WARD MANAGEMENT SYSTEM

AQSA
TABASSUM
(02) SHAMSA
KANWAL(28)
HIRA KHALID
(08)
BUISNESS PROCESS
ENGINEERING

Windows UserCLASS: BSE VA

WARD MANAGEMENT SYSTEM:
1. PROCESSa DISCOVERY:
Oura researcha showeda thata thea warda rounda participantsa themselvesa alreadya hada aa prettya
gooda overviewa ofa theira owna warda rounda process.a Thisa howevera hasn’ta resulteda intoa aa
documenteda overviewa ofa thea warda rounda process.a Hospitalsa needa toa understanda thata
documentinga thea processa isa thea firsta stepa ina tryinga toa improvea it.a Thea processa overviewa
allowsa cleara communicationa betweena thea differenta participantsa anda ita isa thea basisa ofa aa
gooda processa analysis.a

LANDSCAPE MODEL:

PROCESS PORTFOLIO:
Determine Patient Need:

 Strategic Importance: 90%

 Feasibility: 40%
 Health: 90%

Schedule Operation:

 Strategic Importance: 95%

 Feasibility: 50%
 Health: 30%

Manage Patient Services:

 Strategic Importance: 85%

 Feasibility: 70%
 Health: 35%
Setup OT:

 Strategic Importance: 80%

 Feasibility: 60%
 Health: 70%

Process Surgery:

 Strategic Importance: 70%

 Feasibility: 65%

Health: 70%

2. PROCESS ARCHITECTURE:
AS IS MODEL:
Patient Satisfaction Fish bone Diagram:
STAKEHOLDER ANALYSIS:
Suppose that in hospital management system around 100 requests received per day and
hospital makes 50 requests into account per day and more over only emergency cases are
handled beyond that. Each request booking brings a profit of 100 Euro to the hospital
management system and about 2% customers complained that they are not satisfied from their
operation and 10% patients complained that there is delay in their operation.
ISSUE REGISTER:
ISSUE 1:
ISSUE NAME: Patient Satisfaction
PRIORITY: 1
DESCRIPTION: Staff, doctors and the equipment used in surgery makes feel to patients
unsatisfied.
ASSUMPTION: About 2% of patients complained that they are not satisfied.
QUALITATIVE IMPACT: The patient severe from series of inconvenience and probably about 2%
of patients that complained about satisfaction will leave this hospital for future.
QUANTITATIVE IMPACT: 2%*50*E100=Euro 100 per day
ISSUE 2:
ISSUE NAME: Delay in Operation
PRIORITY: 2
DESCRIPTION: Patients are not deal on exact time due to which operation is not conducted on
time.
ASSUMPTION: About 10% of patient complains that they are not treated on the exact time of
their operation time.
QUALITATIVE IMPACT: Not applicable
QUANTITATIVE IMPACT: 10%*100=10 inquiries per day
Patient Satisfaction Fish bone Diagram:

Delay in Operation Fish bone Diagram:

PICK CHART:

Issue Difficulty Payoff Description

1. Patient 1 1 In order to satisfy the patient is a challenging task
Satisfaction and it’s hard to accomplish as well as customer pay
high for the operation so there satisfaction matters
2. Delay in 0 1 Delay in operation can be easily managed by surgeon
operation if he starts the operation on time and patient pays
high for operation.
Difficulty Payoff
Easy-0 low-0
Hard-1 High-1

3. PROCESSa ANALYSISa
Aftera youa havea madea ana as-isa processa model,a ita isa importanta toa starta
communicatinga abouta ita witha alla thea differenta processa participants.a Thea nexta
stepa isa toa starta analysinga thea performancea ofa thea warda round.a Whata area thea
currenta problemsa anda howa cana wea improve?a Thea processa analysisa shoulda botha
bea donea ina aa quantitativea mannera asa wella asa ina aa qualitativea manner.a Thea
quantitativea measuresa cana bea usefula toa understanda whata thea costa driversa ofa
thea warda roundsa area anda wherea thea doctorsa losea thea mosta time.a Thea
qualitativea analysisa ona thea othera handa mighta showa somea lacka ina qualitya ofa
care,a whicha isa alsoa verya essentiala toa thea warda round.a Previousa sectionsa
alreadya showeda thata thea warda roundsa havea twoa biga problemsa fora processa
analysis.a Thea firsta onea isa thata nothinga getsa measured,a soa youa justa don’ta knowa
thea performancea ofa thea process.a Thea seconda onea isa thata knowna problemsa
aren’ta documented.a Thisa sectiona willa givea ana overviewa ofa howa hospitalsa cana
improvea theira processa analysisa approach.a Thena wea willa definea performancea
measuresa fora youra analysisa everythinga startsa witha understandinga thea goalsa ofa
thea processa youa area tryinga toa analyze.a Whata isa importanta fora thea warda round?
a Ita isa essentiala thata youa thinka abouta thea goalsa ofa thea differenta levelsa ina
youra hospital.a Whata area thea hospitala widea goals?a Whata area thea goalsa fora oura
department?a Whata area thea goalsa fora thea warda rounda itself?a Thisa isa essential,a
 becausea thea warda rounda alsoa hasa ana influencea ona thea departmenta goalsa anda
thea goalsa ofa thea hospitala itself.
DEVIL’Sa QUADRANGLEa
Nexta toa thea warda rounda goals,a ita isa alsoa importanta toa thinka abouta thea overalla
hospitala goals.a Thea ultimatea goala ofa aa generala hospitala isa toa offera thea besta
possiblea carea toa patientsa ata thea lowesta cost.a Wea willa incorporatea thesea goalsa
intoa thea processa analysisa bya introducinga thea Devil’sa Quadrangle,a whicha isa aa
generala processa analysisa methoda thata focussesa ona foura maina goals

