1. Select a General Hospital, 100 beds or
more.
2. Randomly select 6 patients (two patients
for each shift) attending the emergency Department (ED) with the diagnosis of
chest pain.
3.
The actual
process of care for patients presenting to the ED of the selected hospital
should be assessed through direct observation of the care provided to each
patient.
4. All activities in the process should be
listed sequentially. The start point of the process is the arrival to the
hospital ED and the end point is the patient admission of discharge to
inpatient setting. For listing of activities, the following should be
considered
-
actual observation of the process
-
interview with all employees involved in the process as physicians,
nurses, radiologists, laboratory specialists, transporters,
housekeeping....ect.
-
thorough review of the literature related to the mapping of patient flow
through the ED.
5.
Based on
the previous step, prepare a time flow sheet for patients presenting to the ED
with the diagnosis of chest pain. (See example for a flow sheet in the
Appendix)
N.B. This flow sheet is only an example, every student
is expected to design his own flow sheet based on actual observation of the
process
6. Take a convenient sample (Patients should
be included sequentially till the required sample is collected) of 9 patient
(three from each shift) and use the time flow sheet to calculate the time
metrics for each patient (then calculate an average for each metric by adding
the time for each patient and then dividing by
7. The process of care should then be mapped,
through drawing a Current state Value Stream Map (CSVSM) specifying the steps
of the process, the average throughput time, average value added and non-value
added time for each step in the process.
8. Specify points of delay in the process and
suggest suggestions for improving the process.
9. Design a future state value stream map
(FSVSM) for the process after improvement.
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