The present study was conducted at a Tertiary care corporate hospital of Hyderabad. Which is in operation from 1989 with 1,000-plus-bed facility.

1. Business Process Re-engineering
At Cardiology Department
Case Studies
Group Member
Syed Basit Raza(7040)
S M Asad(7269)
PAF KARACHI INSTITUE OF ECONOMICS AND TECHNOLOGY

3. Introduction
• The present study was conducted at a tertiary care
corporate hospital of Hyderabad.
• Which is in operation from 1989 with 1,000-plus-bed
facility.
• Cardiology department, scheduled and unscheduled
operations often have to coexist and be managed.
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4. Cont..
• Cardiology department involves intensive, careful and
complete observation of patient flow, delays and short
comings in the patient movement and workflow.
• Primary data is collected through observations, informal
interviews and face to face interaction.
• Secondary data is collected through records of the hospital
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5. Cont..
• The aim of this study is to suggest a better process and
reduce the time constraints.
• A complete process & workflow ware studied in detail.
• The process which is taking much time or which is not
smoothing the workflow can be reengineered.
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7. Case Study: Cardiology Department
The old process
Admission Process
Ward/ICCU Process
Billing & Discharge Process
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8. Work Flow Of The Admission Process
• Patient is advised for admission process by the doctor.
• Patient relatives goes to admission desk with prescription.
• Admission officer calls PRE (patient relationship executive) of cardiac dept and
asks for availability of bed and prepare case sheet.
• Asks patient to deposit the advance to the cash counter.
• Patient is taken to the department by transport .
• PRE in the dept informs nurse about the admission.
• Nurse in the dept checks the case-sheet and sends the patient to the room
allotted.
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9. Work Flow Of In Ward/ICCU
• Case sheet of the patient is checked by DMO (Duty Medical Officer)
• DMO checks the patient and orders nurse to start treatment
• Nurse check medicines and give in written to patient relatives
• Patient relative get medicine from pharmacy
• Nurse check the medicine and starts treatment to patient
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10. Cont..
• Nurse collects blood sample and other samples for investigations as ordered
by doctor
• Nurse calls courier and send the investigation sample to the LAB
• DMO collects report and informs consultant cardiologist/surgeon
• Changes in treatment are noted as per cardiologist/surgeons by DMO
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11. Work Flow Of Billing & Discharge
• When patient is advised for discharge by doctor
• DMO prepares discharge summery
• Discharge summery is send to consultant for checking
• After checking discharge summery corrections are made by DMO and set to
typing
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12. Cont..
• Case sheet of the patient is sent to billing dept by transport
• After completion of billing case sheet is sent back to cardiac dept by transport
• PRE informs relatives of patient to go to billing counter to pay the bill
• After clearance of bill discharge summery with investigation reports is handed
over to Patient attainders by PRE
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14. Problem In Existing System
• Delay in admission process when emergency cases come to the hospital.
• LAN is not properly done to check the availability of the beds.
• Sometimes Transportation of patient is delayed due transport personnel.
• Investigations samples are sent to labs through couriers who delay the
process.
• DMO’s are less in number as compared to consultants which makes a reverse
pyramid in human resources of department.
• After preparing discharge summery, sent to consultant and again DMO makes
corrections suggested by consultant and then again sent for typing.
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16. Solution & Possible Alternative
• A LAN should be introduced in admission desk with every department which
can be useful to see the availability of beds in departments.
• Transportation personnel should be always there to receive and carry the
patient.
• A separate section for emergency and IPD investigations should be started.
• DMO’s should be given work of only one department, otherwise they will be
confused and there may be chances of occurring mistakes.
• Discharge summery should be prepared on system connected with LAN and
consultants checking summaries directly send to discharge summery
department.
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18. After Re-Engineering Process
• When the patient is advised for admission process by the doctor.
• Admission of the patient by checking bed availability by online request.
• Investigation before admission.
• Report delivery on the basis of online requisition.
• Admission of patient according to condition in ward or ICCU
• Medication to the patient after he/she is checked by DMO
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19. Cont..
• After recovery patients shifted to ward or advised discharge by consultant
• Doctor prepare discharge summary online and sends to consultant to check
who send back checked summary to DMO
• DMO sends discharge summary to typing department and collects printed
summary
• Case sheet is send to billing department and patient attenders are asked to
pay bill at cash counter.
• After clearance of billing a feedback form is filled up by patient attender and
discharge summary with reports in handed over.
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21. Conclusion
• BPR has great potential for increasing productivity through reduced process
time and cost, improved quality, and greater customer satisfaction.
• The best processes for performing work, and that processes are reengineered
to optimize productivity without compromising on quality.
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