Ita isa calleda thea Devil’sa quadranglea becausea ofa thea trade-offa betweena thea differenta
goals.a Morea focusa ona costa willa generallya resulta ina lowera qualitya ora lowera
flexibility.a Thea ideaa behinda ita isa thata wea wanta toa improvea thea processa asa mucha
asa possiblea toa improvea alla foura ofa thea dimensions.a Froma thata point,a wea wanta toa
makea changesa accordinga toa trade-offsa anda thea preferencesa ofa thea hospitala
management.a Doa wea wanta morea focusa ona cost?a Ora morea focusa ona quality?a Ora
ona onea ofa thea othera twoa dimensions
OBSERVEDa PROBLEMSa OFa THEa CURRENTa WARDa ROUND:
Duringa thea 60a hoursa spenda ina hospitalsa fora thisa research,a severala problemsa ofa
thea currenta warda rounda werea noteda down.a Thisa sectiona willa givea ana overviewa ofa
thesea problemsa anda discussa theira effecta ona thea goalsa previouslya discussed.a Thisa isa
nota ana exhaustivea lista ofa thea problemsa ofa currenta warda rounds,a soa hospitalsa
shoulda stilla performa processa analysisa ona theira owna warda rounda toa geta aa gooda
ideaa abouta thea problemsa ofa theira owna warda roundsa anda thea impacta ofa thema ona
theira goals.a 6.2.2.1a Micro-problemsa Somea ofa thea smallera problemsa ofa thea warda
rounds,a thata cana mostlya bea fixeda rathera easya area listeda ina thea tablea below.
MACRO-PROBLEMS:
Thea problemsa thata havea aa biggera impacta anda aren’ta asa easya toa fixa area listeda
below:
Thesea problemsa havea aa mucha biggera impacta thana thea onesa discusseda beforea anda
thata isa whya wea willa goa deepera intoa alla threea macro-problems.a Thesea problemsa
doa nota occura ina alla thea hospitalsa anda mosta hospitalsa alreadya havea founda aa waya
toa deala witha thesea problems.a Ita remainsa howevera importanta toa discussa thema toa
makea surea wea understanda thea reasonsa ofa theira existencea ina thea hospitala whicha
haven’ta fixeda thema yet.a
1.a Administrativea work:a Becausea ofa thea responsibilitya ofa theira job,a doctorsa
currentlya musta filla ina aa lota ofa papera worka and/ora signa offa ona it.a Althougha thea
reasonsa behinda ita area baseda ona thea goalsa ofa thea warda rounda anda area therea toa
makea surea thata lessa mistakesa ina thea warda rounda occur,a thea implementationa
hasn’ta beena adapteda toa newa technologies.a Thisa problema hasa aa negativea impacta
ona alla foura dimensionsa ofa thea Devil’sa Quadranglea anda isa accordinglya verya
importanta toa fix.a
2.a Communicationa errors:a Somea hospitalsa stilla worka ina aa verya olda fashioneda waya
wherea quitea somea communicationa happensa viaa orala ora papera communication.a Thisa
hasa aa cleara impacta ona thea amounta ofa communicationa errorsa anda diminishesa thea
carea offereda toa thea patients.a Ita alsoa isa thea reasona fora doublea work,a doublea
checkinga anda rework,a whicha alla havea aa verya bada impacta ona thea foura dimensionsa
ofa thea Devil’sa Quadrangle.a
3.a Warda rounda scheduling:a Onea ofa thea returninga problemsa ina multiplea hospitalsa
isa thea organizationa ofa thea warda rounda ina thea dailya workinga routinea ofa thea
