Betty's Project 402

Strategies To
Improve Your

Facility

Maria De La Torre
Daisy Cortez

Table of Contents Page 10: Economic Ordering Quantity
Model
Page 3: Introduction Page11-13: New Tech
Page 4: Problems that occur at Grey Page 14-17: CPM
Hospital Page 18-21: Inventory Shortage
Page 5: Shift Complaints Page 22: Expanding Grey Hospital
Page 6: Managing Shifts Page 23: Conclusion
Page 7: Accommodating Staff Page 24: References
Page 8: Ordering Inventory
Page 9: The EOC

Introduction

Monica Perez has been the CEO of Brynes Hospital for 6 years and has been
transferred to another Hospital for her great work.

She made great improvements at Brynes Hospital, and hopes to do the same at
Greys Hospital.

Within the first week Monica notices many issues that need to be solved.

Problems that occur at Grey Hospital

As the ACA changes, issues have occurred at Grey Hospital.

Many nurses had to relocate because scheduling has gotten hectic and there is new
management is the Nursing Department.

The business office manager needs assistants using the Economic Order Quality
Model.

Using multiple attributes to get new surgical equipment.

Developing Critical Path Methods

Shift Complaints

The next day Monica was in the cafeteria
getting a cup of coffee when she overheard a
group of nurses talking. The nurses were
complaining about their work schedules.
They complained about rotating shifts and
not being able to spend time with their
families. This greatly concerned Monica
because if the nurses were unhappy, they
could potentially leave the hospital.

Managing Shifts

As she walked to her office it was all she could think about. As she sat in her office
she pulled out a book from her book stand “Analytics and Decision Support in
Healthcare Operations Management.” She flipped the pages of her book and started
reading about the different types of schedules.

She read about the eight, ten, and twelve hour shifts. When reading she found that
the shift length did not significantly influence job performance between eight and
twelve hour shifts. Also the number of absenteeism were similar in both shifts. In an
10 hour shift their seems to be less absenteeism, Monica decided to do a 10 hour
shift for her nursing staff. The 10 hour shift will give the nurses a four-week
schedule where, they will work for 4 days and have three days off.

Accommodating staff

Monica believed this shift will make her nurses happier because they will have more
days off to be with their families. Her other concern was choosing between the
cyclical or flexible scheduling. The cyclical schedule is repeated period after period.
A cyclical scheduling allows the nurses to pick the shift they want, promotes even
coverage, high stability, and lower scheduling costs.

In a flexible schedule the staff can choose when in the work week they want to start,
but in this schedule the shift they work can change every week.

Among reading this she decided the best option for Grey Hospital is the cyclical
schedule. She believes this schedule will accommodate the needs of the nurses.

Ordering Inventory

As Monica was sitting in her office there was a knock on her door it was her business
office manager Erika. She said she was having difficulty ordering the correct
number of syringes for the hospital. She does not want the hospital to have fewer
syringes than needed or have too many, generating a high cost to the hospital.
Monica then told her the best method to determine the right amount of syringes is
the Economic Order Quantity Model.

Monica said that by using the Economic Order Quantity Model they will be able to
calculate optimal order quantity in terms of minimizing the sum of certain annual
costs. Monica then asked Erika to show her all the information relating to the
syringes ordering cycle.

The EOQ

Monica and Erika first
determined the holding and
ordering cost associated with
the syringes. From the model
they:

1. Determine Annual Holding
Cost

2. Determine Annual Ordering
Cost

3. Find minimum reorder point

Economic Ordering Quantity Model

In order to solve the syringe problem, Monica
and Erika used many formulas to determine
EOQM,

Annual holding Cost=Q/2(H)

Annual Ordering Cost=D/Q(S)

Total Annual Cost= Q/2(H)+D/Q(S)

Economic Ordering Quantity Model

New Tech

As Monica was walking around the
hospital she found herself in the
surgical department. In the surgical
department she found that they could
get a new surgical robot. The Robot
could provide minimally invasive
surgery for patients. The patients will
be able to have minimally invasive
surgery which will improve the quality
of care, and provide faster recovery
time for the patient.

New Tech (con.)

Monica went to the chief of surgery and asked him to provide her with a list of
possible robotic surgery systems.

When Monica received the list the following week she found that he had included a
chart that listed the possible system with their attributes, importance, and minimum
satisfaction level.

This made it much easier for her to pick the right surgical system for the hospital.
Monica then decided to use multiples attributes to decide the best surgical system
to buy.

New Tech (con.)

As she examine the chart Monica first looked at the Minimum Attribute Satisfaction
Procedure in which it shows the specific acceptance standards needed from the
surgery system. This is important because meeting these standards provides the
surgical team and patients with the best system.

As Monica looked at the standard and the chart she narrowed it down to two
systems.

Between the two she decided to use the Most Important Attribute Procedure. In the
most important attribute procedure the system is chosen by which is closer in the
list to the most important attribute. Monica then decided to purchase the minimally
invasive Davinci Robotic Surgery System.

