The case is focused on Pre-Admission Testing Area (PATA) of Massachusetts General Hospital to investigate the actual capacity of PATA and provides some recommendations to improve its ability. It will identify the PATA operations and challenges in the hospital that need attention. PATA is an outpatient clinic in the hospital that conducts pre-operative assessments of surgical patients before their procedures. Massachusetts General Hospital is one of oldest and largest hospital in the U.S that is located in Boston. The hospital is providing healthcare services in the country and serving the nation. It has 23,000 employees who have delivered high-quality healthcare services to the people. The waiting time in the hospital environment can generate negative impression among the patients .
Bottlenecks
The bottleneck in any part of the system or process where patients flow is affected and resulted in delay and waits. It determines the efficiency of the PATA and other tasks. The processing bottleneck has identified at Massachusetts General Hospital that become an important cause of patients delay . PATA inefficiency has reduced the speed of the process and created different problems. The hospital has experienced the operational and other challenges that affected the customers. PATA becomes busy and complex that affected the hospital's reputation in the market. It has the very low capacity and unable to manage the flow of patients in the hospital effectively and smoothly. The chief of anesthesia at Massachusetts General Hospital Dr. Jeanine Wiener-Kronish has described that the PATA has been fighting with long patient wait times and other ineffectiveness since last two years. The patients and attendants have faced various difficulties in getting the appointment. It has affected the operations of the hospital and disturbed the entire preoperative care system. The hospital has struggled with overcapacity and reduces admissions and other verse events.
It is the biggest challenge for Massachusetts General Hospital to manage the overcrowding and run its operations smoothly. The time management is also an important issue and patients, and the management has to consider and fix it quickly. The long wait times has affected the patients and working capacity of medical doctors and registered nurses. It has increased complexity, stress, and tension in the organizational culture and affected all stockholders. The limited capacity of PATA the mismanagement has occurred in patients flow and the clinic is able to see about 65% of all out-patients. The surgery’s process has affected and increased late sitting of the surgeons and other staff. The relatives of the patients have shared bad experiences of PATA and complaint against the system. It has increased dissatisfaction among the patients. However, the hospital is providing high-quality patients care and family- focused care. The management has strongly focused on facing the challenges and managing PATA in an effective manner. Massachusetts General Hospital needs to improve the efficiency of PATA that would have the biggest impact for staff and patients . PATA process can be improved through tackling the bottleneck and creating effective flow map of the patients.
Process Map
An effective process map is an improvement method that would increase the capacity of PATA in Massachusetts General Hospital and helps to run the operations smoothly and effectively. It maps the flow of patients in an efficient manner to control the challenges and issue of delays and waiting and improve PATA process in the hospital. Processing mapping is a power tool for the management to understand the real challenges from the patients’ perspective and identify various opportunities for growth and improvement. It helps to take effective decisions on the basis of fact and increase satisfaction among patients and relatives .
(1- mints) (2 mints)
(5 mints)
(15-20 mints)
(15-25 mints)
(4 mints)
(2 mints)
Check in
The hospital should arrange effectual reception area and arrange three to four front desks attendants. The bottlenecks are identified in this step, and it is crowding area where a large number of the patients are arriving simultaneously. The receptionists should welcome the patients and handle their flow easily. It should be a separate counter for existing patients and new patients and attendants note down their time of arrival. The entire process of existing patients took about one minute while for new patients two minutes. The attendants should walk with the patients to the lab and inform lab technicians about patients’ arrival. The lab technicians should continue further process efficiently.
Vitals and EKG
The laboratory should be divided into different sections according to the services levels. Four stations should be designed to take patients vitals and EKG during the beginning of the appointment. It is required to develop six stations for taking the patient blood sample at the end of the appointment. The average number of qualified and skilled lab technicians is required to work at every station and perform required tasks efficiently. The technicians took required tests and attached it with patients’ chart. The entire process would take five minutes per patients and improve the capacity of PATA.
Registered and charged Nurse Visit
The hospital has to focus the charged nurse’s capacities that play an important role in managing the flow of patients. The step contains with different bottlenecks and it resulted in delay and waited. The charge nurse performs various tasks such tracking patient rooms, providing lunch to the patients, and other. The charge nurse has to focus all functions in a timely manner and control the patient's flow. The number of registered nurses should be more than five who complete nursing assessments form of the patients. They need to quickly manage all paperwork of the patients and perform others duties in the exam room. The entire process needs more attention and it should be completed in 15-20 mints.
Physician faces time
It is a more complex task, and different bottlenecks are identified in this step. The physician should review EKG and patient’s electronic medical record promptly. The medical history and physical exam interview should be completed 10-15 mints. The physician should collect the complete patient’s information such as smoking, alcoholic, and other history and examine heartbeat, lungs, eyes, mouth, and other body parts. If the patients found suitable for surgery than the physician and patient sign the anesthesiology consent form. The entire process should be completed in 15-25 minutes.
Blood work
The front desk should immediately transfer the blood work order to the laboratory when it received. The technician should perform different task and complete the step in 4 minutes.
Check Out
The patients return to front desk along with index card and if the card meets the requirements then the patient is allowed to leave. The step should be completed in 2 minutes.
Recommendations
The hospital needs to increase its performance at different steps and improve PATA efficiency. The process map will help to perform various tasks in a timely manner. The management needs to add more resources to different locations and improve its operations efficiency.
References
Ángel, M. (2014). Agile Kaizen: Managing Continuous Improvement Far Beyond Retrospectives. New York: Springer.
Kelsey, M., Jérémie, G., & Retsef, L. (2012). Massachusetts General Hospital's Pre-Admission Testing Area (PATA). MIT Sloan Managment.
Masaaki, K. (2015). Human-Computer Interaction: Users and Contexts: 17th International Conference, HCI International 2015, Los Angeles, CA, USA, August 2-7, 2015, Proceedings, Part 3. Springer.
The story, P. (2016). Dynamic Capacity Management for Healthcare: Advanced Methods and Tools for Optimization. New York: CRC Press.
