In this case study, a team is chartered to improve the process of transferring or discharging patients from a small hospital in south Florida. The overall inflow of patients at the hospital is increasing, leaving fewer beds available for patients entering the hospital. The process of transferring or discharging a patient and preparing that room for a new patient has become critical to hospital operations. Slow turn around time can result in extended stays in the emergency room, recovery room or admitting which leads to patient, physician, and family member dissatisfaction.
The process of discharging or transferring patients (from one room to another) is complex and involves several hospital departments. A team approach was use to address the problem, with all departments represented. Data was collected on the process for 175 total transfers and discharges over a 10 day period in the hospital. Only weekday data (Monday thru Friday) was collected (weekend data will be done another time). The patient transfer or discharge process is as follows:
A physician orders a patient transferred or discharged.
- An escort is called.
- The escort arrives on the floor.
- The escort leaves the floor with a patient.
- The cleaning crew is notified that the room is ready.
- The cleaner arrives and the room is cleaned.
- The system is updated in the computer.
- The room is now ready for the next patient.
The posted excel file (Hospital Transfer and Discharge Data) contains data on the 175 transfers or discharges. Using the DMAIC process and the tools you have learned in this class to describe in detail how you would attack and solve this problem. Your paper should address mode by mode (define, measure, analyze, improve and control) what you would do. You have learned about many of the tools. Not all of them are applicable in all situations, so be specific on the ones you feel are applicable to this case.
Here are some items to make sure address in your paper within the DMAIC process. These are essential and must be included in the report or you lose points:
a. Create and comment on a bar chart for the total number of transfers by time of day.
b. Create and comment on a bar chart for the total number of discharges by time of day.
c. Create and comment on a bar chart for the total number of transfers and discharges combined together by time of day.
d. Comment on the bar charts. Hospital policy is that all discharges take place by 1pm and transfers take place before 6pm. How are they doing? (5 pts)
e. Create and comment on a run chart for transfers and discharges combined by day of the week (Monday thru Friday).
g. Calculate the averages and standard deviation for the following and comment:
- Time to Clean the room (Actual clean time once the cleaner gets to the room).
- Delay in Cleaning (The time it takes to respond to the cleaning request)
- Time to Update the system (A nurse or administrator updates the computer regarding room availability)
- Escort response time (this is the time it takes for the escort to respond to the request
- Escort patient (this is the time it takes to put the patient in a wheelchair and wheel the patient to the hospital exit or another room)
- Total time for all elements to occur (this is the sum of all previous elements).