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Submit (attach) your responses to the four parts below in .doc, .docx, .ppt, .pptx, or .pdf file formats. Use input from the Discussion Topic 3 to complete parts 2 and 3 of this assignment
1. Create and submit a Deployment Map (swim lane flow chart) for the situation described in the Assignment 3 Scenario attached. Provide a summary of your findings based on the map (i.e, where you expect problems might exist, comments on process complexity, decisions depicted, etc.). NOTE: You may create the map by hand if you prefer.
2. Create and submit a Fishbone (Ishikawa) diagram for the problem of “Patient Wait Time†using the brainstormed list below. Use the five major causes of People, Materials, Equipment, Methods, and Environment in the fishbone diagram. NOTE: You may create the diagram by hand if you prefer.
Your Team's Brainstormed List of Root Causes to Patient Wait Time:
Operators can’t make the appointment themselves
Patients don’t know what times to call in for an appointment
Patient does not know who their insurer is
Pharmacy takes too long
Pharmacist must wait until the patient arrives with the prescription before they know the Rx is required.
Poor communication between Medical Assistant and RN
Schedulers are not available
Lab equipment is not available when needed
Patient can’t get a appointment on the day they want
Patients can’t get an appointment at the time they want
Poor communication between RN and MD
Not enough Operator training
Not enough staff
Not enough exam rooms
Poor communication between MD and Pharmacist
Patients don’t know where the pharmacy is
Too much patient travel from place to place
Patient care related supplies are not available when needed
Staff are too busy
Hand-offs (between staff) are too long3. Use 5-6 students' input from the Discussion group's multi-votes to identify the top 1-2 causes of "Patient Wait Time". Submit the raw multi-votes (i.e., how many votes each idea received) and a summary of the top 1-2 causes of patient wait time.
4. Submit an FMEA using the template provided to address at least 5 potential risks (Failure Modes from Discussion Topic 3, part 2) if we address the problem of "Patient Wait Time". In other words what could go wrong or what unintended consequences could arise if we try to fix the problem of 'patient wait time'. As part of the FMEA, include a description of the action(s) you would recommend to mitigate only the single most important risk (i.e., largest Risk Priority Number, RPN). Summarize your findings.
STUDENT 1
Discussion #3
COLLAPSE
1.) 5 causes to patient wait time:-Staff are too busy
-Not enough staff
-Pharmacy takes too long
-Not enough exam rooms
-Patients cant get an appointment on the day they want
2.) Trying to fix the problem of patient wait time due to the pharmacy taking too long could arise the issue of quality vs quantity. If they decrease the pharmacy’s time to prepare and research prescriptions, that reduces their time to double check or catch mistakes. This potentially could cause mistakes or lack of clarity in prescriptions to the patient. Yes, they would have shorter wait time but would there quality of treatment be sacrificed due to the allotted time allocated to the pharmacists preparing their supplies.
If one increased the amount of exam rooms available for patients to reduce the amount of time they wait, it could unintentionally cause mixs up between doctors and their patients. If theres more rooms available to see more parties, the tim for each patient could potentially get shortened and the doctor would have less time to do more. This old cause him or her to be in a hurry and maybe mix up the rooms patients are in which could be an issue also leading to an increased patient wait because now the doctor is going to have to leave the room and find the correct one. Also, this could increase the costs with maybe not enough benefits. They would have to find more money to build or furnish the rooms when maybe the overall time spent with each patients may decrease, results in another problem in health carethat patients have. Even though they would be solving the possible wait time, it could cause another problem that may need solving.
| Subject | Nursing | Pages | 8 | Style | APA |
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Answer
Fishbone Diagram for the “Patient Wait Time”
Five Causes of Patient Wait Time
These causes include;
- Hand-off (between staff) are too long
- Not enough examination room
- Patients cannot get an appointment at the time they want
- Pharmacy takes too long
- Not enough staff
When the duration spent by staffs when carrying out hand-offs is reduced, a number of negative consequences may arise in the process. The first consequence is medical errors. Hand-off issues contribute to medication errors within the healthcare facility. When the process of hand-off is fastened, there can be an incomplete transfer of important medical information leading to patient safety problems (Barton, 2009). This is because when the incoming staff has limited knowledge on the patient’s condition, there is high likelihood of low quality care or administration of incorrect medication. Secondly, reducing the amount of time spent during handoff can lead to poor communication that ultimately results in poor access the vital medical information (Barton, 2009). Adequate amount of time is thus required to ensure the adequate and accurate transfer of essential information to the other care provider.
