Discuss about the Forecasting Emergency Department Overcrowding.
The success of organizations is determined by the operational efficiency of the organization in service delivery. Organizations strive to deliver quality services and products to their consumers in the most cost-effective way but keeping in mind the need to maintain the quality of the products or services. An organization can, therefore, be said to be operating at their maximum operational efficiency when it receives maximum output from the resources employed or the inputs. For operational efficiency to be achieved there is a need to ensure that there are adequate material and information flow in various organizational departments (Narasimhan, 2014, P. 216). Lack of operational efficiency in an organization contributes to increased costs, inability to meet the consumer demands as well as the overall decrease in the organization's revenues or profitability. This report, therefore, seeks to provide an understanding of how we can improve the operational efficiency and effectiveness of NSW Health Emergency Department and improve the quality of patient care. It will provide the techniques, principles, practices as well as Information technology solutions which can facilitate the improved process and information flow in the emergency department.
Operation management in any organization or business is involved with the science of understanding business processes and identifying effective strategies to improve the processes. In this case, we refer operations management to the science of understanding the emergency department operations in NSW health Emergency Department and developing the methods to improve hospital efficiency in service delivery and quality health care (Matthias & Buckle, 2015, P. 114). The hospital had experienced concerns over the continued demand from customers for the provision of quality services and at the lowest cost. The introduction of modern information systems led to the development of challenges in operational processes. The hospital has a burden of reducing medical errors and increasing patient’s safety in the emergency department through improved operational procedures and general information flow. Due to the overcrowding effect in the emergency department, there is a great need to develop effective strategies and techniques to facilitate information flow
Different emergency departments have embraced the use of different operation management practices in solving the problems facing them or in improving service delivery to their customers. One of the standard methods used in most emergency departments is the lean management practice or principle. The training seeks to improve the operational efficiency of the emergency departments by attempting to provide or meet the demands of the customers in a more efficient manner with little wastes (Amaral & Costa, 2014, P. 4). The lean management practice emphasizes the creation of value to their services and products and argues that the emergency services and products should be designed to meet customer demands and expectations and set the right prices. The further outline that every step of the operational process in the emergency department should produce value for the customers by eliminating the wastage of resources.
The Lean management practice/principle
Lean management practice is designed to ensure that the system flows efficiently or without other intermediate processes of storage. However, the flow of material and information affects the operational process and is determined by the content being delivered
The lean practice emphasized that the data or the operational process in the emergency departments must be flexible and centered on meeting individual consumer demands. This means that the executive management process in these departments should produce or provide their services based on consumers’ needs and not based on what the hospitals consider to be good for the consumers (Saghafian et al. 2015, P. 109). The primary emphasis of the practice is to achieve perfection by creating a constant review strategy to the operational processes in different hospital emergency departments from the floor and learning from the past mistakes as these are critical in enhancing quality health care and improving the hospital emergency.
Another common practice and principle in operation management is the waiting time formula. This practice is employed in almost every emergency department and consists of providing an understanding of how long it takes to complete an operational process in the emergency department, the overall activity time, utilization rate as well as the variations in the methods (Song et al. 2015, p. 3045). The practice provides to the management of the hospitals with parameters which can be used to in improving the efficiency of the operations by reducing the waiting time. The crowding effect in most emergency departments has resulted due to lack of time management and delays in service provision. This practice or operation management principle has played a vital role in reducing delays and minimizing the time taken to provide a particular service or activity time.
The efficient Frontier Practice/Principle
Lastly, many emergency departments have adopted the principle or practice of efficient frontier. The method provides a comparison of the performance of emergency departments in delivering quality healthcare concerning two practical dimensions (Liebler & McConnell 2016, p. 8). The first dimension is the responsiveness of the emergency departments towards consumer health care needs while the second dimension is the utilization rate of the operational processes in the emergency departments. The practice advocates for two strategies for improving efficiencies in emergency departments (Haddow et al. 2014). The management of the hospitals can either choose to apply this practice by moving along the efficient frontier. Such a move will require the management’s efforts to increase the emergency department capacity without improving their efficiency.