doctorsa anda nurses.a Ina severala hospitals,a thea warda roundsa aren’ta planneda ina ona
aa fixeda timea schedule.a Thea doctorsa justa passa bya thea departmenta whena ita fitsa
intoa theira owna schedule.a Thisa isa verya bada asa ita makesa ita harda fora thea nursesa
toa bea readya themselvesa anda toa preparea thea patientsa fora thea warda round.a Ita isa
alsoa thea onea ofa thea roota causea ofa thea microa problemsa ofa gettinga disturbeda
duringa thea warda round.a Ifa youa cana performa thea warda rounda ona aa scheduleda
moment,a thena everyonea ina thea hospitala willa knowa whena theya cana reacha thea
doctor/nurse,a ora whena theya shoulda postponea it.a Thisa macro-problema alsoa increasesa
thea variabilitya ofa thea warda rounds,a whicha isa againa verya bada fora thea foura
dimensionsa ofa thea Devil’sa Quadrangle.a Asa youa cana see,a alla threea ofa thesea
problemsa havea aa negativea impacta ona alla foura dimensionsa ofa thea Devil’sa
Quadrangle.a Thisa makesa thema verya importanta anda thata isa whya hospitalsa shoulda
reallya focusa toa fixa thesea issues.a Asa mentioneda before,a somea hospitalsa havea donea
thisa anda theira warda roundsa area workinga significantlya bettera thana thea othera ones.
GENERALa PROCESSa ANALYSISa RECOMMENDATIONS:
a Thea processa analysisa phasea indicateda threea extraa recommendationsa fora thea
Belgiana hospitalsa toa improvea theira BPMa approach:
Recommendationa 1:a Geta ana overviewa ofa thea relevanta goalsa Hospitalsa shoulda
clearlya definea theira performancea measuresa toa bea ablea toa analysea thea performancea
ofa theira warda rounda anda toa bea ablea toa prioritizea thea biggesta problems.a Ita isa
importanta toa decidea ona thea relevanta goalsa fora youra hospitala anda youra
department.a Thea goalsa listeda ina thisa sectiona cana bea useda asa aa guide,a buta aren’ta
fittinga fora everya warda round.a Asa mentioneda before,a warda roundsa ina ana internala
disciplinea willa fora examplea puta morea emphasisa ona reallya checkinga upa ona thea
treatmenta witha thea patienta insteada ofa justa informinga thea patient,a whicha isa mainlya
thea goala fora surgerya departments.
Recommendationa 2:a Measurea thea relevanta performancea measuresa botha quantitativea
anda qualitative.a Ita isa alsoa importanta toa measurea thosea performancea measures,a
sincea justa havinga thema doesn’ta providea youa witha thea relevanta information.a
Recommendationa 3:a Documenta thea performancesa anda thea problems.a Followinga
recommendationa 2,a ita isa ofa coursea alsoa importanta toa documenta thesea
performances,a sincea youa otherwisea can’ta performa anya analysisa ona them.a Hospitalsa
ina generala alreadya havea starteda toa doa thesea kindsa ofa thingsa fora theira
accreditationa efforts.a Buta thisa isn’ta enough.a Accreditationa isa verya importanta fora
hospitalsa anda isa aa verya gooda start,a buta ita isn’ta aa substitutea fora aa gooda businessa
processa management.a Hospitalsa shoulda investa ina botha accreditationa anda BPMa sincea
botha cana improvea thea effecta ofa thea other.a Accreditationa standardsa cana fora
examplea bea useda toa definea thea goalsa anda performancea measuresa ofa thea BPMa
analyses

