Student Dissertation

Agency : Patient Waiting Time; Turnaround Time; Admission Process; Analysis of Admission Process

Objective : 1. To understand the inpatient admission process. 2. To analyze the admissions, turn-around time. 3. To identify the major reasons for the increase in TAT in admission process. 4. To recommend different measures for reducing the patient waiting time during admission process.

Background : The inpatient services are very important services for the hospital and healthcare system. The patients get admitted in the hospital for number of days depending on severity of their disease. Inpatient facility occupies about 30-35% of hospitals functional area and their capital investment and operational cost is high. The patients getting admitted to the hospital require the highest possible quality of medical and nursing care facilities. This study is done to reduce the waiting time for the patients coming for admissions to the hospital. The admission process has different stages and delay in admission can be due to many reasons like non-availability of beds or incomplete documents etc. Managing long waiting lines creates a great dilemma for managers, seeking to improve the quality of their operations. Not only managers but customers also dislike long waiting in a queue. If customers feel that they are waiting long in a hospital they will either prefer to leave the queue or will not come to the hospital for the next time when they are in need of seeking service. This can further reduce customer demand and eventually revenue and profit. Overcrowding in the IPD for admission creates burden for staff and dissatisfaction for customers

Methodology : 1. Type and study design – Descriptive study done at the IP admissions. Turn-around time for admission process will be studied with respect to the time at which the admission request form has been received and at what time the whole admission process was completed. 2. Data collection method – Primary data will be collected by observation. 3.Sample size – All the inpatients coming for admissions, which will include admissions from OPD and emergency. 4. Sampling technique – Systematic random sampling 5. Sampling size – 200 patients that were admitted in the hospital. Primary data will be collected to analyze the Turn-around time for admission process from In-patient department. The time was noted at which the patient gets the admission request form from the emergency or OPD till the admission process gets completed and the patient was sent to the allocated room.

Findings : Data was collected for 200 patients coming for IP-admissions. Each patient was traced step by step and the time was noted for each step in a proper line with the process map developed. Data was divided into planned and unplanned admissions. Out of 200 patients, 104 patients were having planned admissions and 96 patients were having unplanned admissions. According to the study 70% admissions were delayed due to one or the other reason. Maximum delays were due to the non – availability of beds. Hospital is mostly under high occupancy, because of which it becomes very difficult to take new admissions, in that case new admissions can be done when the patients getting discharged will vacant the beds. Out of 140 patients 60 patient’s admission was delayed due to non – availability of beds. There were many other reasons for the delay in admission process such as incomplete documents with the patient, TPA processing, patient has not taken the estimated for the line of treatment and less working counters due to which long queue was formed and admissions were delayed. We should work on all these situations to reduce the waiting time by proper management of staff, improving communication with other departments, making discharges more faster and providing beds for the patients who require on urgent basis. In the situation of high occupancy either priority should be given on first come first basis or in some urgent situation priority can be given to the patient requiring immediate treatment. Delay in admission leads to patient dissatisfaction which will further effect the quality of the organization reducing customers and hence effecting revenue and profit.