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To prepare for Part I of your Final Assessment, read the “United General Hospital Emergency Room Case Study”. Next, consider how you might summarize your findings against national standards upon evaluating Ron’s experience in the ER. Then, complete the Productivity Metrics Dashboard, by identifying six to eight activities or processes that were carried out during Ron’s visit. Be sure to include the duration of each activity or process and their duration.

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Productivity Metrics Ro Experience in United General Hospital Emergency Room-Solution

Productivity Metrics Ro’s Experience in United General Hospital Emergency Room

Introduction

In contemporary times, organizations have experimented and singled out the most effective measurements for productivity. Due to the products and services offered by different business entities productivity can be measured using different methods and at different levels ranging from the raw organizational output of an asset in a manufacturing firm to specific individual performance of a vendor or staff member in a service industry like healthcare organizations. By definition, productivity refers to the effectiveness of output while metrics describes the methods of measurement (Sauermann, 2016).(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

As such, there is need for healthcare executives and managers to ensure their teams are productive. Studies indicate that while most organizations in the healthcare industry desire to have maximum productivity the teams often encounter organizational barriers with the facility losing a significant portion of its productive capacity due to organizational drag. A recommended solution to truly know how productive one’s team is to track through productivity metrics like the planned to completed task ratios of tasks assigned. (Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Consequently, this essays targets to present a nurse professional’s findings of selected healthcare organization findings against national standards using a case study approach. To achieve the goal, the United General Hospital’s Emergency Room (UGH-ER) is selected while Patient Ron’s experience in the ER is evaluated and used to complete the Productivity Metrics Dashboard. These activities are registration, copayment, wait for nurse, vital signs, wait for the exam room and wait for physician. Other activities used are the observed time taken in minutes during the actual examination, test order entry, referral requests and follow up appointment schedule.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Summary Findings of the Professional’s Review of Ron’s Experience

Patient Ron was taken to UGH- ER by his wife Mary who surmised that her husband was in unbearable pain after he agreed to pay a visit to the emergency room of UGH presenting with a swollen ankle on a Saturday afternoon secondary to a fall from a ladder that Saturday morning. UGH is an acute care facility whose client base is suburban Mid-western community. The table that follows is ER’s activities observed time (OT) in the facility, National average (NA) and the differential OT versus NA.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Ps. Differential time has been arrived at as the difference between the national average and the observed time at UGH-ER.

The red coded figures are the figures where the activity’s observed time is above the acceptable difference from the national average, yellow color is where the activity is within the acceptable difference limits while color green is for activities whose execution takes a shorter time than the difference with the national average. As Savva & Tezcan (2019) note to decrease the ER wait times, the wait time should be tied to payments. There is need to address these issues with nursing professionals coming up with effective solutions since the hospital industry constituted 5.6 % of the US economy even as the Centers for Medicare & Medicaid Services (CMS) continue to regulate the industry by controlling about 45% of the hospital reimbursements (Savva et al, 2019).(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Activities That Generated the Inefficiencies Analyzed in UGH-ER

To appropriately identify how to measure the ER team’s productivity, one has to choose metrics that speak directly to the organization goals, and the process to examine the selected metrics. The first activity is the registration process that forms the foundation upon which the patient accesses healthcare services. According to Liang et al., (2014), the EDs are the gateways in most acute care hospitals where patients wait as they are attended in the hospital. Mary notes that she had to stand in line for half an hour to register yet the UGH-ER was half –full. (Productivity Metrics Ro Experience in United General Hospital Emergency Room)

This long wait time was in and of itself an indicator of UGH’s ER inefficiencies in attending to urgent matters. This is because longer wait times in the ER may increase the patient’s health risks, lead to ED overcrowding and cause the number of patients who leave the ED without being seen to increase (Xie & Or, 2017). Additionally, patients have low satisfaction with the services offered at the hospital. The second activity that generated the inefficiency was copayment. Many America health insurers offer patients like Ron a co-payment for ER visits. The processing time should take the least possible time. Nevertheless, Mary reports that she had to wait for ten minutes despite using her credit card citing a flawed payment process.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

At the time the patient is buying a health insurance plan, the patient hopes that the medical expenses will be covered on time particularly during emergencies. One cannot help noting that the RN had to use three computers to key in the information to validate the co-pay amount and therefore process the credit card. Besides, nursing staff shortages UGH-ER could also be experiencing faulty machines and poor coordination thus causing unnecessary delays. Wait time for nurse as the third activity is necessary, as a patient has to pass through a RN in order to have the patient’s medical examination information processed and then booked for the next physician. Most importantly, the process should be quick to decrease the wait time. In the case of Ron and Mary, they had to spend 45 minutes awaiting Ron’s admission into the exam room despite the excruciating pain that Ron was experiencing. Friesgaard et al (2017) opine that patients in acute pain should be given priority. (Productivity Metrics Ro Experience in United General Hospital Emergency Room)

