الفهرس | Only 14 pages are availabe for public view |
Abstract This study aimed mainly to evaluate the effectiveness of the current flow of patient processes and value stream activities performed in hospital ED operation setting. This purpose could be attained by determining if patient length of stay in the emergency department is prolonged by waiting time and service delays that can be avoided by an efficient design of the service delivery process. Therefore, this study targeted identifying the inefficiencies and major bottlenecks interrupting current process flow at the ED and its ancillary departments in the studied EDs, and exploring possible sources of waste embedded in the structural elements of ED service operation which considered the main causes of patient processing delays. The research approach utilized to study the research problem is a mixed model research. The core assumption of the mixed model form of inquiry is that the combination of quantitative and qualitative approaches provides a more complete understanding of a research problem. The targeted research population settings of this research include the Emergency departments of three public hospitals providing health care services to the community in Menoufia governorate. Two of the ED setting chosen, the university hospital and the instructional hospitals, are considered treasury hospitals with substantially larger capacity serving the population of the governorate. The third chosen were the central hospital of emergencies at Quessna. The research approached two different populations; a-Care receivers seeking health services from the Emergency department and b-Main providers of healthcare service in the emergency department operation setting. Primary data was collected using a triangulation methodology. Three different methods of data collection were utilized. Unstructured observation and Personal in-depth interviews were used in order to stand on the nature of operation at the emergency department , to observe waiting time and service delays, and to understand the functionability and the employment of the elements of producing service at the emergency department. The third data collection method utilized is the survey to finalize the results and reach a decision of proving or disproving the hypotheses. Two different questionnaire instruments were designed to collect data from care providers and care receivers. Questionnaires directed to patients were designed to ask about the time spent at the ED and their experience with the operational elements at the ED. For care providers, physicians and nurses drawn out in the sample were first informed about the research problem, then they were handed the questionnaire to be answered and collected. Also, the questionnaire designed for care providers contained two sections asking about their overall evaluation of the patient flow at the ED and their evaluation about each structural element of operation in particular. In order to accomplish the objectives of the present study, collected data were analyzed by statistical techniques such as descriptive statistics , correlation analysis, linear regression, ANOVA, Mann-Whitney test, Kruskal-Wallis test and two independent sample t-test. By investigating the significance of the relationship between the time intervals spent between core service delivery processes and total patient length of stay in the Emergency department, the research results proved that there is a significant relationship between total time that patient spent in the ED and the length of the waiting times intervening core patient processing time in the emergency department. It was also found that, for each patient type of severity, certain time intervals length were more significantly, strongly , and directly correlated to the length of the total. |