4.PROCESSa REDESIGNa
Thisa sectiona willa indicatea howa hospitalsa shoulda performa thea redesigna ofa theira
warda rounds.a Howa cana certaina problemsa bea fixeda anda whata shoulda thea warda
rounda looka likea accordinga toa thea chosena goals?
Importancea ofa thea softwarea systema onea ofa thea maina observationa thata wasa madea duringa
thea empiricala researcha wasa thea effecta ofa aa gooda computera systema ona thea efficiencya ofa
thea warda rounds.a Thea implementationa ofa aa correcta systema cana significantlya improvea
severala ofa thea micro-a anda macro-problemsa ofa thea warda rounds.a Wea willa goa overa somea
ofa thea listeda macroa problemsa anda mentiona howa aa gooda systema cana improvea them.

1.a ADMINISTRATIVEa WORK:a thea implementationa ofa aa gooda systema allowsa thea
doctora toa automaticallya generatea thea correcta filesa anda toa digitallya signa offa ona
thema bya usinga hisa account.a Thisa savesa ana immensea amounta ofa timea fora thea
doctora anda ita alsoa facilitatesa easiera usea ofa thesea documents.a Dischargea papersa fora
examplea cana bea automaticallya filleda ina froma thea patienta filea anda printeda insteada
ofa havinga thea doctora filla ina thea papersa manuallya fora everya patient.a Thea
digitalizationa alsoa lowersa thea amounta ofa errorsa madea ina thesea documents.a Thea
samea goesa fora laba requests,a whicha hada toa bea filleda ina manuallya before,a anda
thena hada toa bea transporteda toa thea correcta department.a Thesea papersa easilya gota
lost,a ora thea informationa ona thema wasn’ta alwaysa easya toa read,a whicha coulda leada
toa significanta errorsa ora doublea work.a Thisa cana easilya bea changeda bya doinga thea
laba requesta viaa thea computera system,a whicha alsoa allowsa thea peoplea froma thea
othera departmenta toa immediatelya aska ifa somethinga isn’ta clear.a
2.a COMMUNICATIONa ERRORS:a Onea ofa thea biggesta advantagesa ofa aa gooda softwarea
systema isa thea informationa overviewa ita provides,a nota onlya toa thea doctor,a buta alsoa
toa alla othera peoplea involveda ina thea carea ofa thea patients.a Thea systema allowsa
doctorsa toa digitallya informa nursesa ofa medicala ordersa anda explaina whya certaina
ordersa area made.a Alla relevanta doctorsa anda nursesa froma thea samea departmenta
havea accessa toa thea samea orders,a whicha diminishesa thea amounta ofa communicationa
errorsa significantly.a Ita alsoa allowsa communicationa toa happena ina betweena warda
roundsa anda allowsa differenta doctorsa toa takea overa thea patientsa ofa colleagues
3.a INFORMATIONa OVERVIEW:a Althougha thisa wasn’ta onea ofa thea macroa problems,a
thea impacta ofa aa gooda softwarea systema ona thea informationa overviewa shoulda alsoa
bea mentioned.a Thea informationa overviewa isa verya essentiala toa thea warda rounda
sincea thea warda rounda isa alla abouta communicatinga anda gatheringa thea correcta
information.a Thea wholea preparationa phasea ofa thea warda rounda cana bea significantlya
improveda ifa thea doctora hasa accessa toa alla thea necessarya informationa ina aa mattera
ofa seconds.a Ina hospitalsa wherea thea systema isa lacking,a doctorsa musta searcha
througha severala pilesa ofa documentsa toa finda alla necessarya informationa ona thea
patientsa anda theya aren’ta alwaysa surea thata theya havea accessa toa thea latesta results.a
Aa gooda informationa overviewa alsoa allowsa nursesa toa morea closelya followa thea
treatmenta anda thea decisionsa ofa thea doctors.a Nursesa knowa whya theya area
performinga severala ordersa anda aren’ta relayinga anymorea ona thea shorta explanationa
froma thea doctorsa duringa thea warda rounda itself
TO-BEa MODEL:

REDESIGNa TIPSa TOa IMPROVEa MICRO-PROBLEMS:

Severala micro-problemsa wherea alreadya listeda ina previousa sections,a buta thea solutionsa
toa thesea problemsa weren’ta discusseda yet.a Severala smalla tipsa toa improvea thesea
problemsa willa bea givena next.
DISTURBANCES:
Micro-problema onea cana bea fixeda rathera easilya bya implementinga fixeda schedulesa fora
thea warda rounds.a Doctorsa willa stilla geta disturbeda fora importanta anda urgenta
matters,a buta othera callsa willa bea delayeda untila aftera thea warda round.a
ATTENTIONa DROP:
Thea attentiona dropa cana onlya bea fixeda bya loweringa thea timea aa doctora musta
focusa duringa hisa warda round.a Thisa cana bea achieveda bya improvinga thea warda
rounda itself,a ora bya splittinga thea warda rounda betweena severala doctors.a Hygienea
Thea thirda micro-problema focussesa ona thea hygiene.a Thisa isa onea whicha alreadya hasa
receiveda aa lota ofa attentiona ina hospitalsa anda isa thusa alreadya improveda aa lota bya
implementinga disinfectanta ina everya room.a Ita nowa remainsa importanta toa increasea
thea awarenessa ofa thea staffa toa utilisea thisa disinfectanta everya time.
PATIENTa PRIVACY:
Thea lasta problema occursa ina warda roundsa ofa thea seconda modela wherea theya opta
toa takea aa toura cara witha thema duringa thea warda round.a Thea doctora oftena goesa
intoa thea patienta rooma anda leavesa hisa computera unlockeda outsidea ofa thea room.a
Thisa makesa ita possiblea fora peoplea thata passa bya toa seea privatea information.a Thisa
cana bea fixeda bya utilizinga aa systema whicha automaticallya locksa ifa ita isn’ta useda anda
unlocksa verya smoothlya ifa thea doctora returns.a Toa makea surea thata thea doctora
doesn’ta losea timea whilea logginga ina everya timea aftera hea hasa visiteda aa patient,a
youa cana worka witha personala badgesa whicha automaticallya unlocksa thea system.a Onea
ofa thea observeda hospitalsa alreadya useda sucha aa system.