hospital-Based Emergency Care and your other Learning Resources. Note when andwhy bottlenecks typically occur and identify other problems in efficient processing of EDpatients. Also list strategies used to address these challenges. With these thoughts in mind develop a list of questions about the patient flowprocess (covering input throughput and/or output phases) to ask your interviewee.Through these questions you should find out about challenges they have encounteredregarding patient flow and ways they have addressed it. Phrase these questions in yourown words. At minimum your questions should encompass the following: What are crucial challenges this ED has faced in recent years related topatient flow? On what basis were these challenges identified? Were quantitative dataused to identify and confirm the existence of problems and if so which types of data?Focusing on one of these challenges what process improvement orreengineering efforts has this ED taken to address the challenge? Did the departmentfollow Lean and/or Six Sigma or other comparable approaches in addressing this?Did the ED use any internal or external best practices to make thesechanges? If so which ones?Did the organization or ED establish any metrics to determine if expectedoutcomes are being met? If so what were the metrics?Did the implemented changes achieve expected outcomes? o Conduct your interview with at least one of the administrators or managersof a local hospital’s Emergency Department (see list of possible interviewees by titleabove). Ideally conduct this interview in person in the hospital. If this is not feasible however you may complete this interview by phone. If follow-up questions are needed these may be conducted by phone and/or email. o If possible arrange for a tour of your selected ED so that you mayobserve firsthand the layout and other notable features of the ED that may impactpatient flow.3. Completing the Application Do further research through Walden Library and/or the web to learn more aboutthe patient flow challenge identified by your interviewee. According to your research what are best practices for this process improvement issue? Write a 3- to 4-page paper in which you address the following:Identify the name and organization of your interviewee (unless that personhas requested anonymity).Summarize the responses from your interviewee to your questions.Based on the interview and additional research you conducted what is theindustry best practice for this performance improvement issue? Which key stakeholders are likely to be affected by the performanceimprovement effort and how?Provide with any further conclusions about the ED’s operations or layout and best practices as they relate to the challenges facing this ED.
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