The management can, therefore, achieve this by hiring new staff and building more treatment spaces. However, studies have shown that having more areas for treatment does not necessarily lead to reduced crowding in the emergency departments but having the right systems controlled to enhance efficiency (Batt & Terwiesch 2015, p. 44). Secondly, the practice holds that the management of hospital can also choose to move towards the efficient frontier which means that, they will be required to increase the efficiency of the emergency departments. Increased efficiency leads to increased utilization rates as well as the increased responsiveness of the departments to consumer demands (Brown et al. 2015, p. 367). This can be achieved by eliminating general waste, reducing the variability of the emergency operations or activities and increasing their flexibility. Such an initiative will eventually lead to improved efficiency of the emergency departments and impact positively on the provision of quality healthcare.
Impact of Operation management practice and principles on the process and information flow
Successful implementation of these practices and policies should result in the definite improvement of the operations of the emergency department and improve the quality of healthcare provided by meeting consumer demands. The methods should give the management of the hospitals with an opportunity to impact the operations of the emergency departments (D’Andreamatteo et al. 2015, p. 1202). The lean management practice helps in improving efficiency in the emergency department by ensuring that the management is determined in meeting consumer demands through the provision of services which create value for the consumers. The practice, therefore, provides the control with an opportunity to continually review its operational management activities and learning from their past mistakes.
The waiting time formula has dramatically impacted and contributed to the reduced crowding effect in most emergency departments. Through designing systems to control the time taken for every activity in the emergency department, the management has to be able to reduce time wastage for the consumers as well as enhance their levels of efficiency regarding increased responsiveness to consumer demands (Fagel 2016, p. 12). The practice or principle provides the management with an opportunity to reduce the time and the length of stay at the emergency department by regulating various parameters such as the utilization rate or the activity time. Lastly, the efficient frontier practice or principle has enhanced the effectiveness of emergency services through improved efficiency and responsiveness to consumer demands (Hillman, 2014, p. 492). It provides the management with an opportunity to examine which approach best suits their goal and may decide on whether to use the strategy of moving along the frontier or moving towards the efficient frontier. In this case, running towards the frontier is more useful as it leads to increased efficiency through increased utilization rates and responsiveness.
The supply chain and inventory management concepts can be instrumental in developing the process of health care or hospitals emergency departments. The ideas involve the efficient integration of some players in the industry or business such as the manufacturers, the suppliers, distribution agents, warehouses among others (Kadri et al. 2014, p. 107). The main aim of integrating these players is to ensure that good and services are produced and distributed in the right quantities, are delivered to the correct locations, the delivery is done in time in a manner that minimizes the operational costs and offers satisfactory services to the consumers. The concept is beneficial in the healthcare sector due to the number of players involved in providing health care to consumers. The healthcare supply chain can be designed to include product manufacturers, the purchasers of the products and the healthcare providers (Skinner 2016, P. 8). For the hospital emergency department to improve their efficiency in service delivery and in meeting consumer demands, there is a need to integrate these players by developing an effective healthcare supply chain and inventory management strategy.
Inventory Management Concepts
The central inventory concepts which can be used to improve the efficiency of the emergency department include; the adoption of the just in time or stockless inventory management systems to reduce waste, outsourcing the inventory management systems as well as the use of new models to improve patients scheduling decisions which help in lowering crowding effect. The management can also create better demand forecasts (Kang & DeFlitch 2014, P. 3974). The primary goal however of the inventory management, as well as the supply chain concepts in health care, is to reduce the operational costs of the facility and general health care and still maintain the quality of service provided by improving service efficiency and increased the productivity of the system.
For improved efficiency and effectiveness of NSW Health Emergency Department, there is need to adjust the operations of the department from registry or admission of patients in emergency treatment. The waiting time formula systems will help in enhancing the prioritized queue systems in the departments.
The major problems experienced in achieving efficiency and effectiveness of emergency departments include increasing the flexibility of the emergency healthcare systems. Some hospitals still use the traditional emergency response systems and have been reluctant in adopting the new policies. The modern emergency centers have also faced a challenge in increasing the flexibility of these systems in meeting consumer demands.
