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Case Study: PATA

In Australia, it is often found in hospitals that the hospitals’ weakness led to the delivery of poor health care services. These weaknesses include undifferentiated service lines, staff or management problems, lagging in technology, limited resources, poor patient flow, limited workforce, and many others (Khanna et al., 2017). There are many ways to combat these issues like the use of newer technologies, online counseling, and others. The following sections will discuss the explanations for the issues that arose in the PATA case study, analysis of the proposed solutions, and steps for solutions.

PATA is an outpatient clinic with only one waiting room, one lab, and 12 exam rooms. Therefore, the patients faced many issues like the waiting was full, the patients had to wait for nearly 1-2 hours for their appointments, and they also had to wait in long waiting lines. Many patients had come as they were referred to Massachusetts General Hospital but the lack of workforce resulted in a delay of quality care. There was variability in surgeon assessments with a lack of clear guidelines, resulting in poor quality care of patients that made the patient sicker. It was difficult for the hospital to make the availability of additional resources because the clinic also did not get high revenues. This explains that an improper and rough flow of patients with insufficient resources of the hospital makes it very difficult for any hospital to provide quality care services to the patients (Leviner, 2020).

This also results in crowding of patients in emergency departments. It was also found that there were issues in pre and post-operative assessments with patients getting more sick because the surgeries start at a delayed time because of missing and incomplete work-ups. The consumers/patients were very upset and unsatisfied with the services provided to them because due to limited workforce and resources their treatment was delayed or canceled. Moreover, the number of patients piled up in the hospital because the nurses did not get complete time to document the patient information resulting in effective care for which the patient had to return to the hospital again. This ultimately resulted in more patients in the hospital.

To deal with the issues faced by PATA, the task force came up with many solutions. They prioritized visits for patients with long medical histories, co-morbidities, and other potential complications like cancer patients, diabetic patients, or elderly patients. This approach is good to some extent as more serious patients should get priority for treatment over less serious patients. However, in this way, the severity of the less serious patients may increase to a great extent if they do not get health services before time. The remaining patients like the comparatively healthier patients were provided with their respective work-ups on their surgery days. This approach is not appropriate as in this way the surgery that is an important or life-saving act for patients might get delayed resulting in a risk to patient safety. Any delays in surgeries can lead to an increase in the risks of mortality (Maine et al., 2019).

The hospital also planned towards canceling or post-pounding the appointments as they were overloaded with work. Some were told to go back to their homes and come on their day of treatment/surgeries only. This solution has many negative impacts on the health of the patient like delay in treatment due to distance of traveling, the patient might get serious complications before coming to the hospital on the day of his treatment/surgery and communication among the health care professionals with the patient for a shared decision making did not get enough time. They also planned to conduct online patient education sessions and electronic system for patient data collections. However, this solution has a few drawbacks like the patient might not feel satisfied with such services or they might also not get access to these online services if they faced technical issues.

There is a solution that can be made to deal with the issues faced by PATA, the solution is Smooth patient flow. This is possible with strategic planning, equipment integration, technology assessments, assets management, and equipment planning (Song et al., 2019). It ensures quality care to patients, reduced delays, and safe and timely care to the patients. A smooth patient flow help through it constituting strategies like providing governance, transfer guidelines, ISBAR handover, estimating the date of discharge, short term escalation plan, and many others. Benchmarks should be made every month, removing and identifying the bottlenecks in the system, avoiding batch processing, standardizing the administrative and clinical processes, and the different classes of activities that should be segmented (Hall, 2013). There should be appropriateness and effectiveness with which the beds are used for the patients in the hospital. There should be an aim to reduce the inputs in the emergency department, increasing the hospital staffing, and improving the exit points of the patient from the hospital (Showell et al., 2012). The servers should also be increased to provide appointments or other assistance to the patient as early as possible.

The weaknesses that lead to ineffective services in the hospital are undifferentiated service lines, staff or management problems, lagging in technology, limited resources, poor patient flow, limited workforce, and many others. The variability in surgeon assessments with a lack of clear guidelines results in poor quality care of patients that made the patient sicker. Due to limited workforce and resources, their treatment was delayed or canceled. More serious patients should get priority for treatment over less serious patients. The delay in treatment due to the distance of traveling can make the patient serious before coming to the hospital on the day of his treatment/surgery. The smooth patient flow can reduce the crowd in hospitals.

References

Hall, R. W. (2013). Hospitals and clinical facilities, processes and design for patient flow in patient flow: Reducing delay in healthcare delivery.

Khanna, S., Boyle, J., Good, N., Bell, A., & Lind, J. (2017). Analysing the emergency department patient journey: discovery of bottlenecks to emergency department patient flow. Emergency Medicine Australasia, 29(1), 18-23.

Leviner, S. (2020). Patient flow within hospitals: A conceptual model. Nursing Science Quarterly, 33(1), 29-34. https://doi.org/10.1177%2F0894318419881981

Maine, R. G., Kajombo, C., Purcell, L., Gallaher, J. R., Reid, T. D., & Charles, A. G. (2019). Effect of in-hospital delays on surgical mortality for emergency general surgery conditions at a tertiary hospital in Australia. BJS Open, 3(3), 367–375. https://doi.org/10.1002/bjs5.50152

Showell, C., Ellis, L., Keen, E., Cummings, E., Georgiou, A., Turner, P. (2012). An evidence based review and training resource on smooth patient flow, eHealth Services Research Group, University of Tasmania, Australia.

Song, H. J., Dennis, S., Levesque, J. F., & Harris, M. F. (2019). What matters to people with chronic conditions when accessing care in Australian general practice? A qualitative study of patient, carer, and provider perspectives. BMC family practice, 20(1), 79.

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