The use of flow charts to enhance service delivery in Arnold Palmer Hospital (APH)
Arnold Palmer Hospital Flow Chart
The Sequence of steps in the flow chart:
- Expectant mothers enter APH's Labor and delivery check-in desk for entry.
2. If the baby is born on the way to the facility or if birth is imminent, the mother and baby are taken by elevator and registered and admitted directly at bedside.
3. If the baby is not yet born and the birth is not imminent, two pathways may follow (5 and 6).
4. The mother is taken to a labor and delivery triage room on the 8th floor for an examination.
5. If registered the mother is then referred to the labor and delivery triage room on 8th floor.
6. If not yet registered the mother is referred to the first floor for registration
7. If there are no complications, birth proceeds and step 11 is taken.
8. When there are complications two steps follow (12 and/or 13).
9. If ready for delivery the mother is referred to L.D room on 2nd floor till birth.
10. If not yet ready to deliver two channels may be taken-steps 14 or 15.
11. When the baby is born, if there are no complications, after 2 hours the mother and baby are transferred to a mother-baby care unit on floors 3, 4, or 5 for an average of 40-44 hours room on floors 3, 4, or 5 for an average of 40-44 hours.
12. If there are complications with the mother, she is taken to the ICU.
13. If there are complications involving the child, then the child is held in Neonatal ICU until stability is established.
14. If no contractions and false alarms women are sent home to come at a later date.
15. If there are no contractions women are allowed to walk around the compound to speed up progress.
16. After being treated for complications the mothers go back to a mother-baby care room upon stabilization or are discharged at another time if not stable.
17. The baby is later transferred to the baby nursery near the mother, after the baby has stabilized and complications ended.
18. The mother walks around and later goes back to the labor and delivery triage room on 8th floor for further examination.
19. The mother is then discharged from the mother-baby care if she is found to be stable.
20. The baby is discharged with the mother.
21. If there is progress and no complications step four (4) follows.
22. If the baby still has problems it is discharged at a later date with the mother.
Improvements to the flow chart
Firstly, the chart should be enhanced to cater for missing components such as processes to be followed when still births and caesarean births occur. There is an incomplete nature in the flow chart because such components are not catered for. Additionally, since the chart helps fast tracking, there is a need to include the component of time as well as the departments and individual responsible for certain steps within the whole process so as to enhance clarity in the flow of the chart. These comprehensive inclusions that clearly cater for possible processes help reduce obscurity and ambiguity in the organization of a business’s activities (Dufrene, 2007).
For example if there were C-section births then, the table would include another step in the flow shown by the C-section button in order to cater for steps to follow when normal births do not work. Other changes that would occur on the chart if the all mothers were pre-registered would include the elimination of stages 5, 6 and 9 because these would not be necessary.
Chart after the recommended changes
The chart seems to efficiently define the flow of service delivery in the maternal context and perhaps the same should be enhanced in the pediatric section. In the pediatric section the hospital may also make use of the same concept by ensuring it creates a flow chart that defines the reception of patients into the hospital in the pediatric section. The flow may be used to define the steps registration, diagnosis, scheduling of treatment, categorization of patients and their respective areas to visit as well as the types of conditions. This should also include a differentiation of different classes of pediatric diseases, where each will be accorded its on flow channel with the flow charts after the diagnosis process that separates different types of patients. This process could also flow in similar manner portraying the flow from reception, care and finally to discharge. These kinds of charts would help make flow of service delivery easy, less obscure and well ordered like in the maternity section (Nelson, 2007).
Dufrene, D. D. and Lehman, M. C. (2007),. Business Communication, 15th edition, Cengage Learning
Nelson, C. E. (2007),. Practice-Based Learning and Improvement: A Clinical Improvement Action Guide, 2nd edition, Joint Commission Resources