Carolyn Watson

What are some of the constraints that may be placed on a hospital emergency room in its ability to service all incoming patients? After watching the video clip, it appears that St. Alexius Medical Center has definitely done a good job at preventing a number of constraints by continuously improving or implementing new procedures, equipment, and technology.

For instance, St.Alexius Medical Center has changed their old pharmaceutical procedures and implemented a new technology driven electronic pharmacy cart in which nurses have to sign in, prescriptions are scanned, and the computer unlocks/opens the correct drawer and tells the nurse exactly where the medication is located as well as keeps an inventory of all medications stored or used throughout the day. St. Alexius Medical Center’s new pharmaceutical procedures ensure that every patient receives and are billed for the correct medication(s) (McGraw, N. D. ).

However, as hospital emergency rooms like St. Alexius Medical Center continue to improve or implement new procedures, equipment, and technology to prevent a number of constraints. Hospital emergency rooms may never be able to eliminate the two major constraints that are placed on them and their ability to service all incoming patients – nurse and room availability. In view of the fact that it is practically unfeasible to effectively schedule nurses per shift because no one can ever estimate the number of incoming patients that might come in on a particular shift.

For example, most hospital emergency rooms over staff nurses during the winter which is expected – since this is the season that has the highest illness rate – but in the case of our recent major upper respiratory virus outbreak – that occurred at the end of the summer – thousands of hospital emergency rooms were completely caught off guard and were very understaffed to accommodate their enormous levels of incoming patients.

Room availability, on the other hand, is usually delayed because of one major factor: waiting times. Since incoming patients usually have to submit to completing a number of tests such as: lab, x-ray, CAT Scan, EKG, or ultrasound to find out what’s going on with their bodies. Incoming patients usually have to wait extremely long periods of time because of delays for their results after each procedure.

Then patients have to wait for their doctor to properly diagnosis their test results which all contribute to tying up a lot of rooms in most hospital emergency rooms. In this case, most hospital emergency rooms are unable to service all their incoming patients in a timely manner because most of the time they do not have any rooms available due to delays in one department or another which creates a constraint on the entire process. What are the “bottlenecks” and how would you propose to eliminate them?

According to Jacobs & Chase (2011), bottlenecks can be defined as any resource whose capacity is less than the demand placed upon it (p. 264). A bottleneck is a constraint within the system that limits throughput. As a result, a bottleneck is considered as the part of the system that has the smallest capacity relative to the demand (Jacobs & Chase, 2011, p. 264/p. 659). In this case, the two major bottlenecks hospital emergency rooms are faced with every day are delays and waiting times.

Since bottlenecking always seems to occur as a result of individual departments optimizing their own throughput – the number of incoming patients or procedures per hour – without considering the effects their decisions may have on other departments (Jacobs & Chase, 2011, p. 659).

For example, the lab department is short of staff and the department manager suggests that they will only be able to process four lab procedures per hour, instead of their normal eight procedures per hour without informing the emergency department.

As a result, the department manager’s decision to change the number of procedures they were able to process per hour has created a huge back up in the admitting department and many other departments as well as caused admitted patients/their families to wait extremely long periods of times for their test results/doctor diagnoses. In the end, hospital emergency room delays play a key role in their incoming and admitted patients waiting times.

Since hospitals’ operations quality and service measures are solely based on opinion rather than hard evidence that is used by many other organizations (Jacobs & chase, 2011, p.654).

Delays and unreasonable waiting times can affect hospitals’ reputation and decrease their incoming patient flow making them unable to meet their monthly financial deadlines. As a result, hospital emergency rooms should develop a new computer application that allows all personnel to effectively communicate between each department. This application could also inform all personnel about who is present in each department as well as inform them when there is a shortage of staff in another department.

In addition, hospital emergency rooms should purchase a new tracking system that will help them keep track of each register incoming patient from the time they are admitted to the time they leave as well as show delays that will cause long waiting times which can be evaluated later to effectively reduce delays and waiting times (McGraw, N. D. ). References Jacobs, F. R. & Chase, R. (2011)

Operations and Supply Chain Management (14th Ed. ) McGraw-Hill McGraw (N. D. ) Operations Management: Featuring St. Alexius Medical Center Retrieved from: http://bevideos. mhhe. com/business/video_library/0072970634/swf/Clip_04. html.

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