MGT603 Systems Thinking Assignment - Written Report, Laureate International Universities, Australia

Learning Outcomes -

• Analyse, select and apply systems modelling tools in integrating, optimising and enhancing business processes within contemporary organisations.
• Synthesise technological and non-technological solutions to business problems that promote integration and that optimise whole-of-enterprise operations.

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Instructions: Assessment is about uncovering the complexities in operations management generally, identifying key themes, intended and unintended consequences and proposing a holistic solution to the problem using a Systems Thinking lens. Conduct additional research, including further research on how emergency departments function in any hospital.

Answer - Wait Time Management In Hospital

Executive Summary

This report is related to a case study. A hospital is facing issues of longer waiting time of the patients in emergency unit. To solve the issue some research and findings should be made. With the help of current value stream map of the hospital the new implementation ideas are tried to keep in the report followed by an overall conclusion.

Table of Contents

Introduction/Background (100)

This report is based on hospital management. There are several complexities in hospitals which have to managed very carefully. In this study, a situation is given and the analysis will be done based on the situation. Some data is collected from the different hospitals and the structure of work in hospitals has been understood by the proper analytical method. The situation is about waiting time for the patients in emergency department which has to be improved. In this research the way of reducing the waiting time without affecting the works of hospital is tried to be found with the help of system architecture analysis.

Identification and analysis of the System Archetypes

There are ten different archetypes in management. They are Shifting burden, Tragedy of commons, Accidental adversaries, Growth, Failed fixes, Escalation, Success to the successful, Attractiveness principle, Dissolving goal and Limits to growth. Archetypes are needed to understand the internal problems and working culture of the hospital. Making and studying archetypes also helps to build a further model for future structure of the hospital. In hospital industry, there are many problems that are to be solved by proper archetypes. From the above archetypes there are some few which can be related with the structure of any hospital. In this study there are a situation that states a proper problem. The patients of the emergency department of a hospital is facing a long waiting time. From the archetype of the hospital, it has to be understood why the problem is taking place. The factors of the archetype need to be identified.

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The emergency department of any hospital works in a standard structure. Firstly there is a registration section, where the patients need to be registered to the hospital. In this sector the system can be more time consuming with low number of employees or backdated system configuration. The coordination between the workers in the registration sector is very much needed to maintain a healthy work flow. To decrease the waiting time of the patients, this sector is to be improved first.

In a general hospital archetype, there comes the waiting section next. In this section patients have to wait for a long time. The reason of this is the increasing population in an area. The hospital should be modified after every three and four years to maintain the perfect ratio with the increasing population. Some other factors are also need to be modified to replaced with some new factors to avoid extra waiting time for the patients.

Expanding the hospital physically with improving numbers of the staffs is an example of Failed fixes archetype as in this archetype the problem of longer waiting time is solved with the procedure, but with increasing population the problem will take place within a short period again.

There are some other works done between two flowing step, such as sending the patient history to the nurse, sending the history and crucial health statistics of patient to nurse and doctor, etc. This is called information flowing procedure and the time it takes is called flowing time. Flowing time have to be decreased using more systematic structure.

By doing these practices a few moments of waiting time can be reduced. The archetypes are very helpful in knowing the internal architecture of a hospital. Suitable archetyp has to be use for proper output. The Growth archetype can be useful in preventing unwanted expenses of a hospital. These waste expenses can be used in improving the infrastructure of the hospital and the solution can be met.

Archetypes help the managing body of the hospital to have a view like a clear picture of the hospital system, internal structure and flow of work between two sectors. This makes the management easy. With the help of it managers can have an idea about future problems that can take place in the system and take necessary decisions to prevent it.

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Analysis of the current State Value Stream Map

Value stream mapping is a kind of flowchart that are made with different icons. It helps to understand the working map of the hospital. From this flowchart it can be very easy to understand the particular working structure and the internal information flowing for any organisation as well as hospital. Value stream mapping is of two types. One is Current Value Stream Mapping and the other is Future value stream mapping.

