Question

OPERATIONS MANAGEMENT

SECTION A Read the case study below and answer the questions that follow. Arnold Palmer Hospital The Arnold Palmer Hospital (APH) in Orlando, Florida, is one of the busiest and most respected hospitals for the medical treatment of children and women in the U.S. Since its opening on golfing legend Arnold Palmer's birthday September 10, 1989, more than 1.5 million children and women have passed through its doors. It is the fourth busiest labor and delivery hospital in the U.S. and the largest neonatal intensive care unit in the Southeast. And APH ranks fifth out of 5,000 hospitals nationwide in patient satisfaction. "Part of the reason for APH's success," says Executive Director Kathy Swanson, "is our continuous improvement process. Our goal is 100% patient satisfaction. But getting there means constantly examining and reexamining everything we do, from patient flow, to cleanliness, to layout space, to colors on the walls, to speed of medication delivery from the pharmacy to a patient. Continuous improvement is a huge and never-ending task." One of the tools the hospital uses consistently is the process flowchart. Staffer Diane Bowles, who carries the title "Clinical Practice Improvement Consultant," charts scores of processes. Bowles's flowcharts help study ways to improve the turnaround of a vacated room (especially important in a hospital that has operated at 130% of capacity for years), speed up the admission process, and deliver warm meals warm. Lately, APH has been examining the flow of maternity patients (and their paperwork) from the moment they enter the hospital until they are discharged, hopefully with their healthy baby a day or two later. The flow of maternity patients follows these steps: 1. Enter APH's Labor & Delivery check-in desk entrance. 2. If the baby is born en route or if birth is imminent, the mother and baby are taken by elevator and registered and admitted directly at bedside. They are then taken to a Labor & Delivery Triage room on the 8th floor for an exam. If there are no complications, the mother and baby go to step 6. 3. If the baby is not yet born, the front desk asks if the mother is preregistered. (Most do preregister at the 28-30- week pregnancy mark). If she is not, she goes to the registration office on the first floor. 4. The pregnant woman is taken to Labor & Delivery Triage on the 8th floor for assessment. If she is ready to deliver, she is taken to a Labor & Delivery (L&D) room on the 2nd floor until the baby is born. If she is not ready, she goes to step 5. 5. Pregnant women not ready to deliver i.e., no contractions or false alarm) are either sent home to return on a later date and reenter the system at that time, or if contractions are not yet close enough, they are sent to walk around the hospital grounds (to encourage progress) and then return to Labor & Delivery Triage at a prescribed time. 6. When the baby is born, if there are no complications, after 2 hours the mother and baby are transferred to a "mother-baby care unit"room on floors 3.4. or 5 for an average of 40-44 hours. 7. If there are complications with the mother, she goes to an operating room and/or intensive care unit. From there, she goes back to a mother-baby care room upon stabilization or is discharged at another time if not stabilized. Complications for the baby may result in a stay in the Neonatal Intensive Care Unit (NICU) before transfer to the baby nursery near the mother's room. If the baby cannot be stabilized for discharge with the mother, the baby is discharged later. 8. Mother and/or baby, when ready, are discharged and taken by wheelchair to the discharge exit for pickup to travel home.

Question

A) With the aid of examples, provide a discussion of any 2 hospitals of your choice that compete on different competitive strategies. Your response should indicate what strategy each hospital implements and justify your assertions. (20 marks)

Answer 1

The hospitals that maintain the highest quality care to the patients in terms of safeguarding the rights of patients and giving them the most remarkable journey by healing with utmost care and passion is categorised as being the best. Likewise, in India there is this hospital by the name Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, Emergency Department. The services offered here are taking care and managing patients who have Sustained falls, Road Traffic Accidents, Blunt Injury, Abdominal Injury etc. The victims are either brought by the patients relatives or self or by the police(for those who meet accidents or are lying on the streets unattended due to injury). The department follows a process and a protocol.

1. The patients are first brought to the emergency department and shown to either the resident doctor or the triage officer (Nurse)

2. After the initial assessment the patient is categorised to either Red, Yellow or Green depending on the condition of the patient. For this they follow the WHO recommended guidelines which is modified as per the Indian setup.

3. The relatives are simultaneously asked to follow the procedure to make the patient hospital file.

4. The line of treatment depends on the area the patient is categorised into: Red- Emergency, no delay, treatment starts immediately, Yellow- treatment can be delayed for an hour or so, Green- the patient is ambulatory, treatment can wait. Also, there is no designated area for Black but when the patient is brought dead s/he is announced Category Black as per triage protocol.
5. Since it is a Govt institute, all cost is free.

6.The team shows utmost team work and staff are dedicated and designated to specific areas to take care of the patient.

7. The team is thoroughly professional and are highly skilled to take care and manage patients during mass casualty too.

Another such hospital is Artemis Hospital, Gurugram, India- This hospital is already a Joint Commission International accredited hospital. The hospital follows all the guidelines laid down by the JCI. There is a protocol of IDTR that is Interdisciplinary Team Rounds which takes care of taking rounds of the patient by the team comprising of the Doctors, Nurses, Physiotherapists, Dietician and significant others. While the patients also follows a process where by the patient is either admiited in the ward via OPDs or Emergency departments, otherwise from ICUs or OTs. Depending on the patient condition and stay in the hospital the team decides what is best for the recovery of the patient.