The fourth cause of inefficiency at the UGH-ER was the examination process, Healthcare professionals agree that an examination is one of the most significant activities prior to a patients’ treatment or their admission in a hospital. The process should lead to accurate diagnosis of the health problem and should be conducted in a timely way so that the patient does not undergo unnecessary suffering while on the waiting line. Timeliness of the service was not the case here as the attending physician was paged for an emergency mid-way through Ron’s examination and it took another twenty minutes for a physician’s assistant to appear thus completing the process in two minutes. The assistant concluded that Ron had suffered broken bone or a sprained ankle thus ordering for an x-ray. Kallerg (2017) remarks that leaving a patient in the ER before treatment is complete puts the patient’ health and life at risk.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Due to the limited scope of this paper, the last activities to be analyzed as sources of inefficiency in the UGH-ER are test order entry and referral requests. A test order follows an examination and involves the physician examining the tests performed to establish the most appropriate therapeutic intervention for the patient (Oyedokun et al., 2016). Suffice to say that although Ron was attended to immediately he had to wait for 15 minutes as the orderly took him to the radiology department and a further 15 more minutes to be escorted back. Last but not the least is that patients not satisfied with the results can request a referral to a higher level of care institution with the referring hospital expected to give immediate feedback. Immediate referral was not the case for Ron as the hospital did not accept the credit card payment method forcing them to look for healthcare services in another facility. Moreover, the checkout nurse failed to see Ron’s prescription and had to consult the physician first causing further delay.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

How the Inefficiencies Noted in UGH-ER Compare To the National Averages

According to Ahsan et al., (2019) the time used during the registration process within the ED is a determiner on how fast the patient receives much needed treatment as a result of resources optimization. The critical care patient should be stabilized even as CMS.Gov (2020) report the average wait time in an ER as 6 minutes but in the UGH –ER it was observed at 15 minutes. The difference in time maybe because of the processes within the hospital like the case where a nurse had to enter data using three different computers. (Productivity Metrics Ro Experience in United General Hospital Emergency Room)

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Productivity Metrics Ro’s Experience in United General Hospital Emergency Room

The next negative impact of observed time was the case of wait time for nurse and the time it took the RN to book the next available physician. The same CMS.gov report of July 21, 2020 indicates the national average time as 15 minutes but Mary and Ron took thrice that time. The 45-minute wait time to the examination was probably caused by manpower shortages or a long queue thus potentially worsening the patient’s health condition. The wait time to the physician put at 6 minutes by the CMS. gov report but took 20 minutes at UGH-ER is bound to have serious adverse effects on the patient if not addressed. Possible causes could be inadequate machines, poorly skilled staff to man the machines or even nursing staff shortages. Similarly, the referral request that took 15 minutes at UGH –ER should ideally take10 minutes as per the national average with an acceptable differential of 5 minutes.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Copayment time processing time was another cause of unnecessary extended processing time mainly due to the use of multiple computers to process the information. The nurse professional should also remember that the complexity of the patient’s condition also has a role to play in determining the time taking to process referral requests and follow up appointment.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Methodology Used To Determine Acceptable Differentials for Each of the Metrics

The five metrics identified are registration, copayment, and wait time for nurse, wait time for physician, and referral request. To get the acceptable differential time for the emergency room processes activities, I computed it by taking a rage of the national averages as captured in the table below.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Activity	Acceptable differential
Registration	(9-6) =3
Co payment	(6-4) -2
Wait time for nurse	(30 -15) -15
Wait time for physician	(14-6-) = 8
Referral requests	( 10 -5 ) = 5

Conclusion

In conclusion, this essay has established that several factors play a role in determining the time taken to offer services to patients. The factors range from overcrowding in the ED to machines efficiency, to nurse – patient ratio within the ED, amongst others. Community hospitals like other healthcare organizations have to devise measures and implement strategies to address these issues if they are to improve the quality of care and enhance patient safety in their facilities. The hospital management should at all times endeavor to improve service delivery by offering patient focused care that acknowledges their unique health needs, preferences and health beliefs.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

References

Ahsan, K. B., Alam, M. R., Morel, D. G., & Karim, M. A. (2019). Emergency department resource optimisation for improved performance: a review. Journal of Industrial Engineering International, 15(1), 253-266.

