MGT603 Systems Thinking - Assignment Help on Emergency Department Value Stream Task

• Background

The increase in aging population and escalating health issues are leading to increasing number of patients in Emergency Department (ED) of hospitals. Based on increasing rate of patients visiting ED, the emergency departments are reporting to perform at over capacity, causing substantial increase in waiting time of patients (Abdulmalek & Rajgopal, 2007). Additionally, it is evident that due to limited resources, staff is not increased in overcrowding hospitals, which can lower the quality of health care services provided to patients. The waiting time in ED varies across hospitals, yet generally it is mentioned in studies conducted on ED that wait time is almost 30 minutes, while treatment time is 90 minutes (Kamma, 2010). However, patient surveys indicate variation in stated wait time and waiting time is generally more for patients with less acute issues. It is provided by Dako et al. (2018) that emergencies cannot be scheduled and thus prioritizing to patients with serious issues can further increase the waiting time for less acute patients. Regardless of this justification, there is greater need to assess the value adding and non-value adding activities in the operations of ED, such that overall waiting time can be reduced for patients. 

The underlying report has required to assess the current value stream map of a hospital with an aim of lowering the wait time for patients to half, such that turnaround time of patients can be improved. For this process, patient’s transport across different sections of ED is assessed along with waiting time, such that non value adding activities can be eliminated to lower the waste time. Firstly, the assessment of system archetypes is carried out to identify activities that could hinder the performance. Followed by this, existing value stream map is assessed and new map is suggested to reduce the waiting time for patients in ED. Finally, a discussion on intended and unintended consequences is carried out. 

• Identification and analysis of the System Archetypes that may impede performance 

The system archetypes are important ways for identifying the behavior of structures within a specific system and it can be used as diagnostic mechanism for recognizing the loop holes in existing system, which might impede the performance of organization (Lin, Jin & Chia, 2014). The emergency department performance of hospital is also based on system archetypes which might intervene to increase the waiting time for patients (Lot et al., 2018). The two system archetypes are identified for diagnosing the reason of increased waiting time for patients in emergency department of hospital. The identified system archetypes are; limits to success and shifting the burden. 

Limits to success: This archetypes indicates that being successful can also be dangerous for the long run success of organization, as it can trap us into thinking that past patterns will continue to succeed in future (Braun, 2002). This archetype shows that emergency department of hospital is continually making reliance on its existing procedure which has helped it to deal with overcapacity of patients. However, the success of dealing with overcapacity of patients has also contributed to increasing waiting time for patients. The team of hospital needs to understand that although its existing practices are successful in and dealing with overcapacity of patients, yet the wait time between each phase of the process is required to be minimized. This can be done by changing phases of value stream map and by simplifying the process through which efficiency of treatment can be enhanced. 

Shifting the burden: Shifting the burden archetype indicates that any division and department in organization does not operate in isolation and intervention of many factors could increase complexity of problem (Wolstenholme, 2004). Therefore, the problem is identified in interconnection of different symptoms to reach at reasonable solution (Lummus, Vokurka & Rodeghiero, 2006). The underlying issue of increased wait condition in emergency department of hospital is caused by interconnection of different phases within treatment process of emergency department. There is greater need to simplify the procedure, such that burden of treatment can be shift with an aim of lowering the wait time between each phase of the process.