Assignment 4 - HIM6350
docx
keyboard_arrow_up
School
University of South Florida *
*We aren’t endorsed by this school
Course
6350
Subject
Medicine
Date
Jan 9, 2024
Type
docx
Pages
7
Uploaded by MajorGalaxy9288
1
Assignment 5
Stephen Skinner
University of South Florida
HIM6350: e-Medicine Business Models
Week 5
June 4, 2023
2
The process
chosen for this assignment is titled ‘X-ray ED Patient.’ This particular
emergency department (ED) serves a large patient population in a level one trauma center. In the
workflow model diagrams shown in previous assignments, a standard process is illustrated for
providing diagnostic radiographs for general walk-in patients at the ED. From the time that a
patient enters the ED to the time ED physician reads a radiologist report, there are many
activities and subprocesses in between.
Undoubtedly, the process leaves much room for improvement. Often times when patients
are roomed, they will not be ready to have the X-rays done due to bloodwork,
electrocardiograms, physician consults, respiratory breathing treatments, and many other
reasons. This results in repeated attempts by radiographers to transport them over to the X-ray
rooms. Nursing staff in charge of transporting patients may be caught up with other tasks or just
forget to bring them and delay the transport process. This particular ED is most certainly the
busiest in the entire region due to the number of beds available within the facility and the ability
to care for a wide range of conditions. That said, other nearby ED’s, orthopedic clinics, and
urgent cares could treat less severe cases quicker with respect to the number of patients being
seen. Therefore, changes must be made to this ‘X-ray ED Patient’ process in order to quickly
diagnose and treat patients while maintaining a competitive advantage over nearby facilities.
Patients who come to the ED looking for quick in and out medical treatment are often
kept within the facility much longer than they should be due to the lack of diagnostics being
readily available. The ‘express’ lounge can be used to treat ambulatory, non-severe patients that
can be instructed to walk over to the X-ray department once cleared in triage and determined that
they are able to walk by themselves by providers. This same approach was used by Kwok et al.
(2021) where they aimed to cut down the time to X-ray ED patients by 50% and received
3
positive feedback from patient surveys and ED staff after implementation. Patients who are able
to ambulate independently will arrive to the X-ray waiting room, where cameras inside the room
will let radiographers know they have arrived for imaging on monitors in the tech lounge. Simple
X-rays like portable chest films, supine abdomen films, and small extremities (hands, ankles,
feet, etc.) can be done within the express lounge rooms with portable machines. Qualified
student radiographers nearing graduation can be hired and used for imaging these non-severe
orders from the express lounge.
An alert system will be introduced in the electronic health record (EHR) and radiology
information system (RIS) that lets radiographers know that the patient is ready to have their
images done portably. This same alert system within the EHR and RIS will be utilized for any
imaging order placed by providers. Nursing staff will decide if they need to bring patients over
first or begin bloodwork and other tests instead. Radiographers will be notified when patients are
ready to be transported, to be done portably, or when they will be brought over. Using this
system will prevent radiographers from repeatedly checking on patients who are unable to have
imaging done and free them up to perform other studies. Additionally, it prevents any sort of
conflict between radiology and nursing staff fighting to perform their jobs. Fostering this revised
workflow that allows for imaging and other diagnostic tests to be done quickly and efficiently
will gain a competitive advantage over nearby competitors because patients will not only be
treated quicker but also have access to expedited care once diagnoses are made.
Core competencies for this process include a wide range of imaging services, fast
diagnoses, appropriate medical care, and access to specialists. The stakeholders that will benefit
from this are the patients, ED providers, imaging staff, nursing staff, radiologists, and the
organization itself that strives to beat out other facilities in the area for medical treatment.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
4
There are a variety of measures of performance that will be used for this process. The
time it takes from the moment an order is placed by a provider to the time a radiographer moves
the order over in the RIS. This can address any lack of attention being paid to the order list and
make sure that members of the imaging staff are constantly keeping their eyes on it. EHR/RIS
alert time to the time an exam is begun can measure the efficiency of the new system. The
amount of time it takes for X-rays to be performed and orders closed out within the RIS and
PACS is another useful measure. The moment an order pops up on the radiologist worklist to
when the ED physician reads a report can be tracked as well. Waiting room check-in time
compared to the discharge time will be monitored to determine areas of improvement. Total
number of X-rays performed daily with the new process can be compared to old numbers.
Process differentiators will be a mix of two discussed by Sharp and McDermott (2009):
operational excellence and customer intimacy. Operational excellence will be the main
differentiator, as this new workflow creates a system where it is predictable and mostly error-free
due to the alert system letting staff know when patients are ready to be imaged. Customer
intimacy is the other differentiator because this new system will allow patients to be discharged
from the ED quicker than before. Patients with less severe, minor issues can be quickly imaged
through the express lounge and receive treatment faster.
The overall environment for this ‘X-ray ED Patient’ process will be one that holds
radiologic procedures to a high standard and respects the value that imaging has in regard to
working towards patient diagnoses. Patients nowadays expect to be quickly seen by providers
and treated so they can get better and return to their normal day-to-day lives. This system will
expedite this entire process from a radiology perspective and radiologists will be able to read
images quicker, leading to ED physicians utilizing diagnostic reports faster to guide their courses
5
of treatment. Consultations with specialists can also be made timelier with more emergent cases
where patients do not have time to sit around waiting forever for imaging to be done and
diagnostics to come back. In a large region where patient emergencies are abundant, this ED
must be able to best provide rapid, efficient care better than other facilities can and ultimately
this system will help to gain the competitive advantage it needs.
6
PROCESS SUMMARY POSTER
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
7
References
Kwok, M.M.K., Chiu, A., Chia, J., & Hansen, C. (2021) Reducing time to X-ray in emergency
department ambulatory patients: A quality improvement project.
BMJ Open Quality
,
10
(2). doi: 10.1136/bmjoq-2020-000995
Sharp, A. & McDermott, P. (2009). Workflow modeling: Tools for process improvement and
application development. (2nd Edition). Artech House.