• Researched on healthcare industry to understand current managerial problems and its root causes • Structured an agile BPM maturity model and process maps for current system and its key recommendations • Developed a solution paper with the sound recommendations based on BPM approaches

1. MIS-712 ADVANCED BPM
FINAL PROJECT: BAD BED MANAGEMENT
PREPARED BY – PUJAN MOTIWALA

2. BPM MATURITY MODEL FOR
CURRENT SITUATION
Goals
 Increased throughput.
 Decreased average length of patient’s stay.
 Improved recording of treatment costs.
 Fewer ambulance diversions.
 Increase in patients’ satisfaction ratings.
Known Needs
 Redesign the process flow
 Centralizing patient placement
 Introducing new technology
 Well-documented patient flow solutions
Business Process
Management
Maturity
Strategic Alignment
Process
ImprovementPlan
Strategy & Process
Capability Linkage
Process Architecture
Process Output
Measurement
Process Customers &
Stakeholders
Governance
Process Roles and
Responsibilities
Decision Making
Processes
Process Metrics &
PerformanceLinkage
Process
Management
Standards
Process
Management
Controls
Method
Process Design &
Modeling
Process
Implementation &
Executions
Process Control &
Measurement
Process
Improvement&
Innovation
Process Project &
Program
Management
IT
Process Design &
Modeling
Process
Implementation &
Executions
Process Control &
Measurement
Process
Improvement&
Innovation
Process Project &
Program
Management
People
Process Skills &
Expertise
Process Education &
learning
Process
Collaboration &
Communication
Process Knowledge
Process
Management
Leaders
Culture
Process Values &
Beliefs
Process Attitudes
Behaviors
Reponsiveness
Process Change
Leadership Attention
to Process
Process Social
Networks
The primary focus is
to have high-impact
with low-risk process
Operation improvement
plan is properly aligned
with the financial goals
of business strategy
Process Roles &
Responsibilities are
properly understood
Patient flow solution
should be well
documented
Technology supports
capturing and
modeling processes
The administrative
and clinical staff is
process skilled
Increasing effective bed
capacity between five
and 20% by redesigning
their processes.
Top management treats
the first project as a
critical success factor.

3. Problems for the current system:
 Recent merger with regional healthcare provider and bed capacity is at premium
are major reason why hospital cannot afford 20% rise in bed. The hospital staff
has to work over and beyond the normal hours, leading to overtime pay and thin
operating margin resulting in hiring freeze. These factors combine to result in
Financial stress.
 Operational stress is due to low patient throughput. The decreased patient flow
problem is because of several factors such as laboratory and radiology are
unable to keep up with the system, physicians & nurses have less time to focus
on individual patients and A study found that for each additional patient with heart
failure, pneumonia, or myocardial infarction assigned to a nurse, the odds of
readmission increased between 6 percent and 9 percent. Another study found
that when patients are discharged from an ICU because of overcrowding, they
are at much greater risk of being readmitted to the ICU. Mortality rates have also
been shown to increase when the ratio of surgical nurses per patient decreases,
while patients held in the emergency department (ED) until inpatient beds are
freed up have higher rates of morbidity and mortality. But the primary factor in
the system is emergency and recovery departments are filled with patients
requiring beds, while the patients occupying the beds are not discharged on time.
Root causes of the problems:
1. The critical diseased patient may not be properly treated causing several
readmissions and thus rise in overcrowding of the emergency department.
2. The laboratory and radiology are unable to keep up with the system as they are
not acknowledged on time.
3. The traditional database management system needs manual inputs which does
not update in sync with the real time location system resulting in more time
consumption.
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1.5
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4.5
Graph Charts

4. BPMM
Business Process Management Maturity
Model
Foundation Capability Business
Architecture
The Third Wave
Strategic
Alignment
Level 1 Level 1
Level 3
Drives Synergies
Level 4-5
Hospital wide approach
Governance Level 1 Level 1
Level 2
IT wide approach
Level 4-5
Hospital wide approach
Methods
Level 2
Workshop approach
Level 2
Integrated Database
system
Level 3
Integrated into Business
Architecture assures 5% bed
availability
Level 4-5
Integrated RTLS & Automated
database system
assures 20% bed availability
Tools &
Technology
Level 2
RTLS for modelling
Level 2
Extended use of RTLS
Team 3
Link to Operational structure
modelling
Level 4-5
Integrated RTLS & Automated
database system
People
Level 2
Established Staff
Level 3
Staff gets Updates
from Automated
system
Level 3
Staff is on their toes and no
patient readmissions
Level 4-5
Whole hospital
Culture Level 1
Basic Financial
awareness
Level 2
Integrate into IT
Culture
Level 3
Part of Financial planning
Level 4-5
Integrate into hospital culture
Agile BPM Maturity
Application Focus Service Focus SOAKey
Factors
Enabling
Factors

5. Recommendations:
ADMINISTRATION DEPARTMENT
1. The modification of Database technology is a must. As the new automated
database is installed, it can sync with the real time monitoring of beds.
2. The system will get inputs about scheduled discharge time, patient discharge
update and bed availability update for next patient.
3. The system will give outputs based on real time location tracking system such
as notify staff head to send maintenance and housekeeping staff to clean the
dirty beds and display beds available for emergency and recovery
departments.
4. The system will also give daily reports based on beds management which can
be used as feedback for the next day.
5. The housekeeping and maintenance staff should be on their toes to clean dirty
beds and hence allotting maximum time for the dirty bed task. The staff should
notify the system about the availability of the cleaned bed for new patient with
help of the real time location system.

6. CLINICAL DEPARTMENT
1. The nurses should determine the patient’s condition and symptoms based on
which he/she should categorize patients into two sections: Regular patient and
Critical patient.
2. As doctors/physicians cannot treat each patient the usual seasonal inflow of
people sneezing, sniffling, and showing the usual flu symptom scan be treated
as regular patients by nurses and junior doctors in the Premedical Diagnosis
Room. These patients don’t require any bed service, so this extra beds can
again be allotted to the patient having severe diseases.
3. The critical diseased patient affected by disease like heart failure, pneumonia,
or myocardial infarction should be given proper treatment by doctors and
physicians so to improve hospital outcomes. Therefore, eliminating major
readmissions of the patients.
4. After the bed is used by patient, the automated system should immediately be
notified of dirty bed.
5. After determination of the patient’s conditions, a scheduled discharge input
should be provided in the automated system.
6. As soon as new critical diseased patient arrives the laboratory and radiology
department should be notified to start required tests. Therefore, utilizing less
time to notify the physician/doctor to treat the patient accordingly.
REFERENCES
http://www.commonwealthfund.org/publications/newsletters/quality-
matters/2013/october-november/in-focus-improving-patient-flow