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Analysis of the Current State Value Stream Map

Value stream map is a graphical representation of which helps in analysing the current state and designing a future state which helps in enhancing the flow of the product or service until and unless it reaches the destination, which is to the end – user. Here, the value stream map of an emergency room has been provided (Xie, Yang & Yang, 2018). The main task or primary job of the emergency room of a hospital is to diagnose the medical condition or issue of the patient and then provide the relevant treatment which helps in quick recovery from the medical state. However, the value stream map which has been provided here, describes a situation, where the patient need to wait for a longer period of time before they are being provided with relevant medical services (Cheng, 2020). The patients have asked to improve the waiting time, which will help in attending the doctors in minimal duration. Through this approach, the hospital would also be able to treat more number of patients in a single day. This report will first analyse the situation using the value stream map. After that, a recommended solution will be produced and the future state of the value stream map will be implemented graphically.

The public hospital has an emergency department which takes care of the patients and their treatments during emergency cases. The emergency department runs in a particular procedure to execute the jobs.

 The first step for the patient is to reach the hospital premises and register the name and fill in the type of injury and insurance details (Williams et al. 2019). It is mandatory to fill in such details because this helps to understand the background of a patient clearly and provides a transparent image which will later help the in the diagnosis. Some of the requirements included in the detail’s form are name, age, date of birth, address, contact number, email id, guardians name, insurance details and injury details etc. The injury details are considered as highly vital because the whole treatment depends upon that. Once the patient is registered, the patient is attended by a nurse who guides the patient to the waiting area. At the time of attending the nurse collects the patient history and needed information for further treatment (Akhoundan et al. 2018). The patient is then carried to the available ER room. As the patient reaches the ER room the nurse examines the patient analyzing the history and vital statistics of the patient. After the check up is conducted by the nurse, the physician who will be treating the patient is called upon. At the time of examining, diagnosis reports and other requirements are supplied to the doctor by the nurse who attended the patient previously. As per the recommendations done by the doctor after the check up the medical requirements for the patient’s treatment are brought by the nurse (Muthupandian et al. 2019). The doctor is also informed that the medical supplies required for the patient’s treatment are arranged and the patient is ready for the treatment. Once all these tasks are completed the doctor starts to treat the patient considering all previous reports and examination. After the treatment of the patient the doctor suggests and give instructions to the patient before the departure procedure. The departure methods suggested by the doctor are extremely important to follow, also the instructions that is to be followed after departure is vital because the health condition of the patient highly depend on the activities those are being followed in home. The doctor also gives certain instruction regarding the departure procedures. The instructions about the patient’s departure is conveyed to the nurse and the treatment information gets conveyed to the hospital records so that it can be referred for later use. This treatment information is again conveyed to the insurance company from the hospital’s side (Ramesh et al. 2022). Sending the present health records to the respective insurance company of the patient will allow the patient to have easy treatment in future. Finally the patient is released from the hospital.

System Archetypes Impeding the Performance

This was in short the present Value Stream Map of the department of emergency based on system archetypes. This assists one to easily understand the procedure that a patient faces in the emergency department.

The whole system or procedure followed by the public hospital is beneficial to the patients but is not flawless. The feedbacks of the patients shows that they are not satisfied with the procedure of the hospital as it makes them wait for a long time to carry out the treatment and then release the patients (Handayani & Kasidin 2022). The system involves a lot of waiting which can be avoided by changing the method that is followed in the emergency department. Starting from the time when the patient is brought to the waiting room with the help of the attendant of the hospital. Then as the attendant brings the patient to the ER room, the patient again has to wait before the nurse evaluates the patient details that is the background of the patient, the health history, vital statistics of the patient and the injury details. The nurse then collects the check up details of the patient and the already collected patient details and patient history along with the injury details and conveys all these information to the doctor. The nurse also is responsible to connect the patient to the correct doctor for the treatment. Therefore the time when the nurse executes these tasks the patient again keeps waiting in the ER room (Geiger et al. 2019). After the doctor is contacted the doctor goes through the patient details, injury details and the health history of the patient before starting to check up. The patient keeps waiting in the ER room all this time before the doctor arrives. After the doctor arrives and does the check up of the patient and then depending upon the check up the doctor instructs the nurse to make the necessary arrangements which will be required to perform the treatment of the patient. As instructed by the doctor the nurse arranges for the equipments and supplies the medical requirement needed for the treatment. The patient again waits for all this while which is invested on preparing the medical needs and the equipments for the treatment. The doctor then rechecks on all the needs and after confirming proceeds with the treatment. After the patient goes through the treatment the doctor gives certain instruction before releasing the patient. Also after the treatment the recent results of the treatment and the current health records are sent to the hospital records (Lin et al. 2019). The hospital after evaluating and checking on these details stores them for future need and security. The hospital also sends these results and reports to the insurance company, with which the patient is involved. The reports are sent to the insurance company for the patient benefits. After all these process the patient is released from the hospital.

