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Homework answers / question archive /   HealthCare Operations Management HW The manager of RCAD's vascular lab would like to evaluate its examination and reporting processes and determine if there are opportunities for improvement, beginning with the largest- volume procedure for the vascular lab, the outpatient carotid duplex scan

  HealthCare Operations Management HW The manager of RCAD's vascular lab would like to evaluate its examination and reporting processes and determine if there are opportunities for improvement, beginning with the largest- volume procedure for the vascular lab, the outpatient carotid duplex scan

Operations Management

 

HealthCare Operations Management HW

The manager of RCAD's vascular lab would like to evaluate its examination and reporting processes and determine if there are opportunities for improvement, beginning with the largest- volume procedure for the vascular lab, the outpatient carotid duplex scan.

 

The carotid duplex scan process begins with the patient arriving for testing at the outpatient registration department. Following registration, the patient is sent to the radiology waiting area to await the test. When a room and machine become available, the patient is called back for testing by the technologist. The technologist checks the written order against the order on the schedule and clarifies any discrepancies with the referring physician's office. The next step involves a series of scripted questions designed to obtain a thorough history related to this testing event. Once this is completed, the examination takes place. If the findings of the examination fall into the ranges that have been designated as critical values, the referring physician is notified immediately. At this point, depending upon the decision made by the referring physician, the patient is either escorted out of the department or admitted to the emergency room (ER) or the hospital. Once the patient has left the department, the technologist completes the worksheet with the examination raw data and the technical findings of the exam. The worksheet is submitted to the department coordinator for entry into the vascular lab examination database/report-generation software. Once the report is generated, it is placed into the reading physician's box, along with the video footage of the examination for review. It is important to note that the analog nature of this material requires the reading physician to come to the lab to review this data. If any changes to the report are needed, it is resubmitted to the lab coordinator for correction. Once the report has been approved by the reading physician, it is physically signed and submitted back to the coordinator to be mailed. The coordinator photocopies the signed report and mails it to the referring physician through the United States Postal Service (USPS).

 

  1. Create a flow chart depicting the outpatient carotid duplex scan process.
  2. Suppose the process has been divided into three subprocesses: patient registration, vascular lab/examination, and the reporting process. Identify an opportunity for improvement, based on the visual representation in section (a), for patient registration and the vascular lab/examination subprocesses.
  3. In order to get a more thorough picture of the carotid duplex scan examination and reporting process, the manager worked with the patient access team to conduct a time study. Twenty observations were recorded and rounded to the nearest minute, as shown in Table I and Table II. Performance ratings and allowance factors are displayed in Table III, while Table IV is also provided for typical allowance percentages. Complete Table III by calculating the observed time, normal time, and standard time for each activity.
  4. The manager of the vascular lab believes he has identified a viable option to reengineer the reporting subprocess. This alternative would be to add the vascular lab onto the radiology information system (RIS) and utilize the automatic faxing function for report storage and

 

distribution. The RIS offers automatic faxing to referring physicians, as well as to inpatient care areas. This process takes place immediately following transcription of the reports (preliminary reports) as well as upon final signature. The system also offers the ability for reports to be reviewed remotely and electronically signed. Create a revised flow chart reflecting implementation of the RIS solution.

  1. The costs of the conversion to the RIS solution would mostly consist of labor costs to implement the change, since it involves an existing enterprise license. It is estimated that by implementing RIS, it will take forty-seven hours and forty-five minutes to complete the steps from and including test write-up to mailing the test. Do you agree that this is a viable option to reengineer the reporting process in the vascular lab?
  2. The manager of the Vascular Lab finds out that the complaints of late registrations of patients were commented by patients in patient satisfaction surveys. In order to shed light on this issue, a time study team made observations and compiled the data in Table V. The measurements are recorded in minutes (rounded to the nearest minute) of response time of registrars (at the registration desk) once the patient has arrived at the Vascular Lab.
    1. Using the standard deviation approach, construct 99.7 percent confidence limits for patient waiting time for the registration.
    2. Develop an appropriate control chart for the days.
    3. Are there any days in violation of the confidence limits?
    4. Calculate the range for each day and calculate LCL and UCL for a mean chart using the range approach.
    5. Construct a corresponding control chart and identify any key violations of the limits.

 

Tables

 

 
 
 

 

Table I

 

 

 

 

 
 
 

 

 

Table II

 

 

 

Table III

 

 

 
 
 

 

Table IV Typical Allowance Percentages for Varying Healthcare Delivery Working Conditions

 

 

 

Table V

 

 - Rubric for the Assignment

 

Assessment

 

Element

%

Description

1- Presentation of results and solutions on Word file.

60%

Problem is well understood, and solutions are based on the knowledge gained in the course.

2- Presentation of the tables on an Excel sheet.

25%

Appropriate    presentation    of    results    on    tables                       and calculations via Excel.

3- Report content (see writing rubric)

15%

The final report is well organized and clearly written. It is a coherent, whole text. Effective transitions between sections.

 

 

Writing rubric

 

Excellent

− No spelling and grammatical errors.

Content coherently organised, with effective transitions between sections and proper citation.

− Prose uniformly very clear and easy to read, and with distinctive style.

Very good

− No spelling and grammatical errors.

− Content coherently organised; transitions often effective.

− Prose generally clear and easy to read.

Good

− No spelling and grammatical errors.

− Content mostly coherently organised; transitions sometimes effective.

− Prose mostly clear and moderately easy to read.

Minimum acceptable

− Some spelling and grammatical errors.

− Content organised, though with some incoherence; transitions attempted.

− Prose readable with minimal difficulty.

Unacceptable

− Many spelling and grammatical errors.

− Poor organisation (or no attempt at organisation).

− Prose difficult to read or comprehend.

 

Appendix

 

What is carotid duplex scanning?

 

Carotid duplex scanning is a non-invasive ultrasound method that measures blood flow through the carotid arteries, the large arteries that run from the heart through the neck to the brain. Carotid duplex scanning is often the first test done to assess stroke risk, and often helps the medical team decide what other tests may be needed to determine a diagnosis and treatment plan.

 

Your physician may order carotid duplex scanning to evaluate symptoms including:

 

  • Stroke
  • Transient Ischemic Attack
  • Loss of muscle control
  • https://www.cedars-sinai.edu/Patients/Programs-and-Services/Stroke-Program/Images/neck-and-vascular-system.jpgOther symptoms that might result from narrowing or blockage of the vessels (stenosis)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

·

Ref:     https://www.cedars-sinai.edu/Patients/Programs-and-Services/Imaging-Center/For-Patients/Exams-by-Procedure/Ultrasound/Carotid-Duplex-Scanning.aspx

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