In this study, one current value stream mapping of a hospital has been provided. Current value stream mapping is made based on the present situation or structure of the hospital. It shows the mapping of the Emergency department.

As discussed earlier, the first sector of the emergency department is the registration. After the registration the patients have to be wait in the waiting section. These are the first two sector of the current value stream map what is provided.

The next step is to go to the emergency room. While going to the emergency room the information of the patients are sent to the attending nurse and after checking all the important criterias an emergency room is allotted to the patient. This procedure takes some amount of time. This time can be reduced to reduce the waiting time in waiting area.

In the emergency room the patients are examined by the nurse. Then the doctors examine the patients. After examining the patients the doctor sends the necessary diagnosis requirements to the attending nurse. The nurse the collects all the instruments and necessary medicines and bring them to the doctor. The doctor does the treatment and after that the patients are instructed to depart. Between all two steps there are waiting times. The departing instruction is made by the doctor depending on the condition of the patient. All the waiting time should be shortened by some value to bring a big change in waiting time. From the provided current value stream mapping these informations about a hospital has been acquired.

Recommended New State Value Stream Maping Idea

The new state value stream map is to be made with the necessary changes in the old stream value map. The changes have to be made for one or more goals. In this study the goal is to reduce the waiting time of patients in emergency unit of a hospital throughout all the stages till the release of the patient. From the above analysis of current value stream mapping of the hospital it has been found that there are many delay factors in the structure of the hospital.

The waiting time can be shorten by improving the registration section's infrastructure. This can be improved by employing more workers and upgrading the systems.

In the current structure of the hospital there needs many time in flowing the informations to one sector to another. This problem can be removed by implementing a core information system which can be handled by all the departments and informations can be easily acquired.

A secondary solution can be done by expanding the hospital but it cannot give a permanent solution.

The best solution is to implement a core information system as mentioned.

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Intended and Unintended Consequences

In any organisation there are two types of consequences. One is intended consequence and the other is unintended consequence. Intended consequence are those consequences which are done intentionally. In many organisations there are some factors which are the result of intended consequence. Relating to the current study, there are also several intended consequences in the hospital. One of them is the non cooperation of the staffs in the hospital. The coordination of the staffs are important to make a work smooth. But there are some staffs in hospitals who intentionally do not cooperate with others. They do not want to work. This is an intended consequence which can be reduced by the management of the hospital only. The management have to be strict about it and have to made necessary policy to reduce this type of consequences.

Another example of intended consequence is the mentality of a doctor. This is also need to be improved. Not all but some doctors are also want to get rid of their work as they are unethical. Unethical doctors need to be warned about their responsibilities.

Some unintended consequences are also there. Increased population is itself an unintended consequence in hospital management. Population is increasing globally with its natural nature. So this is unintended to the management of hospital. However it has a huge impact on waiting time of the patients in any department of the hospital. Expanding the the physical structure of the hospital as well as the staff strength of it can be a solution temporarily but not permanently. It would be better to focus on intended consequences to provide a permanent solution for the situation

A new value stream mapping is needed to be done to make the structure if the hospital suitable for the patients and to decrease the waiting time in the emergency unit of the hospital. As discussed earlier a core information database need to be made such as all units can get the necessary data with no longer waiting. This may help the situation to be healthy.

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Conclusion

This report shows how to understand the work physics of a hospital from current value stream map and spot a light on suitable archetypes to change the structure. It concluded with giving a view on how the new wor structure should be made with different ideas. In this report a solution line is tried to be drawn on the given situation. The wait time of the patients in emergency unit should be decreased by applying those methods in the system. Overall this study will help the students who are learning how to manage a system of a hospital as well as the managing body of the hospital.

Recommendations

As per the given case, the patients of emergency unit of a hospital are facing long waiting time. To improve this situation some analysation should be made on the current value stream map or the structure of the hospital. From the analysation the intended and unintended consequences have to be found that have crucial impact on the situation. New idea should be implemented with suitable management archetype. In this case two different solutions can be helpful. Firstly to improve the coordination among the staffs of the hospital and the other one use to install an advanced core database system. Using that system the flow of information can be faster than earlier.

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