Emergency Department Congestion at Saintemarie University Hospital Case Solution And Analysis, HBR Case Study Solution & Analysis of Harvard Case Studies

Emergency Department Congestion at Saintemarie University Hospital The case solution

Process Modeling and Analysis

Draw a process model for the Emergency Department at Saintemarie Hospital. To map the patient journey through it. What different resources are needed to provide patient care at the ED? Which of these resources is the bottleneck?

The process map clearly defines the flow of operations in the emergency department. The main factor that we noticed was the employees’ or the staff’s performance. As the turnover rate in the hospital was increasing due to the stressful jobs; many nurses and doctors started to resign from their posts and stated that the reason behind their resignation was job stress and dissatisfied patients. The main issue was less number of nurses and doctors in the emergency department. The number of visitors was high and the number of nurses and doctors to attend the patients was low. Due to the less number of staff in the hospital; the patients had to spend more time in the waiting area and doctors also took an extended period of time in the examination room.

Due to the long working hours; the performance of nurses and doctors was decreasing and it was affecting the quality of the services. The bottle neck that we identified is the number of staff that is present for the services in the initial waiting phase and patient management. The hospital should increase the number of staff, i.e. nurses, doctors and administrative staff in order to speed up the process.The hospital should also divide the patient and waiting room based on the different departments and the patients of particular department should be allocated to the concerned department as soon as possible. Another bottle neck that we found is that there is only onelaboratory and that central laboratory is used for the heavy traffic of the patients, which results in delay in the test reports, so the hospital should make sure that sufficient staff members are present in the laboratory to deal with this huge traffic and the emergency department tests are given the first priority. Another bottle neck is that the hospital only has one CAT scan which also contributes in delay. Hospital’s management should focus on buying another CAT scan machine in order to have an efficient time management.

Variability (and Queuing) Analysis

Data Given

Estimating Waiting time at the Saintemarie ED

p = Average processing time (min) =230 (PM: 3hs 10 min + D: 40 min)

Arrivals/ day = 164

a = Average interval time (min) = 8.78

No: of servers =34.38

Utilization= 0.76

CV_a = 1

CV_p = 0.78

Standard deviation for PM: 3hours

So the calculations are below:

The bottle neck capacity as we can see that the average processing time is 230 and the shifts consist of 12 hrs.The hospital has more tasks for the staff to complete which surpasses the human work capacity for 12 hours. Whereas we can see that in figure 2; the hourly patient inflow was on average is increasing and the arrival rate is 68%, which is much higher.

Inventory Management

Over the past few years; there has been a recurring debate at the management level of the hospital regarding the possible solution of dividing the ED into two separate units: inpatient (acute cases) and out-patient (non-acute cases). DuPont has always refused this solution, given the significant costs it would entail in building such a separation. Has the time come to make such a one-time investment? Justify your answer.

Sometimes a onetime investment is way better than preventing the cost incurred. As the quality is decreasing and the turnover ratio is also decreasing due to the stressful long working hours; the management had to make a decision in order to tackle all the issues that were occurring. The management had to conduct a cost benefit analysis in order to pursue this option...............

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