Case Study

Read the following case and answer all the questions that follow.

The acute patients journey

When an acutely ill patient needs to be treated urgently, the whole healthcare system has to respond in a co-ordinated manner. For example, if a patient attends local doctors (general practitioners) clinic with abdominal pain and the doctor assesses this as a probable acute appendicitis, the patient needs to be admitted to hospital for surgery immediately. First the local doctor might phone a house officer (doctor) at the local general hospital to agree the probable diagnosis, so that the patient can be surgically accepted by the hospital. An ambulance will be immediately requested, to take the patient to hospital. However, the target response times may be breached if the ambulances in the area are allocated to other emergencies. Commonly, Mondays and Wednesdays see most elective surgery and so these are frequently the most difficult days for unplanned admissions. In many hospitals, medical wards overflow at times. This can result in patients medical outliers being placed on surgical wards, further restricting space. One bed manager highlighted other problems: Requests for beds should come through us. This does not always happen, as patients can be admitted via the back door by consultants etc., without telling us. It can be confusing when we think we have free beds but we havent. We continually monitor where beds are available on the computer and by doing a ward round. We conduct a census on wards to find free beds not recorded on the computer. When a patient needs urgent surgery, a theatre slot needs to be found. This can be complicated as the theatres usually have particular elective clinical specialisms booked for each half-day session, with just a few slots reserved for emergencies. Theatres are not all equipped in the same way: theatres specialising in orthopaedics, for example, need specialist pieces of equipment.

Question 1 Differentiate operations in a hospital from operations in an iPhone production factory.

Question 2 Explain reasons that cause delay in the admission, treatment and discharge process.

Question 3 Suggest FIVE (5) quality tools to measure the performance of the hospital. Explain how the tools are applied and their objectives.

Question 4 Explain the reasons why private hospitals charges are expensive for a simple appendicitis surgery from operational perspective.