Improving Emergency Department through business process redesign: an empirical study

Abstract

The Emergency Departments (ED) of hospitals are poised for continuous improvement due to increasing demand. The ED are places where the efficiency of the services provided can save lives and therefore it should be seen as an area of maximum interest for process optimisation. This research aims at verifying if the application of Business Process Management (BPM) heuristics positively impacts the length of stay (LoS), without deteriorating the quality of the service provided. The methodology that underlies this research is a case study carried out in the ED of a public hospital. The data was gathered from individual interviews, focus groups, direct observation and document analysis. The BPM life cycle stages were followed. In addition, a simulation tool was used, and heuristics were chosen based on Devil’s Quadrangle theory. Three scenarios of the ED were considered. Additionally, three heuristics and any combination of them were also considered. Results show that heuristics positively impact the time variable without affecting the quality of the service, resulting in value gains for the patient. In terms of time consumption, the average LoS in the process was reduced by 22.5%, 15.9%, and 20.9% for each of the considered scenarios, while the maximum LoS was reduced by 29.2%, 36.2% % and 37.4%. Implications from these results were analysed. The novelty of this research is supported by the absence of studies applying BPM heuristics to ED. This research is a step forward to ally BPM heuristics and ED processes.