1. Operations Management Final Paper ANGUSTIA, BERNADETTE C. VEGA, ALFONSO GABRIEL A.

2. St.Martin de Porres Charity Hospital 1959 – Blessed Martin de Porres Medical Free clinic Handled by Dominican Priory 1965 – Medicine, Pediatrics, Dental, Nutrition, Laboratory Later on became an infirmary  “St. Martin de Porrese Charity Hospital” 1979 – classified as 30-bed secondary hospital 1983 – classified as a TERTIARY Hospital

3. St.Martin de Porres Charity Hospital Currently a 150-bed capacity tertiary hospital Services offered: Surgery – main service Medicine Pediatrics Obstetrics and Gynecology Radiology Nutrition Dentistry Ophthalmology ENT Emergency Medicine

4. SMPCH’s VMO Vision: aims to provide quality and affordable medical and healthcare services to the less privileged members of the society. Mission: Inspired by God’s love, the hospital fosters a work environment where volunteers, professionals and benefactors take active and compassionate interest in the patients they serve.

5. SPMCH’s VMO Primary Objective: Medical service for the indigent sick members of the society giving higher priority to the charity patients over paying patients (who may have better possibilities to secure personal medical services in other hospitals).

6. SMPCH ER TRIAGE Non-urgent Urgent Emergent Stabilize patient Referral to proper service

8. Identifying The Server-Customer

9. Service- System Design

10. Process Flowchart Patient arrives at ER N N Y Triage Patient is examined by the physician on duty. Patient is given appropriate treatment. Is the patient< 18?years old Patient is decked under pediatric service. Does the patient have an Ob-Gyne complaint? Patient is decked under Ob-Gyne service. Will the patient need surgery? Patient is decked under Surgery service. Patient is decked under Internal Medicine service. Y N Y

11. Process Flowchart Patient is reassessed. Will the patient be admitted? Patient is given home instructions and OPD follow-up. Patient pays ER bill at window 1 Patient returns official receipt to ER NOD. Companion is given OPD record and brought to admission. Data sheet is brought to the ER by admitting staff. Ward is informed by the ER NOD and admitting section Patient is sent home. Patient is brought up to the ward.

12. Process Flowchart

14. Patient Arrival Data: Descriptive Analysis Direct observation of patient arrivals Average influx: 60 patients for 2 days Ave. No. of patients: 30 per day 47% involved abdominal pain and fever

15. Patient Arrival Data: Descriptive Analysis Patient arrival: 6am-2pm shift- 20 patients (33.33%) 2pm-10pm shift – 28 patients (46.67%) 10pm-6am shift – 11 patients (18.33%) Average time to evaluation from time the patient comes in is 35 MINUTES. Longest time to be seen recorded 5 hrs 20 mins Shortest time recorded is under a minute

16. Patient Arrival Data: Descriptive Analysis Longest discharge time – 10 hrs 32 mins Fastest discharge time – 5 mins Primary Services: Medicine 20 patients (33.33%) Pediatrics 18 patients (30%) Surgery 11 patients (18.33%) Obstetrics 10 patients (16.67%)

17. House of Quality

18. Fish-Bone Analysis

19. Poka-Yoke System Referral Logbook Keep track of referrals Monitor time response Quality control tracker of services Out-source diagnostics and imaging modalities Business agreement with diagnostic centers MOA prioritizing SMPCH patients Lab result delivery

20. Poka-Yoke System User-friendly ER forms and Pathway forms Lessen writing/charting time Symptom-specific pathway forms help facilitate faster more efficient flow Help lessen human error

21. Radar Chart

22. Conclusion OpMan tools helped identify relevant and quantifiable observations Main causes of lag in patient care in the ER: Long physician waiting time Unavailability of medications and supply Delay in imaging and laboratory exams

23. Conclusion Recommendations Service referral log books Symptom-specific pathway forms Outsource laboratories and imaging exams Scope and Limitation Main focus: FEASIBLE ACTIONS given the circumstance that would be easily implemented Recommendations involving increase in capital investments were not inquired into as much