CPM

As Monica is getting aware of Grey’s Hospital she comes across the front desk of the
Emergency Room and talks to the staff members.

She introduces herself and asks for information on step by step regulations on how
they check in patients and how they handle each emergency that comes thru the
main entrance.

As they explain the process she is writing down notes on how the facility can
improve by cutting down wait times and make it an easier process.

She came up with the idea of doing this with CPM (pg. 437). CPM is the critical path
method to cut down on projected time step by step.

CPM (con.)

CPM allows her to find ways to test out different strategies, she comes up with three
plans to test among the staff. With this she wants to hear back from them and figure
out what is easier for them to follow.

For example, when breaking down the Emergency room procedures she comes up
with 6 different steps they will have to follow.

She makes a list as the example shown on page 438.

With this staff members can train one another on how to properly treat patients
who come with excruciating pain.

CPM (con.)

The Emergency Room procedures are as followed:

1. Check- In
2. Determine if its high risk, urgent, or nonurgent
3. Medical Examining
4. Disposition
5. Admission
6. Discharge

CPM (con.)

With this strategy it makes it an easier for the patient to be checked and faster
process.

Monica found that it was an improvement with timing and focuses on the quality of
care that Grey Hospital is providing.

This way there is a breakdown of the needs each patient has and have the
department more organized in each floor of the building.

It focus on the protocols of having a patient checked and taken care of to prevent
them from being readmitted to Grey’s Hospital.

Inventory Shortage

The following week Monica came across a conversation staff members were having
on the inventory shortage.

As she was walking passed them this was bothering her and she found that it would
be best to set a meeting with one of the leaders in the surgical department to discuss
what is going on in the facility.

She questioned if it was the demand of something or if it’s Grey’s Hospital not
preparing themselves with enough inventory for each supply needed.

She needed to find a break down and solution to budget on how much is ordered to
keep in stock.

Inventory Shortage (con.)

As she met with the leader of keeping track of managing inventory they discussed
the issues that have been happening with running low in supplies.

Monica found out that the previous CEO had told the staff that they had a limit on
what they had to order because of the budget they had made.

In this budget it showed that many departments were short on supplies and would
have to contact other facilities or even send them off to the next competitive
hospital because of this.

Not only are they losing money, but they are also not providing quality care to the
patient’s needs and staffs needs in requiring these daily supplies.

Inventory Shortage (con.)

As Monica and the leader of the Surgical Department were done discussing
inventory issues Monica started remembering some strategies she had used in her
previous Hospital.

She needs to do the three basic costs that are associated with inventory: holding,
ordering, and shortage costs (pg. 373).

Monica met with the Surgical Leader within the following day so they can find more
solutions on how they can become more aware of what is being used and what are
the supplies that go to waste. They made a breakdown showing the outdated
medications from the previous month, items that were borrowed from another
facility, and etc.

Inventory Shortage (con.)

Monica also mentioned to the Surgical leader that if shortage cost (pg. 374)
continues to happen this can lead to the physicians goodwill to the risk of lawsuits
and even the death or a patient. Not only is it a risk to the patient it also puts the
reputation of the Hospital at risk in preventing patients from waiting to get surgery
or checked.

As they were discussing costs and shortages to supplies they were discussing on
expanding the hospital to in order to have more surgery rooms, recovery rooms, and
an additional floor for pediatrics.

Expanding Grey Hospital

As Monica becomes aware of the progress she’s made in the facility she is looking to
evolve the facility to become more successful in striving to bloom into a perfectly
running Hospital to become more recognized. With expanding the facility, they can
easily grow more recognition, quality, network, etc.

With expanding the Grey’s Hospital, Monica will have to use the closeness rating
chart (pg. 171).

With the closeness rating chart this allows you to determine how close different
departments should be from one another and allow you to rate each department by
relative strength closeness.

From A being absolutely necessary, E- very important, I- important, O- ordinarily
important, U- unimportant, and X- undesirable.

Conclusion

With these being the factors of determining the department flow, she finds that it
would be broken down on:

(1) whether similar equipment or facilities are used, or similar work per formed; (2)
sharing the same personnel, records, and communication; (3) sequence of work flow;
and (4) unsafe or unpleasant conditions (Muther and Wheeler, 1962)(pg. 172).

Within approx. a year and a half later Monica is recognized once again in running a
successful Hospital with taking risks, managing costs, being a team leader, coming up
with effective changes, earning recognition in accommodating patients and staff
members, and providing quality care to the community.

References

https://www.google.com/search?q=davinci+robot&source=lnms&tbm=isch&sa=X&ved=0ahUKEwi46POW
2pLYAhVSx2MKHW_lCmwQ_AUICygC&biw=1242&bih=602#imgrc=_

https://bonsecours.com/richmond/our-services/emergency-services/emergency-room-process

https://www.slideshare.net/kabra/eoq-ken-homa

https://fcer.com/locations/houston-map/south-shore-harbour/

ANALYTICS AND DECISION SUPPORT IN HEALTH CARE OPERATIONS MANAGEMENT Third Edition By
Yasar A. O zcan