CMS.gov (2020,) Emergecy departmet cahps(Ed cahps) .CMS

Friesgaard, K. D., Paltved, C., & Nikolajsen, L. (2017). Acute pain in the emergency department: Effect of an educational intervention. Scandinavian journal of pain, 15, 8-13.

Källberg, A. S. (2015). Patient safety in the emergency department: Errors, interruptions and staff experience. Inst för medicin, Solna/Dept of Medicine, Solna.

Liang, S. Y., Theodoro, D. L., Schuur, J. D., & Marschall, J. (2014). Infection prevention in the emergency department. Annals of emergency medicine, 64(3), 299-313.

Oyedokun, A., Adeloye, D., & Balogun, O. (2016). Clinical history-taking and physical examination in medical practice in Africa: still relevant?. Croatian medical journal, 57(6), 605.

Sauermann, J. (2016). Performance measures and worker productivity. IZA World of Labor.

Savva N. & Tezca T(2019) To Reduce Emergency Room Wait Times, Tie Them to Payments URL : https://hbr.org/2019/02/to-reduce-emergency-room-wait-times-tie-them-to-payments

Savva, N., Tezcan, T., & Yıldız, Ö. (2019). Can yardstick competition reduce waiting times?. Management Science, 65(7), 3196-3215.

Xie, Z., & Or, C. (2017). Associations between waiting times, service times, and patient satisfaction in an endocrinology outpatient department: a time study and questionnaire survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 0046958017739527.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Question

The Module Pre-Assessment is your opportunity to practice applying module content before submitting the final Competency Assessment. In the Final Assessment, you will be asked to develop a list of processes where inefficiencies are noted and develop a scorecard to measure those areas most important to a healthcare organization.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

To prepare for Part I of your Final Assessment, read the “United General Hospital Emergency Room Case Study”. Next, consider how you might summarize your findings against national standards upon evaluating Ron’s experience in the ER. Then, complete the Productivity Metrics Dashboard, by identifying six to eight activities or processes that were carried out during Ron’s visit. Be sure to include the duration of each activity or process and their duration.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

To prepare for Part II of your Final Assessment, consider how you might explain the balanced scorecard methodology including its strengths and limitations, and the benefits of using the balanced scorecard methodology in United General Hospital’s emergency department.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

For this Module Pre-Assessment, develop a draft of your Productivity Metrics Dashboard and a draft of your slide presentation explaining the balanced scorecard methodology. Be sure to review the Final Assessment Instructions for Part I and Part II of the Final Assessment for more details. Also, include references to support the content of your drafts.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

PART B

The Module Pre-Assessment is your opportunity to practice applying module content before submitting the final Competency Assessment. In the Final Assessment, you will be asked to create a balanced scorecard and a presentation of your productivity recommendations.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

To prepare for Part III of your Final Assessment, consider how you might apply the balanced scorecard methodology to the emergency department at United General Hospital, including what quantitative and qualitative metrics you might use, why you would use the metrics you selected, and how you would identify the targets. Then, reflect on the productivity measures identified in the Unite General Emergency Department and think about what productivity recommendations you might make for a high-level process to collect, track, and measure data for the metrics that represent United General’s emergency department’s productivity.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

For this Module Pre-Assessment, create a draft of your balanced scorecard for the emergency department at United General Hospital and create a draft of your slide presentation recommending a high-level process for collecting, tracking, and measuring productivity data at United General’s emergency department. Be sure to review the Final Assessment Instructions for Part II and Part III of the Final Assessment for more details. Also, include references to support the content of your drafts.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

ASSIGNMENT

To complete this Assessment:

Download the Academic Writing Expectations Checklist to use as a guide when completing your Assessment. Responses that do not meet the expectations of scholarly writing will be returned without scoring. Properly formatted APA citations and references must be provided, where appropriate.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
Be sure to use scholarly academic resources as specified in the rubric. This means using Walden Library databases to obtain peer-reviewed articles. Additionally, .gov (government expert sources) is a quality resource option. Note: Internet and .com sources do not meet this requirement. Contact your coach or SME for guidance on using Library Databases.
Carefully review the rubric for the Assessment as part of your preparation to complete your Assessment work.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

This Assessment requires submission of three (3) files. Save your files as follows:

Save Part I as OM005_PartI_firstinitial_lastname (for example, OM005_PartI_J_Smith).(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
Save Part II (slide presentation) as OM005_PartII_firstinitial_lastname (for example, OM005_PartII_J_Smith).
Save Part III as OM005_PartIII_firstinitial_lastname (for example, OM005_PartIII_J_Smith).