Recommended New State Value Stream Map

Therefore it is understood from the system archetype that quite a good amount of time is needed that it actually should require (Al Amiri & Shawali (2021). This whole factor of killing so much time impacts both the patient and the hospital negatively. If this system can be improved with the help of the given app,then the time of the patients can be saved and the hospital can receive good feedbacks. 

Value Stream Map

Figure 1 – Value Stream Map

(Source – Created by Author)

After analysis and research, it has been found that, most of the users are using smart phones, which contains various kinds of applications (Ahmadi et al., 2018). These application helps the end – user to use various kinds of services. Furthermore, most of the hospitals around the world are also equipped with information system which helps in enhancing the services that are being provided to the patients. Here, the hospital is using the information system in order to record the details of the patients. Adding to that, the hospital is also using the information system to allocate the nurse and doctors for the patient and record the diagnosis which will be provided to them (Gholampour et al., 2020). In order to reduce the wait time and avoiding the queue at the emergency a mobile application can be developed. The mobile application will help the patient get diagnosis from the doctor and the nurse once they visit the hospital(Esfahani et al., 2018). Here, using the mobile application, the family members of the patient, would be able to need to first register the patient in to the hospital information system.

Adding to that, using the same mobile application, the family members of the patient would be able to describe the nature of injury using the options which are present within the application. Once the details has been provided, they would receive an option on the application to book a bed in the hospital. After the bed has been booked, a unique number will be provided to them. Once they visit the hospital, at the reception counter they would need to produce the unique number. The hospital will verify the number with the details of the patient and then they will take the patient to the bed. After that, the diagnosis for the patient will begin. This process will help in preventing the wait times and the queue at the emergency room. Adding to that, through the application, the patient would also be able to claim medical insurance.

In this section, the intended consequences and the unintended consequences will be discussed. The intended consequences include, the process, where the user is able to register themselves within the mobile application (Puspita, 2020). This means that, once the user have downloaded and installed the application on the mobile, they would be able to register without facing any kind of issue. After that, once the user have registered into the application, they would be able to provide the additional patient details which is regarding their personal information. Along with that, the user would also need to provide the description of the injury. Once the description of the injury has been provided, they will be able to book a bed in the emergency room.

However, the unintended consequences, would be like, the user is unable to register on the mobile application. The issue might arise due to a technical problem, which is related to the data and information being transferred to the database. Also, another unintended consequence would be that, the user is unable to enter the details on the mobile application, due to which they are unable to proceed with booking a bed in the emergency room (He et al., 2021). The issues which are occurring in the mobile application will get automatically reported and sent to the developers. The developers would follow the documentation and then fix the application issues with potential solutions, through application updates.

Conclusion

In order to conclude, in this report, a value stream map has been analysed. The value stream map contained the data and information about the various processes which are present within the emergency room. However, after conducting research and analysis it has been found that, after visiting the emergency room, the patients have to wait for longer duration time, in order to receive medical diagnosis from the doctor. However, this process can be improved with the introduction of the mobile application. With the help of the mobile application, the users would be able to first create the profile of the patient by providing the personal information. Adding to that, the mobile application will also contain the option where the user would be able to describe the nature of injury to the hospital information system. Depending on the availability of beds present within the emergency room, the user would be able to book a bed for the patient.

