• Internal Code :
  • Subject Code : MGT603
  • University : Laureate International Universities
  • Subject Name : Systems thinking in public health

Executive Summary

Patient waiting time refers to the total time a patient has to wait before attaining their designated service in a healthcare centre. This report has based on patient waiting time of Royal Melbourne Hospital. There are many complaints have been gathered by officials to understand and evaluate their value stream map. This report has evaluated system architects and value stream maps that are being currently operated into this hospital. A modified value stream map has also being incorporated into this report with effective recommendation. Both effectiveness and disadvantages of this modified value chain map has been stated into this report. An effective operational recommendation has helped to conclude this report. 

Table of Contents

Introduction 3

Analysis of System Archetypes 3

Evaluation of Current Value Stream Map 5

Modified Value Stream Map 7

Consequences of Modified system 8

Conclusion 10

Recommendation 10

Reference List 12

Appendices: 14

Appendix A: Patient waiting graph 14


System thinking with timely approaches is one of the most significant operational needs for healthcare operations. Royal Melbourne Hospital (RMH) is witnessing a problem regarding patient waiting time issues. This report has been formulated by a member of emergency team, responsible for tackling situations. There is a stark increase in the number of complaints regarding long waiting time from patients who acquire health care services from RMH. Aim of this report is to decrease the current patient waiting time by 50%. The objectives include evaluating current value stream map with system archetypes and propose appropriate modifications.

Analysis of System Archetypes

System Archetypes that have been followed by healthcare officials of Australia are being composed of three layers; Archetypes I, Archetypes II and Archetypes III. All these types of Archetypes deal with systematic approaches of time management, tool management and development management (Braitheaite et al. 2016, p. 32). Diagnosis of problems, taking effective medical steps and operation can be included in these three types of Archetypes.

System Archetypes I

Archetypes I have focused upon diagnosing issues and conduct effective interventions to find solution to that problem. Emergency team member has mentioned in this report that, this diagnosing and intervening process needs adequate time to find issues and their solutions. Emergency department of Royal Melbourne Hospital is liable to organise this diagnosis operation (Cooke & Bartram, 2015, p.713). However, patients have stated that emergency department is not a quick response to their problems. Along with that, time management and multitasking operations are not being performed by this department accordingly. Employees of emergency and surgical department have stated that proper time is required to investigate issues and find effective medical treatments and solutions for that (Duckette & Willicox, 2015, p. 56). Two major reasons for this delay are; staff shortage and lack of technical development. These acquire more time to accomplish required healthcare operation. Specific time frame is also required for them to arrange instruments for medical operations. Diagnostic tools also play a major role in managing time and multitasking in this diagnostic operation. 

System Archetypes II

Systems Archetypes II refers to take effective action. In case of Australian healthcare sector, these archetypes significantly deal with archetypes II. Along with the systematic approach of performance management and operation, it is required for healthcare operators to evaluate problems and their roots (Maslach & Leiter, 2017, p. 165). Healthcare sector can be framed as one of the most vulnerable sectors. Therefore, it is required for employees from emergency department to understand health condition and resistance power of body of concerning patients. As opined by Runciman et al. (2017, p. 56), instrumental development can be measured as a pivotal part in this archetype. Royal Melbourne Hospital has introduced technical dependency upon their instruments for operating their patients. According to members of the emergency team, officials also conduct invention policies for implementing new technologies in healthcare operation. 

System Archetypes III

Systems Archetypes III refers to understanding patterns of problems and solutions concerning time management. It has been mentioned previously in this report that patients of Royal Melbourne Hospital have provided their feedback for not getting required service according to time (Royal Melbourne Hospital, 2019). After applying these archetypes, officials have witnessed that delaying in medical service can cause major harm in their healthcare practices.

Evaluation of Current Value Stream Map

Value chain map that is being followed by emergency department of Royal Melbourne Hospital is human resource-oriented and divided into different segregations. Diagram of this value chain system has been mentioned below, which has stated about human resource-based operation of emergency department of concerning hospital. 


Patients are being registered with Royal Melbourne Hospital and problems, as well as injuries, are being evaluated by respective healthcare operators. After coming to concerning hospitals, patients have to wait in the area and submit papers of health insurance (Vincent & Amalberti, 2016, p. 46). After completing the registration process with proper documents of health insurance, patients are taken to attending healthcare officials to make proper diagnosis of their problem. A primary diagnosis has been made by concerning healthcare officials. After jotting down outcomes of those evaluations, patients are being carried to the emergency room where nurses re-examine their patients. After examining that patient, doctor arrives with previous reports and examines the patient's problem. Attending nurses are also liable to doctor for communicating present health status of the patient along with required vital statistics (Australian Government, Department of Health, 2019). After evaluation of patients' problems, attending healthcare observers communicate to nurses for beginning medical assistance, instruments and medicines. 

After gathering these medical instruments, doctors start treatment of that patient. After completing treatment, doctor once again re-evaluates problems of patient and conduct diagnosis process. All these reports and diagnosis along with healthcare operations are being recorded to hospital records. Hospital authority then coveys all these records of respective patients to insurance companies and after getting departmental instructions, doctor allows patients to release and go back to their home (Health Direct, 2019). This process appears to be a bit of time taking as it depends upon human resources. Patients give their feedback on waiting at the time of serious problems with their health. 

Modified Value Stream Map

Member of emergency team has gathered feedback about their patients for getting delayed in their healthcare treatment. However, it has been that previous value stream map, that has been followed by emergency department are human resource-based. Another two drawbacks of this value stream are; lack of technology and employee shortage. Therefore, members of emergency department of Royal Melbourne Hospital have recommended a modified value stream map for reducing complaint about patient's waiting time.


