St. Martin de Porres Charity Hospital Emergency Department

Operations Management Final PaperANGUSTIA, BERNADETTE C.VEGA, ALFONSO GABRIEL A.

St.Martin de Porres Charity Hospital1959 – Blessed Martin de Porres Medical

Free clinicHandled by Dominican Priory1965 – Medicine, Pediatrics, Dental,

Nutrition, LaboratoryLater on became an infirmary “St. Martin

de Porrese Charity Hospital”1979 – classified as 30-bed secondary

hospital1983 – classified as a TERTIARY Hospital

St.Martin de Porres Charity HospitalCurrently a 150-bed capacity tertiary hospitalServices offered:

Surgery – main serviceMedicinePediatricsObstetrics and GynecologyRadiologyNutritionDentistryOphthalmologyENTEmergency Medicine

SMPCH’s VMOVision:

aims to provide quality and affordable medical and healthcare services to the less privileged members of the society.

Mission:Inspired by God’s love, the hospital fosters a

work environment where volunteers, professionals and benefactors take active and compassionate interest in the patients they serve.

SPMCH’s VMOPrimary Objective:

Medical service for the indigent sick members of the society giving higher priority to the charity patients over paying patients (who may have better possibilities to secure personal medical services in other hospitals).

SMPCH ERTRIAGE

Non-urgentUrgent Emergent

Stabilize patientReferral to proper service

Defining the System

Identifying The Server-Customer

Service- System Design

Process FlowchartPatient arrives at ER

N

N

Y

Triage

Patient is examined by the physician on duty.Patient is given appropriate treatment.

Is the patient<18?years old

Patient is decked under pediatric service.

Does the patient have an Ob-Gyne complaint?

Patient is decked under Ob-Gyne service.

Will the patient need surgery?

Patient is decked under Surgery service.

Patient is decked under Internal Medicine service.

Y

N

Y

Process FlowchartPatient is reassessed.

Will the patient be admitted?

Patient is given home instructions and OPD follow-up .

Patient pays ER bill at window 1

Patient returns official receipt to ER NOD.

Companion is given OPD record and brought to admission.

Data sheet is brought to the ER by admitting staff.

Ward is informed by the ER NOD and admitting section

Patient is sent home.

Patient is brought up to the ward.

Process Flowchart

Operations and Supply Management Tools and Recommendations

Patient Arrival Data: Descriptive AnalysisDirect observation of patient arrivalsAverage influx: 60 patients for 2 daysAve. No. of patients: 30 per day47% involved abdominal pain and fever

Patient Arrival Data: Descriptive AnalysisPatient arrival:

6am-2pm shift- 20 patients (33.33%)2pm-10pm shift – 28 patients (46.67%)10pm-6am shift – 11 patients (18.33%)

Average time to evaluation from time the patient comes in is 35 MINUTES.

Longest time to be seen recorded 5 hrs 20 mins

Shortest time recorded is under a minute

Patient Arrival Data: Descriptive AnalysisLongest discharge time – 10 hrs 32 minsFastest discharge time – 5 minsPrimary Services:

Medicine 20 patients (33.33%)Pediatrics 18 patients (30%)Surgery 11 patients (18.33%)Obstetrics 10 patients (16.67%)

House of Quality

Fish-Bone Analysis

Poka-Yoke SystemReferral Logbook

Keep track of referrals Monitor time responseQuality control tracker of services

Out-source diagnostics and imaging modalitiesBusiness agreement with diagnostic centersMOA prioritizing SMPCH patientsLab result delivery

Poka-Yoke SystemUser-friendly ER forms and Pathway forms

Lessen writing/charting timeSymptom-specific pathway forms help facilitate

faster more efficient flowHelp lessen human error

Radar ChartWaiting time

Quality of service

Physician waiting timeDiagnostic delay

Observaiton period

0

5

10

ActualDesired

ConclusionOpMan tools helped identify relevant and

quantifiable observationsMain causes of lag in patient care in the ER:

Long physician waiting timeUnavailability of medications and supplyDelay in imaging and laboratory exams

ConclusionRecommendations

Service referral log booksSymptom-specific pathway formsOutsource laboratories and imaging exams

Scope and LimitationMain focus: FEASIBLE ACTIONS given the

circumstance that would be easily implementedRecommendations involving increase in capital

investments were not inquired into as much