The recommendation which has been provided and documented in this report is about a mobile application. The mobile application will be used primarily in order to book a bed in the emergency room. Adding to that, with the help of the mobile application, the patient would be able to avoid the waiting time at the emergency room. Furthermore, through the mobile application, the users would be able to describe the nature of injury of the patient, which will further help the doctors and nurses to decide the type medical diagnosis which needs to be conducted on the patient.

References

Ahmadi, H., Nilashi, M., Shahmoradi, L., Ibrahim, O., Sadoughi, F., Alizadeh, M. &Alizadeh, A. (2018). The moderating effect of hospital size on inter and intra-organizational factors of Hospital Information System adoption. Technological Forecasting and Social Change, 134, pp.124-149.

 Akhoundan, M. R., Khademi, K., Bahmanoo, S., Wakil, K., Mohamad, E. T., & Khorami, M. (2018). Practical use of computational building information modeling in repairing and maintenance of hospital building-case study. Smart Struct. Syst, 22(5), 575-586.

Al Amiri, N., & Shawali, A. A. (2021). Talent management strategies of a public UAE hospital in the Industry 4.0 era: A qualitative analysis. Problems and Perspectives in Management, 19(1), 14-27.

Cheng, Y. M. (2020). Quality antecedents and performance outcome of cloud-based hospital information system continuance intention. Journal of Enterprise Information Management.

Esfahani, A. A., Ahmadi, H., Nilashi, M., Alizadeh, M., Bashiri, A., Farajzadeh, M. A., ...&Rasouli, H. R. (2018). An evaluation model for the implementation of hospital information system in public hospitals using multi-criteria-decision-making (MCDM) approaches. International Journal of Engineering and Technology (UAE), 7(1), 1-18.

Geiger, S. W., Marlin, D., & Segrest, S. L. (2019). Slack and performance in the hospital industry: a configurational approach. Management Decision.

Gholampour, A., Jamshidi, M.H.M., Habibi, A., MotamediDehkordi, N. &Ebrahimi, P. (2020). The Impact of Hospital Information System on Nurses' Satisfaction in Iranian Public Hospitals: the Moderating Role of Computer Literacy. Journal of Information Technology Management, 12(4), pp.141-159.

Handayani, R., & Kasidin, K. (2022). Employee Performance Analysis Based on Human Resources Management Practices in Private Hospital in Surakarta. Media Ekonomi dan Manajemen, 37(1), 109-126.

He, X., Bai, Y., Yue, L., Wang, H., & Liu, Y. (2021, September). Design and Implementation of Information System Based on Java Technology Platform. In Journal of Physics: Conference Series (Vol. 2033, No. 1, p. 012123). IOP Publishing.

Hertin, R. D., & Al-Sanjary, O. I. (2018). Performance of hospital information system in Malaysian public hospital: A review. International Journal of Engineering & Technology, 7(4.11), 24-28.

Lin, F., Deng Jr, Y., Lu, W. M., & Kweh, Q. L. (2019). Impulse response function analysis of the impacts of hospital accreditations on hospital efficiency. Health Care Management Science, 22(3), 394-409.

Muthupandian, T., Sabarirajan, A., Arun, B., Venkateswaran, P. S., & Manaimaran, S. Service Gap In Hospital Industry-A Patient Centric Analysis.

Puspita, S. C. (2020). Analysis of Hospital Information System Implementation Using the Human-Organization-Technology (HOT) Fit Method: A Case Study Hospital in Indonesia. European Journal of Business and Management Research, 5(6).

Ramesh, R., Shams, S., Yahyazadehfar, M., & Aghajani, H. (2022). Meta-synthesis of Technology and Innovation Foresight Models in Health and Hospital Industry Management. International Journal of Hospital Research.

Williams, P. A., Lovelock, B., Cabarrus, T., & Harvey, M. (2019). Improving digital hospital transformation: development of an outcomes-based infrastructure maturity assessment framework. JMIR medical informatics, 7(1), e12465.

Xie, C., Yang, P., & Yang, Y. (2018). Open knowledge accessing method in IoT-based hospital information system for medical record enrichment. IEEE Access, 6, 15202-15211.

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