In responses to these issues, it is essential to for the operation management of the emergency department to design systems which are flexible or customized to meet consumer increasing demands. Flexibility will ensure that there are increased efficiency and utilization rates as well as the department responsiveness to consumer needs (Wylie et al. 2015, p. 98). With the increased technological advancements in the health sector, it is essential for the management also to adopt modern technologies and inventory as well as supply chain systems to help in improving their service delivery.
The significant barriers expected in the implementation of these strategies can either result from resource capabilities of the hospital and especially in adopting or implementing the modern operation management systems. It is also expected that the hospitals may be resistant in embracing the changes due to organizational culture and structure since most hospitals have remained conservative to their practices and even their operational processes.
Operational efficiency and effectiveness in emergency departments can be achieved through the development of effective strategies. However, sound management of the operating processes in the emergency departments is very vital in the reduction of waste and inventory costs. It will also be able to improve the department operational efficiency and bring about a significant impact on the quality of patient care provided in the facility.
List of references
Amaral, T.M. and Costa, A.P., 2014. Improving decision-making and management of hospital resources: An application of the PROMETHEE II method in an Emergency Department. Operations Research for Health Care, 3(1), pp.1-6.
Batt, R.J. and Terwiesch, C., 2015. Waiting patiently: An empirical study of queue abandonment in an emergency department. Management Science, 61(1), pp.39-59.
Brown, C.A., Bair, A.E., Pallin, D.J. and Walls, R.M., 2015. Techniques, success, and adverse events of emergency department adult intubations. Annals of emergency medicine, 65(4), pp.363-370.
D’Andreamatteo, A., Ianni, L., Lega, F. and Sargiacomo, M., 2015. Lean in healthcare: A comprehensive review. Health policy, 119(9), pp.1197-1209.
Fagel, M.J., 2016. Principles of emergency management and emergency operations centers (EOC). CRC press.pp. 12
Haddow, G., Bullock, J. and Coppola, D.P., 2017. Introduction to emergency management. Butterworth-Heinemann.
Hillman, A., 2014. ‘Why must I wait?’The performance of legitimacy in a hospital emergency department. Sociology of health & illness, 36(4), pp.485-499.
Kadri, F., Harrou, F., Chaabane, S. and Tahon, C., 2014. Time series modelling and forecasting of emergency department overcrowding. Journal of medical systems, 38(9), p.107.
Kang, H. and DeFlitch, C., 2014, January. Identifying Emergency Department Efficiency Frontiers and the Factors Associated with their Efficiency Performance. In IIE Annual Conference. Proceedings (p. 3974). Institute of Industrial and Systems Engineers (IISE).
Liebler, G. and McConnell, C.R., 2016. Management principles for health professionals. Jones & Bartlett Publishers.pp. 8
Matthias, O. and Buckle, M., 2015. Accidental lean: performance improvement in an NHS hospital and reflections on the role of operations strategy.PP. 114
Narasimhan, R., 2014. Theory development in operations management: Extending the frontiers of a mature discipline via qualitative research. Decision Sciences, 45(2), pp.209-227.
Saghafian, S., Austin, G. and Traub, S.J., 2015. Operations research/management contributions to emergency department patient flow optimization: Review and research prospects. IIE Transactions on Healthcare Systems Engineering, 5(2), pp.101-123.
Skinner, J., 2016. Forecasting Emergency Department Overcrowding. SPNHA Review, 12(1), p.8.
Song, H., Tucker, A.L. and Murrell, K.L., 2015. The diseconomies of queue pooling: An empirical investigation of emergency department length of stay. Management Science, 61(12), pp.3032-3053.
Wylie, K., Crilly, J., Toloo, G.S., FitzGerald, G., Burke, J., Williams, G. and Bell, A., 2015. Emergency department models of care in the context of care quality and cost: A systematic review. Emergency Medicine Australasia, 27(2), pp.95-101.