Modified value stream map has focused on implementing technical operations in healthcare tasks that are being performed by emergency team members of Royal Melbourne Hospital. This value stream map emphasises upon using a single communication base, composed by technical up gradation. Through this technology and internet-based system, patients can register their problems with insurance papers through online platform. This policy has emphasized time management strategies that could be beneficial for patients by not waiting into hospital. After proper diagnosis in the emergency room, detailed report of problem and solution will be communicated to doctors, nurses and other respective employees. Along with that, these reports will also be communicated and submitted to official record server of Royal Melbourne Hospital. For ensuring payment, it will also verify authentication of insurance papers that have been submitted by referring patients. 

Consequences of Modified system

This modified system can be utilised by officials of Royal Melbourne Hospital for reducing complaints regarding patient waiting time. This modified process is based on a single communication process between patients and healthcare officials. Employees of emergency department will be liable to formulate this effective value system map. However, this system contains both positivity and negativity in applying into organisational operation of Healthcare. 


Prime reason for introducing this system is getting help to reduce complaints from patients waiting time issues. Positive sides of using this modified system are being mentioned below; 

  • Single user interface helps patients to make direct communication with employees of that organisation. It has been previously mentioned that employees of emergency department will be liable to formulate this value stream map.

  • Employees from emergency department are instructed to perform according to the need of patients. Royal Melbourne Hospital authorities maintain their employees from emergency department as highly skilled and trained (Royal Melbourne Hospital, 2019). Therefore, getting services from trained employees will help to reduce complaints regarding patient waiting time. 

  • This modified system has provided special focus on effective communication strategy. This communication will follow a systematic approach and proficiency. Therefore, operational accuracy will be expected to be effective.


Along with positivity, some negative aspects can be a part of this modified approach of healthcare operation that is being operated by Royal Melbourne Hospital.

  • This approach deals with a single communication system. At the time of heavy workflow, this single interface can cause major problems and confusions. In healthcare operation, it is required to avoid all the scopes of confusion. 

  • Employees of emergency department are needed to ensure this program. It requires the full engagement of those employees into maintaining this communication strategy. However, there are other significant jobs are also being noticed, that can be performed by only emergency department. Therefore, is also required for officials to make proper evaluation of work that is being performed by concerning department.

  • This modified system has approached to increase employee base in this communication system. It has been reported that Royal Melbourne Hospital conducts its healthcare operation with a large number of employee base. Those employees are required to perform their operational training based on effective training. Thus, it can be proved to be hard for officials to position their employees as per need. 


Based on the above study, it can be concluded that patients who come to the Royal Melbourne Hospital for treatment, facing problems related to time management. This report has been formulated from a team member of emergency team of this hospital. Three types of archetype have been discussed in this report which is being performed by officials of concerning hospital. Current value system map, that is being followed by concerning hospital have also been mentioned and evaluated. In order to improve time management and multitasking, that will help to reduce complaints regarding service delay. Both positive and negative consequences of this modified value stream map have been included in this report.


This report was based on time management in healthcare sector of Australia. In order to reduce complaints regarding time issues, members of emergency team have prescribed different recommendations. 

  • A simple and effective value stream map is needed, that can be easily accessible to both patients and employees of that organisation.

  • Technical development is required for influencing healthcare sector with special focus on speed and growth. Speed with accuracy should be implemented on all these three types of archetypes for inducing growth and accuracy,

  • A single platform should be maintained by healthcare operators for gathering information from patients and convey directly to healthcare employees.

  • Avoid multiple levels of formality and documentation and use a single interface to form effective communication channel. 

  • Provide effective training and development to their employees for gathering information from patients and make effective diagnosis. In order to perform this task, they also require training for implementing their self-analysis capability to conduct technical usages and implications. 

Reference List

Australian Government, Department of Health (2019), The Australian health system. Retrieved from <https://www.health.gov.au/about-us/the-australian-health-system>

Braithwaite, J., Wears, R. L., & Hollnagel, E. (Eds.). (2016). Resilient health care, volume 3: Reconciling work-as-imagined and work-as-done. Florida, US: CRC Press. Retrieved from <https://books.google.co.in/books?hl=en&lr=&id=MDQNDgAAQBAJ&oi=fnd&pg=PP1&dq=Time+management+in+healthcare+AU&ots=73PjMadSwv&sig=EVRw3N0qPe-J-X62KVlT34VShrs#v=onepage&q=Time%20management%20in%20healthcare%20AU&f=false>

Cooke, F. L., & Bartram, T. (2015). Guest editors' introduction: human resource management in health care and elderly care: current challenges and toward a research agenda. Human Resource Management, 54(5), 711-735. Retrieved from <https://onlinelibrary.wiley.com/doi/pdf/10.1002/hrm.21742>

Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford University Press. Retrieved From < https://www.cabdirect.org/cabdirect/abstract/20173279780>

Health Direct (2019), Australia's healthcare system, Retrieved From <https://www.healthdirect.gov.au/australias-healthcare-system>

Maslach, C., & Leiter, M. P. (2017). New insights into burnout and health care: Strategies for improving civility and alleviating burnout. Medical teacher, 39(2), 160-163. Retrieved from <http://elib.vums.ac.ir/bitstream/Hannan/21929/1/2017%20MT%20Volume%2039%20Issue%202%20February%20%287%29.pdf>

Royal Melbourne Hospital, (2019), Royal Melbourne Hospital, About, Retrieved From <https://www.thermh.org.au/about/about-rmh>

Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to getting it right. Florida, US: CRC Press. Retrieved From < https://www.taylorfrancis.com/books/9781315607443>

Vincent, C., & Amalberti, R. (2016). Safe r healthcare. Cham: Springer International Publishing. Retrieved From < https://www.oapen.org/download?type=document&docid=1001964>


Appendix A: Patient waiting graph


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