Assessment Text
1. Select a General Hospital, 100 beds or more.
2. Randomly select 6 patients (two patients for each shift) attending the emergency Department (ED) with the diagnosis of chest pain.
3. The actual process of care for patients presenting to the ED of the selected hospital should be assessed through direct observation of the care provided to each patient.
4. All activities in the process should be listed sequentially. The start point of the process is the arrival to the hospital ED and the end point is the patient admission of discharge to inpatient setting. For listing of activities, the following should be considered
actual observation of the process
interview with all employees involved in the process as physicians, nurses, radiologists, laboratory specialists, transporters, housekeeping....ect.
thorough review of the literature related to the mapping of patient flow through the ED.
5. Based on the previous step, prepare a time flow sheet for patients presenting to the ED with the diagnosis of chest pain.
6. Take a convenient sample (Patients should be included sequentially till the required sample is collected) of 9 patient (three from each shift) and use the time flow sheet to calculate the time metrics for each patient (then calculate an average for each metric by adding the time for each patient and then dividing by 9)
7. The process of care should then be mapped, through drawing a Current state Value Stream Map (CSVSM) specifying the steps of the process, the average throughput time, average value added and non-value added time for each step in the process.
8. Specify points of delay in the process and suggest suggestions for improving the process.
9. Design a future state value stream map (FSVSM) for the process after improvement
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