Case Study: Maroondah Hospital General Medical Process
Assignments One and Two Case Study Description :
Figure 1 The mapping of the workflow model to the knowledge environment of a hospital The tasks are performed by various resource groups in the hospital: doctors, test experts, therapists, receptionists and schedule planners. The goal of the implementation is to map the organizational knowledge, clinical information and medical knowledge to a workflow definition, so that the activity can be managed more efficiently, and information catalogued for future reference. Hatch (2010) defines organizational knowledge as “When group knowledge from several subunits or groups is combined and used to create new knowledge, the resulting in tacit and explicit knowledge that can be called organizational knowledge.” Its variations include the extent to which the knowledge is spread within the organization, as well as the actual make-up of this knowledge. (Read more: http://www.knowledge-management-tools.net/introducing-organizational-knowledge.html#ixzz3SvYPK1J2). The Accreditation Council for Graduate Medical Education (ACGME) (https://www.acgme.org/acgmeweb/), the Common Program Requirements state that each residency/fellowship program must require its residents/fellows to obtain competence in Medical Knowledge. Medical Knowledge requires residents/fellows to demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient and as further specified by the ACGME Residency Review Committee (University of Maryland Medical Center 2013). The population in the eastern suburbs is increasing, with the hospital facing high demand. The original processes are no longer efficient. There are some major problems which need to be solved in the current system, such as: • • Low efficiency is the most noticeable problem. Sometimes the waiting time is unbearable for patients. • • As the processes involve many different internal units and external organizations, communication is a big issue. To ensure punctual diagnosis requires high level collaboration among these entities and this is sometimes difficult to manage. • • Disease management needs to be enhanced based on the use of Electronic Patient records. The goal of general medical process is to provide high-quality and cost-efficient patient care. In other words, to treat more patients with less expense in the same time period without sacrificing the quality of care. In order to do that there are several issues that need to be considered: • • Guidelines should be represented in a structured format • • Processes should be modelled to reflect guidelines and decision rules • • Patient data should be mapped to Electronic Patient Record • • Resources should be organized to complete tasks punctually. To better understand the problems and issues, you are required to analyse their current business processes. The General Medical Process (AS-IS) The process starts with a receptionist registering the patient at the front desk followed by a schedule planner making an appointment for an initial diagnosis. The diagnosis is carried out by a doctor who will decide what to do with this patient. If the patient does not need any help or cannot be helped, the patient will be released, causing the process to end. If the doctor thinks someone else can further assist the patient, he/she is referred to a doctor with other expertise. If the patient’s symptoms are not clear, the doctor will suggest further tests before drawing any further conclusions. There are many different types of tests (e.g. biochemical tests, visual tests, and function tests). The tests are carried out by various experts, with the test results being forwarded to the doctor for the follow-up diagnosis. The doctor may elect to release the patient, consult other medical practioners/specialists, request further tests or prescribe appropriate therapies/treatments. There are many choices available to the doctor, such as medication, surgery, radiotherapy, and physiotherapy, all of which are handled by a range of medical staff. Following therapy, a prognosis is formulated based on the results of the therapies. For any diagnosis, test or therapy, an appointment has to be made beforehand by the schedule planner.Testing It is the doctor’s decision as to which tests should be completed. There is often a protocol which designates the tests to perform depending on the preliminary diagnosis. The tests can be executed in any order or sometimes concurrently. There are many different tests, some of them are handled internally but others are external via third parties due to the lack of knowledgeable staff and limited equipment. Therapy It is the doctor’s decision how to proceed. In the case of surgery or radiotherapy another specialist is involved who may consider the therapy as a new case and she might start with a more specific diagnosis process before commencing the therapy. Since there may be many therapies that can be executed simultaneously we have applied a repeater pattern as in “testing”. Most of the cost will be covered by the Medicare or Private insurances. Out-of-pocket expenses will be invoiced to the patient following their release. Patients have a month to arrange the payment.