Correcting the issue of inadequate examination room requires the construction of more exam rooms. The primary care examination rooms are currently the center of the healthcare delivery services. Therefore, they require adequate technological advancements, improved organizational flow and point-of-care (Barton, 2009). However, when the number of the exam rooms are significantly increased, it becomes challenging to equip all of them with the required technological advances. The lack of the proper equipment can lead to substandard service provision within the added examination rooms. The way forward is redesigning the existing exam rooms to become patient-centric instead of making their numbers increase across the healthcare facility (Barton, 2009). By improving the quality and not the quantity of the exam rooms, the facility gets to attend to adequate number of patients in an efficient, effective and improved way.
Addressing the issue of patients not getting an appointment at the time they want will result in the use of excess amount of resources by the healthcare facility. When each patient’s schedule is unkept, there is high likelihood of a drain on hospital’s resources. Allowing patients to have appointments just when they want will result in missed appointments that accounts to both waste in time and cost incurred when paying the physician (Samuels et al., 2015). The other issue is manpower. When patients fail to attend the scheduled appointments, they increase the waiting time of the other patients. The non-attendance due to the freedom to attend any time infers underutilization of manpower and the available equipment thus costing the health facility even more (Samuels et al., 2015). The other issue is the patient’s health. When patients only come for checkups if they want, this may lead to delay in recognizing any chronic condition that may be developing with time.
Reducing the time taken to process prescription drugs within the pharmacy can lead to medication errors and low quality care. The pharmacists should be allowed adequate amount of time to look for the appropriate prescription by performing data entry. The data entry process uses codes that are important in double-checking the accuracy of the prescribed drug. The pharmacists must also verify every data entered to ensure that no errors occur in the process (OMOREGBE, 2017). The verification requires ample time and concentration. The counting process of the prescribed drug can also be a slower process since it ensures allocation of the correct amount of the prescribed medicine. Additionally, the pharmacist must be provided with time to process the insurance bills. These bills may at times have problems and cause delays and thus time must be allowed to ensure that the whole prescription process is accurately handled.
Responding to the issue of inadequate staff by employing more medical professionals carries with it some burden on the side of the hospital. The main reason for the inadequate medical staff is the lack of experienced workforce. Therefore, increasing the number of staffs by employing the readily available professional may lead to the inclusion of inexperienced staff within the workforce (OMOREGBE, 2017). Additionally, increasing the number of employees requires undergoing through various recruitment processes thus leading to increased hiring expenses. The cost of hiring new employees may burden the hospital facility thus leading to elimination of important services. Increasing the number of staff can also lead to reduced salaries as a mechanism for reducing expenses by the facility (OMOREGBE, 2017). Underpaid workforce is likely to deliver poor quality patients care services.
References
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Barton, A. (2009). Patient safety and quality: An evidence‐based handbook for nurses. Aorn Journal, 90(4), 601-602. OMOREGBE, N. (2017, July). Design and implementation of a clinical pharmacy management and electronic prescription system. In Advances in Digital Technologies: Proceedings of the 8th International Conference on Applications of Digital Information and Web Technologies ICADIWT 2017 (Vol. 295, p. 171). IOS Press. Samuels, R. C., Ward, V. L., Melvin, P., Macht-Greenberg, M., Wenren, L. M., Yi, J., ... & Cox, J. E. (2015). Missed appointments: factors contributing to high no-show rates in an urban pediatrics primary care clinic. Clinical pediatrics, 54(10), 976-982.
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