:
Long Waiting time for patients at NUH Emergency Department
BACKGROUND
• Why are you talking about it?
Long waiting time for patients in the Emergency Department in view of pandemic situation Covid 19.
• What is the business case? What business problem are you trying to solve or analyze? Be very concise – communicate WHY you are addressing this issue.
Two-thirds of the patients visiting the hospital were either mild or asymptomatic cases causing over crowding and movement which resulting lesser beds and treatment areas. Resource allocation for patients is insufficient although new extended ward has been built to house patients with symptoms that need to be isolated in a room.
Patients waiting contributes to waiting waste
Inventory waste contributes to new resources built still not sufficient to house in influx of patients
(Comments: This part on waste is good. Should extend this to your “Introduction” in the report.
Elaborate more on inventory waste.)
CURRENT CONDITIONS
• What is going on?
• Use facts, date,
• Be visual – use Pareto charts, pie charts, sketches
• Make the problem clear
Observation #1: Average waiting time
Before the pandemic average waiting time for patients was about an hour to 2 hours. Present waiting times can range from 5 to 6 hours before patients can see the doctor.
Observation #2: Peak Period
Define peak period (> xx patients):
The influx of patients usually starts from 1100 hours and runs until 2000hours.
Discussion
The pandemic has caused the process of attending to patients to be more complex and, hence, slower than before the pandemic. There has also been a high increase in patients due to Covid-19 related issues. However, the service providers in the hospitals haven’t significantly changed since the health officials and the equipment remain the same. Therefore, this problem has disabled the level of service delivery in our hospitals. This has led to an increasingly rising need to address the challenges arising from this problem and prepare solutions that could temporarily or permanently solve the underlying situation.
(Comments: Graphs are not clearly labelled. Label axis)
GOAL
• State the specific target(s). State in measurable or identifiable terms.
The objective is to reduce the post-pandemic waiting time for patients from 5-6 hours to the initial 1-2 hours or less before the patients get to see the doctor at NUH Emergency Department.
ANALYSIS
• Use the simplest problem-analysis tool that will suffice to find the root cause of the problem:
Five whys; fishbone diagram, problem or process analysis tree, 7 QC tools (old or new), tools
from the Six Sigma, Kepner-Tragoe, Shainen, Taguchi, TRIZ or other toolbox of your choice.
(narrow down to NUH)
Fish head – problem: address NUH ED long waiting time
PROPOSAL
• Your proposed countermeasures
To create more awareness on social media that tele-consult is available and convenient.
To understand how much stress is on healthcare staff on a television advertisement.
To help create awareness of the effects of covid-19 on healthcare to the public through the media.
(Should focus on NUH ED)
PLAN
• Timeline with who, what, when, where, how.
Plan Involved persons Place Timeline
To employ more staff Ministry of Health NUH offices One month
To create awareness of the effects of the pandemic Media houses and social media personalities The activity will take place online Two weeks
Staff training on how to handle Patients during Covid-19 times Medical Training officials National University of Health Two months
Infrastructure development Ministry involved Hospitals Six months
According to the stated timelines, all the activities involved will be done as said and strictly adhered to
(Comments: Too high level. Rather than doing a Whole-of-Govt approach, think about what your organisation (NUH) can do.)
FOLLOW UP
• What issues or remaining problems can you anticipate?
A further outbreak of Covid-19 could pose a significant challenge to implementing these solutions.
Lack of co-operation from the patients could also threaten saving time.
If sufficient infrastructure and healthcare service provision are not well laid out, it will still be a challenge to reduce waiting time for patients.