During the years 1997 to 2007, the annual number of emergency department (ED) vi
ID: 427334 • Letter: D
Question
During the years 1997 to 2007, the annual number of emergency department (ED) visits in the USA has increased by more than 23 percent which represents twice the growth in population over that period of time while the capacity decreased by more than 5 percent. With such an increase with the decrease in the overall capacity, overcrowding results. Not only the USA has facing this problem, but also overcrowding in ED has also been reported in Canada, Australia, Great Britain and Taiwan. This overcrowding has resulted in long waiting time for patients, dissatisfaction and poor outcomes. The ED in a medical center in southern Taiwan that provides a 24-hour service for traumatic, non-traumatic and pediatric emergencies was studied. This center has 1,600 beds and treats 79,500 patients annually and has a medical staff attending non-traumatic emergencies that includes 15 emergency physicians and nine nurses each of them works eight hours per day. The process map for the entire process is shown below.
1. What is the overall cycle time for the entire process?
2. What is the system cycle time?
3. What is the throughput time?
4. What is the percent value added in this process? What is the percent non-value added in this process? Which of the activities can be considered value-enabling and based on your answer, what is the percent value-enabling time in this process?
5. What is the takt time?
6. If demand increased to 120,000 patients annually, what is the takt time?
7. What would you do in the second situation (referenced in part 6)?
8. Discuss your results and comment on the hospital’s ability to handle the demand.
(clearly explain all of the questions one by one)
The image is blur but it is visible enough.
Patient Traumatic Area or 8.00-22.00 25 Area Triago e the TTAS Nurse Lead time 23 min 10min t0min 30min 10min 3 min 8min 20min 5minExplanation / Answer
Cycle Time is the time taken from start of work till service is rendered and it can be said to be the total working time.
1. In the given question Overall Cycle time would typically include all the time taken to deliver the service including the time taken in laboratories (30 Mins.) and impatient control system (5 Mins.).
Therefore, Overall Cycle time would be = Cycle time + Laboratories Time + Impatient Control System Time
= 55 Min + 35 Min + 5 Min = 90 Mins
2. System Cycle Time is related to cycle time required in Non Traumatic Treatment Area, therefore, we shall arrive at the System Cycle Time by eliminating the time taken in Triage i.e. 4 Min. Therefore, System Cycle Time would be = 90 Mins - 4 Mins = 86 Mins.
3. Throughput Time refers to emergency department processes that impact patient flow. This includes Triage, Staffing, availability of specialty and diagonistic services, surgical scheduling and information technology resources". In the given question, throughput is typically indicated with orange lines. Therefore, we will sum up all the cycle time taken in the processeses indicated by orange lines i.e. Triage + Physical Examination + Laboratory + Impatient Control System + X ray + Ensure the treatments + Medication and Discharged = 4+10+30+5+8+20+5 = 82 Mins.
4. Total Lead time of the process given is 133 Mins and Total Cycle time is 55 Mins. Therefore, percent value added in the process would be = 55/133 x100 = 41.35%
Percent non value added in the process would be = 100- 41.35 = 58.65%
Value enabling activities would be the activities covered in point no. 03 i.e. throughput time = 82 Mins and total time of the process in such a scenario would be = 133 Min + 35 Min = 168 Mins and Therefore, total percent value enabling time would be = 82/168x100 = 48.81%
5. Takt time is the rate at which process should run in order to meet customer service.
Center typically runs for 24 hours a day throughout the year i.e. 365 days, therefore, total available time would be = 365 days * 24 hours * 60 Mins. = 525600 Mins.
Since the center treats total no. of 79500 patients annually, takt time would be = 525600/79500 = 6.61 Mins/Patient
6. Takt time for 120000 patients annually would be = 525600/120000 = 4.38 Mins
7. In such a scenario where patients flow has increased to 150.94% (120000/79500*100), hospital should hire more no. of physicians and nurses so that their shift can be decreased.
8. Hospital should reduce the waiting time for patients so that more no. of patients can be treated. To reduce the waiting time, no. of physicians and nurses should be increased so that multiple patients can be treated at the same time.
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