Reference no: EM13343042

ASSIGNMENT OUTLINE

Your team is required to transform the journey of a patient with shoulder injury.  In the first instance you are to read the Current Patient Journey description (below) and develop an Essomenic model of the 'current patient journey'.  You will then analyse the current journey to determine where opportunities for improvement might exist. Suggest alternative ways that the identified issues may be resolved/improved and develop the 'future patient journey' inclusive of your selected improvements. Document the future patient journey and associated improvements.

DELIVERABLES

• Essomenic current patient journey model
• Description of identified issues and resulting opportunities for improvement
• Description of alternative solutions, both manual and automated (IT based)
• Essomenic future patient journey model
• Description of future patient journey and improvements made
• Reference List

ASSESSMENT CRITERIA

• Completeness and correctness of the models
• Identification of issues and opportunities for improvement
• Identification of possible solutions
• How well the narrative describes your future PJM

SCENARIO

A 15 year old boy is wrestling with his friends when he falls badly and hurts his shoulder.  After sitting down for 20 minutes it still does not feel any better. He is in a great deal of pain and is taken to the local hospital by his mother.

CURRENT PATIENT JOURNEY DESCRIPTION

SCENARIO

A 15 year old boy is wrestling with his friends when he falls badly and hurts his shoulder.  After sitting down for 20 minutes it still does not feel any better. He is in a great deal of pain and is taken to the local hospital by his mother. 

CURRENT PATIENT JOURNEY DESCRIPTION

1. A patient with a shoulder injury presents at the Emergency Department of a metropolitan hospital. The patient has to wait 5 minutes in the triage section before he is seen. A Triage Nurse takes a very brief description of his problems. The patient’s injuries are not considered life threatening and an initial decision is made that he will not be admitted. Process time 3 minutes.
2. The patient then has to register his demographic details with the Admin Clerk. The patient waits for 7 minutes to see the Admin Clerk. Patient’s demographic details and Medicare number are recorded in a paper-based patient record.
   Process time 5 minutes
3. The Patient then sits in the waiting room to be more fully assessed by the ED nurse. Waiting time 50 minutes.
4. Patient is moved into an ED cubicle and is examined by an ED Nurse.  Painkillers are administered and the examination details are added to the patient record. Medication details are also added to the Pharmacy Inventory. Process time 10 minutes.
5. The ED Nurse discusses the case with an ED Doctor and they agree the patient should have an x-ray.  The discussion takes 5 minutes.
6. The ED Doctor writes a referral for the X-ray and hands it to the Patient. Process time 3 minutes.
7. Patient walks from the ED down a few corridors to the x-ray department. This takes 4 minutes.
8. The patient presents at x-ray reception with the paperwork. Demographic and injury information is recorded in the x-ray department system. This takes 2 minutes.
9. Patient waits in the a-ray waiting room for 15 minutes.
10. The radiographer then takes the x-rays. Process time 15 minutes.
11. The patient walks back to the ED waiting room and advises the Admin Clerk that the x-rays have been completed.  Takes 5 minutes.
12. The patient then returns to the ED and waits in the waiting room 2 hours.
13. The ED Nurse comes out to check on the patient once during that time. A sling is put on patient’s arm. Process time: 3 minutes.
14. The Patient is taken back into an ED cubicle and is seen by the ED Doctor. Latest observation data is added to the Patient Record.  This takes 5 minutes.
15. The ED Doctor disappears to check the electronic x-rays and the patient waits for 15 minutes.
16. The ED Doctor comes back and reports that no radiologist is available to report on the x-rays but that they look OK. He tells the patient to go home and rest, gives script for some strong painkillers and tells the patient to see his GP in 3 days.  This takes 7 minutes.
17. Once the patient leaves the ED his entire patient record is entered into the system. This is done the next day by a data entry clerk. Process time 20 minutes.
18. After 3 days the patient contacts the GP and gets an appointment for the same day. Phone call takes 5 minutes.
19. Patient calls the hospital to arrange to pick up his x-rays. He is put on hold for 4 minutes before speaking to someone in the x-ray department who assures him that the x-rays will be ready when he arrives. Conversation takes 3 minutes.
20. Patient presents at x-ray reception. Personal details are confirmed. Upon checking, he is told the x-rays have not been printed. This takes 5 minutes.
21. The patient waits 15 minutes for the x-rays to be printed. No report is included. Patient is told that the GP must call for the report and it will be faxed through to GP.
22. Patient calls GP reception to let them know they need to call x-ray department at hospital to get x-ray report faxed.
23. Patient arrives at GP and waits for 35 minutes for the consultation.
24. The GP calls the patients name and gets a brief description of the previous couple of days. GP calls the hospital to try to get the x-ray report and is informed that the x-rays have not yet been reported on. It is now Friday, and the earliest a report can be expected is Monday. A decision is made to get new x-rays done at a different place. GP writes x-ray referral. Consultation time: 15 minutes.
25. The patient travels to the new x-ray office. Patient hands over referral and gives demographic details. Process takes 4 minutes.
26. Patient waits 45 minutes before being called for his x-ray.
27. X-rays are taken. 10 minutes.
28. Patient waits 5 minutes while x-rays are checked.
29. X-rays are inconclusive, so more x-rays are taken. 6 minutes.
30. Patient waits 30 minutes for x-rays to be printed and report to be written.
31. Patient returns to GPs office.
32. Patient waits 25 minutes to see GP.
33. GP reviews x-rays and report and decides to refer the patient to a specialist. GP writes specialist referral and gives it to patient. Consultation takes 10 minutes.
34. Patient calls Specialist office to make appointment. Patient is put on hold 3 minutes.
35. Patient makes appointment – this takes 4 minutes. However the earliest appointment is not until 3 days time.
36. The patient presents at the Specialist’s reception. Receptionist collects referral from patient, and records patient’s demographic details. Process time 5 minutes.
37. Patient waits to see specialist. Waiting time 120 minutes.
38. Patient has specialist consultation. X-rays are reviewed and injury checked. Specialist enters the case notes into the Medical Director system. Patient is told to that the shoulder is broken but should heal itself without the need for wiring or a cast and that he must rest the injury for 1 month.  He is advised that if the injury is still sore after 4 weeks then he should make another appointment.  Consultation time: 15 minutes.