Post on 23-Mar-2016
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St. Martin de Porres Charity Hospital Emergency Department
Operations Management Final PaperANGUSTIA, BERNADETTE C.VEGA, ALFONSO GABRIEL A.
St.Martin de Porres Charity Hospital1959 – Blessed Martin de Porres Medical
Free clinicHandled by Dominican Priory1965 – Medicine, Pediatrics, Dental,
Nutrition, LaboratoryLater on became an infirmary “St. Martin
de Porrese Charity Hospital”1979 – classified as 30-bed secondary
hospital1983 – classified as a TERTIARY Hospital
St.Martin de Porres Charity HospitalCurrently a 150-bed capacity tertiary hospitalServices offered:
Surgery – main serviceMedicinePediatricsObstetrics and GynecologyRadiologyNutritionDentistryOphthalmologyENTEmergency Medicine
SMPCH’s VMOVision:
aims to provide quality and affordable medical and healthcare services to the less privileged members of the society.
Mission:Inspired by God’s love, the hospital fosters a
work environment where volunteers, professionals and benefactors take active and compassionate interest in the patients they serve.
SPMCH’s VMOPrimary Objective:
Medical service for the indigent sick members of the society giving higher priority to the charity patients over paying patients (who may have better possibilities to secure personal medical services in other hospitals).
SMPCH ERTRIAGE
Non-urgentUrgent Emergent
Stabilize patientReferral to proper service
Defining the System
Identifying The Server-Customer
Service- System Design
Process FlowchartPatient arrives at ER
N
N
Y
Triage
Patient is examined by the physician on duty.Patient is given appropriate treatment.
Is the patient<18?years old
Patient is decked under pediatric service.
Does the patient have an Ob-Gyne complaint?
Patient is decked under Ob-Gyne service.
Will the patient need surgery?
Patient is decked under Surgery service.
Patient is decked under Internal Medicine service.
Y
N
Y
Process FlowchartPatient is reassessed.
Will the patient be admitted?
Patient is given home instructions and OPD follow-up .
Patient pays ER bill at window 1
Patient returns official receipt to ER NOD.
Companion is given OPD record and brought to admission.
Data sheet is brought to the ER by admitting staff.
Ward is informed by the ER NOD and admitting section
Patient is sent home.
Patient is brought up to the ward.
Process Flowchart
Operations and Supply Management Tools and Recommendations
Patient Arrival Data: Descriptive AnalysisDirect observation of patient arrivalsAverage influx: 60 patients for 2 daysAve. No. of patients: 30 per day47% involved abdominal pain and fever
Patient Arrival Data: Descriptive AnalysisPatient arrival:
6am-2pm shift- 20 patients (33.33%)2pm-10pm shift – 28 patients (46.67%)10pm-6am shift – 11 patients (18.33%)
Average time to evaluation from time the patient comes in is 35 MINUTES.
Longest time to be seen recorded 5 hrs 20 mins
Shortest time recorded is under a minute
Patient Arrival Data: Descriptive AnalysisLongest discharge time – 10 hrs 32 minsFastest discharge time – 5 minsPrimary Services:
Medicine 20 patients (33.33%)Pediatrics 18 patients (30%)Surgery 11 patients (18.33%)Obstetrics 10 patients (16.67%)
House of Quality
Fish-Bone Analysis
Poka-Yoke SystemReferral Logbook
Keep track of referrals Monitor time responseQuality control tracker of services
Out-source diagnostics and imaging modalitiesBusiness agreement with diagnostic centersMOA prioritizing SMPCH patientsLab result delivery
Poka-Yoke SystemUser-friendly ER forms and Pathway forms
Lessen writing/charting timeSymptom-specific pathway forms help facilitate
faster more efficient flowHelp lessen human error
Radar ChartWaiting time
Quality of service
Physician waiting timeDiagnostic delay
Observaiton period
0
5
10
ActualDesired
ConclusionOpMan tools helped identify relevant and
quantifiable observationsMain causes of lag in patient care in the ER:
Long physician waiting timeUnavailability of medications and supplyDelay in imaging and laboratory exams
ConclusionRecommendations
Service referral log booksSymptom-specific pathway formsOutsource laboratories and imaging exams
Scope and LimitationMain focus: FEASIBLE ACTIONS given the
circumstance that would be easily implementedRecommendations involving increase in capital
investments were not inquired into as much