Ashford University Healthcare Operations Management Worksheet


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 largestvolume 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).
a. Create a flow chart depicting the outpatient carotid duplex scan process.
b. 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.
c. 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.
d. 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.
e. 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?
f. 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.
Using the standard deviation approach, construct 99.7 percent confidence limits for
patient waiting time for the registration.
Develop an appropriate control chart for the days.
Are there any days in violation of the confidence limits?
Calculate the range for each day and calculate LCL and UCL for a mean chart using
the range approach.
Construct a corresponding control chart and identify any key violations of the limits.
Table I
Table II
Table III
Table IV Typical Allowance Percentages for Varying Healthcare Delivery Working Conditions
Table V
– Rubric for the Assignment
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 25% Appropriate presentation of results on tables and
an Excel sheet.
calculations via Excel.
3- Report content (see writing
15% The final report is well organized and clearly written. It is
a coherent, whole text. Effective transitions between
Writing rubric
− 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.
− No spelling and grammatical errors.
− Content mostly coherently organised; transitions sometimes effective.
− Prose mostly clear and moderately easy to read.
− 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.
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:

Transient Ischemic Attack
Loss of muscle control
Other symptoms that might result from narrowing or blockage of the vessels (stenosis)


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