As you know, the healthcare domain is an evidence-based environment, and in this assignment, we continue with this theme. Goal of this assignment is to provide an evidence-based advice for the management problem explained below. We revisit Liberty Hospital.
Liberty Hospital is a small rural hospital in the city of Lakeview. The hospital is close to a large forest and a series of lakes, and serves a population of around 65.000 inhabitants.
The hospital has 173 beds, and offers care in the majority of medical disciplines. Within the hospital, there is a small pharmacy that stocks the most commonly requested medicine. Moreover, Liberty is part of a larger group of hospitals that has expressed that they are working following value-based healthcare principles.
The management team of Liberty Hospital in rural Lakeview was very pleased with your previous advice. They thought it was well structured, and they appreciate the evidencebased approach. With your previous success in mind, the management team has again reached out for your assistance.
Liberty Hospital has received reports of unsatisfied patients because of waiting time intheir emergency room (ER). Normally, the aim is to have a patient diagnosed within 20 minutes. However, it seems it has become more and more difficult to obtain these numbers. In turn, this raises the risks for patients as their situation tends to deteriorate while waiting. At times, it seems that the ER just does not have enough staff available,yet, at other times it seems staff is mostly waiting for patients to arrive. However, overall,it seems that the ER is commonly overwhelmed by patients, both with complex medical questions as with mild symptoms. Employees involved with the ER report the following:
- “The patients are so varied! Some require a band-aid and should not be here at all, yet others are in need of immediate medical support.” (ER nurse)
- “It is very hard to predict when patients will visit the ER, apart from the obvious holiday or so… I have looked into the data but I did not really understand the patterns I was seeing.” (Internal quality consultant)
- “It is difficult here, at times, we wait 20 to 30 minutes at the door before we can handover the patient. I have seen patients getting worse and worse whilst waiting in the car.” (Ambulance driver)
The ER has made data available to you (online Excel supplement) which shows the various times until diagnosis for the different ER physicians. The data consists of only one type of patients, which can be compared.
In order to help Liberty Hospital with increased waiting times in the ER, you need to provide a management advice. This requires you to look at the data, to what degree is there a problem in the ER? Does this hold for everyone involved? Would you like to know more on the activities of the physicians at certain points in time? Next to the data, you should consult the literature. One could think of key words related to accessibility of ERs,variability between physicians, and process improvement, and come-up with a plan to reduce waiting times or increase process control.
Liberty Hospital has asked to distinguish between actions that can be implemented immediately, as well as activities that could have effects later. The management team of the hospital has requested that you visualize your ideas in a poster format within a week.
Moreover, Liberty Hospital would like to see the graphs you use, and have you indicated where things go wrong.
The poster needs to be informative for all healthcare workforce in Liberty Hospital. By observing the poster, they need to understand what is going on, what the recommendations are, and what the expected outcomes will be.
Deadline and submission
The final poster should be uploaded on Wednesday, December 14 before 14:00 via the hand-in button on Brightspace.
Your final assignment is in the format of a poster, you can use PPT or another program to deliver the end product.
Note, a poster does not have lots of text but uses pictures, graphs, and key words to convey the message. However, you are allowed to reverse a small part of the poster to explain the advice in words (max. 150 words).
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