Assignment 4 - HIM6350

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University of South Florida *

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6350

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Medicine

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Jan 9, 2024

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docx

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1 Assignment 5 Stephen Skinner University of South Florida HIM6350: e-Medicine Business Models Week 5 June 4, 2023

2 The process chosen for this assignment is titled ‘X-ray ED Patient.’ This particular emergency department (ED) serves a large patient population in a level one trauma center. In the workflow model diagrams shown in previous assignments, a standard process is illustrated for providing diagnostic radiographs for general walk-in patients at the ED. From the time that a patient enters the ED to the time ED physician reads a radiologist report, there are many activities and subprocesses in between. Undoubtedly, the process leaves much room for improvement. Often times when patients are roomed, they will not be ready to have the X-rays done due to bloodwork, electrocardiograms, physician consults, respiratory breathing treatments, and many other reasons. This results in repeated attempts by radiographers to transport them over to the X-ray rooms. Nursing staff in charge of transporting patients may be caught up with other tasks or just forget to bring them and delay the transport process. This particular ED is most certainly the busiest in the entire region due to the number of beds available within the facility and the ability to care for a wide range of conditions. That said, other nearby ED’s, orthopedic clinics, and urgent cares could treat less severe cases quicker with respect to the number of patients being seen. Therefore, changes must be made to this ‘X-ray ED Patient’ process in order to quickly diagnose and treat patients while maintaining a competitive advantage over nearby facilities. Patients who come to the ED looking for quick in and out medical treatment are often kept within the facility much longer than they should be due to the lack of diagnostics being readily available. The ‘express’ lounge can be used to treat ambulatory, non-severe patients that can be instructed to walk over to the X-ray department once cleared in triage and determined that they are able to walk by themselves by providers. This same approach was used by Kwok et al. (2021) where they aimed to cut down the time to X-ray ED patients by 50% and received

3 positive feedback from patient surveys and ED staff after implementation. Patients who are able to ambulate independently will arrive to the X-ray waiting room, where cameras inside the room will let radiographers know they have arrived for imaging on monitors in the tech lounge. Simple X-rays like portable chest films, supine abdomen films, and small extremities (hands, ankles, feet, etc.) can be done within the express lounge rooms with portable machines. Qualified student radiographers nearing graduation can be hired and used for imaging these non-severe orders from the express lounge. An alert system will be introduced in the electronic health record (EHR) and radiology information system (RIS) that lets radiographers know that the patient is ready to have their images done portably. This same alert system within the EHR and RIS will be utilized for any imaging order placed by providers. Nursing staff will decide if they need to bring patients over first or begin bloodwork and other tests instead. Radiographers will be notified when patients are ready to be transported, to be done portably, or when they will be brought over. Using this system will prevent radiographers from repeatedly checking on patients who are unable to have imaging done and free them up to perform other studies. Additionally, it prevents any sort of conflict between radiology and nursing staff fighting to perform their jobs. Fostering this revised workflow that allows for imaging and other diagnostic tests to be done quickly and efficiently will gain a competitive advantage over nearby competitors because patients will not only be treated quicker but also have access to expedited care once diagnoses are made. Core competencies for this process include a wide range of imaging services, fast diagnoses, appropriate medical care, and access to specialists. The stakeholders that will benefit from this are the patients, ED providers, imaging staff, nursing staff, radiologists, and the organization itself that strives to beat out other facilities in the area for medical treatment.

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