ARNOLD PALMER HOSPITAL

Operations
Management
Process Design –
Chapter 7

© 2008 Prentice Hall, Inc.

6–1

Arnold Palmer Hospital Case –
Process Analysis

© 2008 Prentice Hall, Inc.

6–2

Presentation by Group 4
Members:
Ma. Corazon Q. Guevarra
Belina S. Katigbak
Gage Rush
Christine Tubig
February 10, 2014
© 2008 Prentice Hall, Inc.

6–3

 a 158-bed pediatrics hospital facility located in
Orlando, Florida, United States
 The hospital is part of Orlando Health and is supported by the Arnold Palmer Medical Center Foundation
 one of the busiest and most respected hospitals in the medical treatment of children and women in the U.S.
 Since its opening in 1989, more than 1.6 million children and women have passed through its doors
© 2008 Prentice Hall, Inc.

6–4

 the fourth busiest labor and delivery hospital in the U.S. and one of the largest neonatal intensive care units in the
Southeast
 ranks in the top 10% of hospitals nationwide in patient satisfaction
© 2008 Prentice Hall, Inc.

6–5

Kathy Swanson-APH Executive Director:
 Continuous improvement process is part of the reason behind APH success
 APH goal is 100% potential satisfaction
 Being able to get there means constantly examining and re-examining every process
 Continuous improvement is a huge and never-ending task
© 2008 Prentice Hall, Inc.

6–6

One of the tools that the hospital consistently uses is the process flowchart
 staffer Dianne Bowles’ flowcharts help study ways to improve the turnaround of a vacated room, speed up the admission process, and deliver warm meals warm
 APH has also been examining the flow of maternity patients from the moment they enter the hospital until they are discharged
© 2008 Prentice Hall, Inc.

6–7

Labor & Delivery Flow Chart
1.
2.

3.

4.

Enter APH’s Labor & Delivery
(L&D) check-in desk entrance
If baby is born en route or if birth is imminent, mother & baby are taken directly to L&D on the 2nd fl, registered, admitted directly at bedside
If baby not yet born, front desk asks mother if pre-registered, else, goes to 1st fl foor registration Pregnant woman taken to L&D
Triage on 8th fl for assessment.
If active labor, taken to L&D on
2nd fl until baby is born; if not goes to step 5

1

2

3

4

5.

6.

7.

8.

5

If false alarm, sent home; if with contraction, sent to walk around hospital grounds, then return to
L&D Triage on 8th fl
Baby is born without complications, mother & baby taken to Mother –
Baby care unit (MBCU) room on floors 3,4,5
If with complications with mother, goes to OR or ICU. Upon stabilization goes back to MBCU; if baby with complications, brought to
NICU before transfer to nursery; if not stable, discharged later
Mother and/or baby, when ready, are discharged 6

8

7

© 2008 Prentice Hall, Inc.

6–8

Flow Chart – Process (case to be reviewed)

© 2008 Prentice Hall, Inc.

6–9

Continuation of the Process Flow Chart

© 2008 Prentice Hall, Inc.

6 – 10

Case Analysis of Old Process
1.
2.

3.

4.

Enter APH’s Labor & Delivery
(L&D) check-in desk entrance
If baby is born en route or if birth is imminent, mother & baby are taken directly to L&D on the 2nd fl, registered, admitted directly at bedside
If baby not yet born, front desk asks mother if pre-registered, else, goes to 1st fl foor registration Pregnant woman taken to L&D
Triage on 8th fl for assessment.
If active labor, taken to L&D on
2nd fl until baby is born; if not goes to step 5

1

2

3

4

5.

6.

7.

8.

5

If false alarm, sent home; if with contraction, sent to walk around hospital grounds, then return to
L&D Triage on 8th fl
Baby is born without complications, mother & baby taken to Mother –
Baby care unit (MBCU) room on floors 3,4,5
If with complications with mother, goes to OR or ICU. Upon stabilization goes back to MBCU; if baby with complications, brought to
NICU before transfer to nursery; if not stable, discharged later
Mother and/or baby, when ready, are discharged 6

8

7

© 2008 Prentice Hall, Inc.

6 – 11

Case Analysis – Old Process
For Improvement:
Objective: Improve services and productivity
Recommendations:
1.Registration process
2.Layout – redesign where mother need not move from one floor to another;
3.Importance of including step “Bills settlement” before discharge

© 2008 Prentice Hall, Inc.

6 – 12

Labor & Delivery Flow Chart – Improved Process
1.
2.

3.
4.

Enter APH’s Labor & Delivery
(L&D) check-in desk entrance
If baby is born en route or if birth is imminent, mother & baby are taken directly to L&D on the 2nd fl, registered, admitted directly at bedside
Registers at 2nd floor
Pregnant woman taken to L&D
Triage for relocation to 2nd fl for assessment. If active labor, taken to L&D until baby is born; if not goes to step 5

5.

6.

7.

8.

Improve process on registration & hospital layout – put L&D Triage and
MBCU on 2nd floor

1

2
X
-remove

© 2008 Prentice Hall, Inc.

3

4

5

If false alarm, sent home; if with contraction, sent to walk around hospital grounds, then return to
L&D Triage on 2nd floor
Baby is born without complications, mother & baby taken to Mother –
Baby care unit (MBCU) room on 2nd floor If with complications with mother, goes to OR or ICU. Upon stabilization goes back to MBCU; if baby with complications, brought to
NICU before transfer to nursery; if not stable, discharged later
Mother and/or baby, when ready, are discharged 6

8

7

6 – 13

Improved Process Flow Chart

Improve Registration at 1st floor, relocate if possible

Relocate Triage from 8th fl to 2nd floor

© 2008 Prentice Hall, Inc.

6 – 14

Page 2

Insert, Billing, OR for presentation to Guard upon discharge

© 2008 Prentice Hall, Inc.

6 – 15

Labor & Delivery Flow Chart – Improved Process - Caesarian
1.

Registers at 2nd floor
(assumption: operation is prescheduled and instructions were given to mother beforehand) 2.

Admitted for preparation

3.

Brought to Operating Room

4.

5.

6.

Baby is born without complications, mother & baby taken to Mother –
Baby care unit (MBCU) room on 2nd floor If with complications with mother, goes to OR or ICU. Upon stabilization goes back to MBCU; if baby with complications, brought to
NICU before transfer to nursery; if not stable, discharged later
Mother and/or baby, when ready, are discharged Improved process on registration & hospital layout – put L&D Triage and MBCU on 2nd floor
66
1

© 2008 Prentice Hall, Inc.

2

3

4

5

6 – 16

Process that the hospital could analyze • Pre-registration- Expectant mothers to pre- register with the hospital either manually of electronically in the 30th week of pregnancy. •The official registration number to be produced electronically during time of admission with doctor’s diagnosis.
• Front desk process to be analyzed •Lay-out: improve on locations of
L&D Triage and Mother and Baby
Care Unit
© 2008 Prentice Hall, Inc.

6 – 17

THANK YOU…. We support
• Kaizen – Continuous

improvement is the key to productivity
© 2008 Prentice Hall, Inc.

6 – 18