When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Instructions:

Before submitting your Assessment, carefully review the rubric. This is the same rubric the assessor will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Rubric

Access the following to complete this Assessment:

To begin, read the scenario below; the “United General Hospital Emergency Room Case Study” and other documents provided; and the “Productivity Metrics Dashboard.” Then, complete Parts I–III.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Scenario:You have been hired as a consultant to increase productivity in United General Hospital’s emergency department. Your consulting engagement entails evaluating productivity metrics for the emergency room (ER), creating a balanced scorecard to measure the department’s performance, and then presenting recommendations to the leaders of the emergency department.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

This Assessment has three parts. Click each of the items below to complete this Assessment.

Part I: Productivity Metrics (Word Document)

As a first step in your consulting engagement, you review Ron’s experience in the ER. Using information from the case study, evaluate Ron’s experience and summarize your findings against national standards as follows (4-5 pages):

Identify 6-8 activities or processes carried out during Ron’s visit to United General. Enter the 6-8 activities or processes and their duration in the “Productivity Metrics Dashboard.” (attachment in the instructions)(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
- Each of the 6 to 8 activities in the chart need to have completed data for the Observed Time, National Average, and Differential OT vs NA. (You will complete the Acceptable differential data for the 5 activities or processes you will discuss below.)(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
  - Include the sources for all data in the sources tab in the “Productivity Metrics Dashboard.”
Write an analysis of activities and processes that create inefficiency as follows:
- Identify five of the activities or processes from the case study/ included in your dashboard that create inefficiency in the emergency department.
- Provide a rationale for your selection of the five activities or processes. Include cited material and References to support your assertions.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
- Identify any discrepancies and outline reasons why discrepancies exist.
Write an analysis of acceptable differentials for the five activities or processes as follows:
- Using benchmarks determined by the Centers for Medicare and Medicaid Services, identify the national averages/benchmarks for five activities or processes you selected.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
  - Enter the national averages/benchmarks in the “Productivity Metrics Dashboard.”
- Determine an acceptable differential to the national benchmark for each of the 5 activities or processes and enter the differentials into the “Productivity Metrics Dashboard.”(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
- Explain the methodology you used to determine acceptable differentials for each of the metrics for these five activities.

Part II: Balanced Scorecard Methodology (Slide Presentation)

The next step in your consulting engagement is creating a balanced scorecard but, first, you must convince the executive committee that the balanced scorecard method is effective. Several members of the executive committee are not familiar with the process. An important part of your role is to educate them. You decide to show them a sample balanced scorecard for an emergency department.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

Create a 5 to a 7-slide presentation that explains the balanced scorecard methodology, including at least two strengths and two limitations, and the benefits of using the balanced scorecard methodology in United General Hospital’s emergency department.
- Include a critique of the hospital’s productivity metrics results and any limitations of the current data collection process and/or metrics being used for the scorecard.

Part III: Balanced Scorecard Creation (Word Document)

After you explain the balanced scorecard methodology, the board and chief executive officer (CEO) want you to create a balanced scorecard for the emergency department at United General.

Create a balanced scorecard for United General’s emergency department. Can be completed in an image or graphic type display. (up to 2 pages)(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
- Include both quantitative and qualitative metrics.
Explain why you selected these metrics for United General and how you identified the targets. (4-6 pages)
- A defense of best practices used for productivity metrics dashboard data collection, analysis/interpretation, and action planning.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)
- Recommend a high-level process to collect, track, and measure data for the emergency department’s productivity metrics.

Related FAQs

1. Is healthcare productivity measured correctly?

Purpose – Healthcare productivity is a growing issue in most Western countries where healthcare expenditure is rapidly increasing. Therefore, accurate productivity metrics are essential to avoid sub-optimization within a healthcare system. The purpose of this paper is to focus on healthcare production system productivity measurement.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

2. What drives efficiency and productivity growth in public hospitals?

The main factors contributing to overall productivity gains are increases in occupancy rates, type and size of the hospital. Conclusions This paper attempts to offer insights in efficiency and productivity growth for public hospitals in Greece.

3. How often should your emergency department monitor metrics?

Learn about the key metrics that should be monitored weekly, if not daily, within your emergency department in order to improve financial performance and optimize efficiency. In many communities, it is not uncommon to see billboards touting lightning-fast wait times for emergency care at this hospital or that health system.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

4. How can measuring improve performance in the emergency department?

Measuring and tracking a range of operational and financial metrics is one of the keys to improving performance in the emergency department and proving your overall value to the hospital and to payers.(Productivity Metrics Ro Experience in United General Hospital Emergency Room)

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Productivity Metrics Ro’s Experience in United General Hospital Emergency Room

Productivity Metrics Ro’s Experience in United General Hospital Emergency Room

Productivity Metrics Ro Experience in United General Hospital Emergency Room-Solution