Many empty hospital beds lined up in a corridor.
Sometimes local, micro solutions are the best way to address hospital delays.

PATA: local solutions for larger problems

There has been significant and well-published reform of emergency and urgent pathways, such as those facing the NHS, but we should not ignore the importance of planned or elective pathways either.

Last week, we broadly considered the role of systems thinking in hospital operations, while this week, we explored BPR at a more granular level.

In the NHS case study we looked at in the previous step, we investigated some of the challenges facing hospital systems at a meta level and, through the lens of emergency access and queuing in primary care, considered some local solutions to the issues faced by hospital managers, leaders and administrators.

Let’s now look at some more micro solutions to local hospital challenges.

Micro solutions to hospital challenges

Sometimes the best approach to improving patient experience is to resolve issues at the local, micro-process level.

As patients move between levels and settings of care, from acute to follow-up or elective to rehabilitation phases, the process of service delivery becomes more complex, often with multiple professions providing services across diverse physical environments.

In practice this means our operational focus needs to ensure that these pathways, processes and systems are as efficient and effective as possible.

Case study video

In response to possible solutions that address these issues, the following video describes the development and functioning of the pre-admission testing area (PATA) at the Massachusetts General Hospital (MGH) in the United States.

Watch the video below:
MIT Learning Edge: MGH and PATA

Based on activities that were once conducted via in-patients prior to further medical interventions, evidence shows that these ambulatory units save significant ‘bed days’ and improve the safety of care.

Bed days are key cost drivers in hospital environments and, as such, are often the focus of reform efforts.

These changes do not always meet patient expectations and need to be actively managed and explained to smooth patient transition and provide assurance that this new approach is as safe – if not safer – than established practices.

Your task

Watch the video and consider PATA from the perspective of systems thinking and BPR.

(Note: for those of you undertaking the full Hospital Operations program for credit towards the Deakin University Graduate Certificate of Hospital Administration, we’ll be returning to investigate this case study in more detail during Course 2: Managing Hospital Delays, Queuing and Scheduling as the basis of your first assessment task.)

What do you think the impact of this and similar units might be in relation to patient experience given your own local, organisational and professional context?

Would this approach work? Why or why not?

Use the comments to share and compare your thoughts with other learners.

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This article is from the free online course:

Hospital Operations: Improving Patient Experience

Deakin University

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