NHS Improvement And Project Management: A Case Study

The issue of longer wait time can results in a major implication to the hospital overall workflow, community reach, quality, patient perception, profitability, efficiency, and can lead to failure in meeting regulatory guidelines and standards affecting the organization operations.

Improving hospital management can reduce emergency room waiting times. “ER Director Jim Schweigert says it’s all about managing the entire hospital flow. (Costello, 2006) This statement is true because in order to improve ER waiting times the management of the entire hospital flow should be looked at closely. “Think of the emergency room like a restaurant where people come in and go out. Now imagine a restaurant where the customers come in, but never leave. They come in for breakfast, they stay for lunch and they’re there for dinner.” (Rice, 2011) When looking at the ER like a restaurant it gives you insight as to why wait times are so long. The overall process of the hospitals internal control should be examined for flaws in specific departments that are causing delays in the processing of patients.

Delays could also be due to further investigation or treatments that may be required prior to a specialist referral or specific health care services. (7) Wait times can be increased due to patient needs outside of the health care system. Only 11.1% of patients on the overall health care waiting lists are due to patient requests for delay of postponing of treatment. (6)

As a result of this, when one patient takes longer to process, the Arrival Queue becomes a bottleneck. Patients begin to stack up behind one another while they wait for the other patients to be processed. This is point in the process that needs improvement. By fixing the time it takes to process each patient and removing or reordering certain steps, the cycle time could be reduced and the bottleneck eliminated.

The U.K. has been suffering from patients waiting times for hospital treatments for many years now. Although it is inappropriate not to consider if other developed countries are suffering as much as the UK, the improvements for hospital treatments have little to no improvement at all in the past few years (Appleby et al., 2005). In 2004 the NHS Improvement Plan announced the ’18 week waiting time’ target plan, this was to assure GP’s would refer patients to hospitals for treatment if needed (The King 's Fund, 2016). The UK is still suffering from long delays, although the 18-week waiting time has been put in to action. The waiting lists for patients are growing for medical treatments, operations and tests that a patient may need.

There is a great need for change in the healthcare industry because people should not have to wait for months to schedule an appointment or wait " 存ix hours to be seen in emergency rooms" (Samitt, 2004, p. 37).

Top-performing hospitals begin discharge planning on admission (33), with staff assessing the patient’s risk factors, needs, resources, knowledge, and family support within 8 hours of admission. Most hospitals have quality improvement (QI) projects in place to improve the discharge process, streamline care coordination mechanisms, and encourage patient self-management of chronic diseases. Some facilities have discharge planning nurses or teams that assist with the discharge process. Often patients are instructed to follow up with their primary physicians (GP) within a determined time. It has been recognized that patients readmitted within 30

Additionally, we function on a daily basis, constantly monitored by metrics, one of which looks at wait times for initial consult appointments, and our system cannot differentiate between an initial visit and a follow up visit.  So, some middle management person in primary care, took it upon themselves to make a unilateral decision to put patients on waiting lists.  Many of these patients suffered from cancer.

First and foremost, my primary priority are the patients. They are here to receive treatment, medications, and counseling due to medical issues or an ailment. Their care matters the most and leads to patient satisfaction. This factor could go either way of high and low patient return and referral rate. I would sincerely apologize to all patients who have been waiting for a long period of time and tell them they will be seen by a doctor shortly.

The average length of time that patients make a request for an appointment and the days between the times of the appointment day is used for third available appointments which include new patients, routine exams and return visits. By using the third next available rather than the next available appointment provides a more accurate indication of appointment availability. According to the Institute for Health Improvement (2011),

An attempt was made to reduce the wait time by initiating a triage system which aimed to reduce wait time from when a patient completes the form to the time it takes to be seen by Registered Nurse, Nurse Practitioner

As can be seen in Table 1 below, the resources causing the long wait times are those that are over utilized, or those that show capacity utilizations greater than 100 percent. The only over utilized resource are the Physicians, who are being over utilized by 21 percent. The other major resources are still underutilized.

Queuing theory tends to deal with problems that involve queuing or waiting. Patients tend to wait to be attended to in PATA for a long time. Effectively managing the flow of patients in an outpatient unit is considered to be the key to achieving excellence and ensure clinical quality. Therefore, PATA should adopt the queuing theory. PATA should develop an effective appointment system in order to match with the capacity (Langabeer, 2009). Developing an effective appointment system could also help in better resource utilization and patient waiting times minimization. PATA should also increase expensive personnel’s utilization as well as equipment-based medical resources in order to reduce patients’ waiting times. Under the queuing theory, PATA should develop a management process whereby they should determine how the patients arrive, how they are served, as well as the patient’s condition when exiting the system. In general, queuing theory will help PATA to make decisions concerning resources needed toward providing the service to patients (Langabeer, 2009). It would also assist in calculating a variety of performance measures, including the average waiting time of patients in the

Even though the price would be lowered because of the bad weather as per the tying in price and weather policy, not everyone would still want to go away. Either it needs to be explained clearly on the website that undesirable weather will not entitle any customer to a refund or to change or cancel their booking without penalty; or the policy must be clear in whatever the company decides is fair. For example, it may state that if the weather is unpleasant can change (but not cancel) the booking to another time.

The VP of marketing, Lori, selected Elliot Wood as the project manager for the Video Game Market Research Project. Elliot had previous project management and market research experience within the company, and he also was an avid video game enthusiast. He still had the Atari system he used to play in high school, and he enjoyed playing newer games with his two children. Elliot, however, was wary of doing business on the Internet and refused to make any of his own purchases online. He also did not let his grade school children use the Internet unless they were