Study On Business Process Reengineering In Out-patient Department Based On Queuing Theory And Information Technology

Out-patient department (OPD) is regarded as the window of hospital, and the service quality offered here is closely related to the profit and reputation of hospital. At present, in large and medium-sized hospitals, especially the 3A hospitals, the phenomenon of "Three Long and One Short" is very prominent,which clearly shows the difficulty of seeing a doctor for patients. Therefore, to improve the OPD service quality and efficiency is an important task facing hospitals. After launching some research work in Peking University Shenzhen Hospital,the paper raises a program of business process reengineering(BPR) in OPD based on queuing theory and information technology.Objectives: To improve the efficiency of hospitals, make full use of resources, and reduce patients'waiting time by reengineering the OPD service flow, consequently to solve the "Three Longs and One Short" problem, improve patients'satisfaction, enhance the comprehensive competitive capability of hospitals and ease the difficulty of seeing a doctor. An optimized flow integrating queuing theory, BPR and information technology is further discussed, which is to be offered as the reference to hospital management.Methods:①Questionnaire Survey, an OPD satisfaction survey was done, and 106 valid questionnaires were collected.②Statistical analysis, structure equation model, rank sum test and other statistical methods were applied to analyze the impact of the waiting time of different sectors to patients'satisfaction.③Queuing theory, a queuing theory model is built to measure the efficiency of each sector in OPD, identify the bottlenecks, and evaluate the allocation of existing resources.④BPR, according to the Six BPR Steps by J. Teng, a reengineered OPD flow is raised.⑤Information technology, the new flow is realized and fixed by integrating card technology, network technology and OPD information system.Results:①The impact of waiting time of each sector on patients'satisfaction ranks from strong to light as: registration, physical examination, triage, taking medicine, getting charged, chemical examination and waiting for doctors. Thus to shorten the waiting time of registration, physical examination and triage is of more significance than the others.②The average waiting time ranks from long to short as: waiting for doctor, physical examination, registration, getting charged and taking medicine. Among the above, physical examination and waiting for a doctor are the bottlenecks.③The time-distribution law: most patients choose to see doctors in the morning, which consequently leads to the significant uneven distribution of doctors'workload between morning and afternoon.Conclusions:①Problems analysis, the main reasons leading to the "Three Longs and One Short" are: over-concentrated time of seeing doctors, over-divided function of departments, unreasonable distribution of functional areas, medical information not shared, insufficient and relatively uneven distribution of resources.②Importance-Performance Analysis, physical examination is the key point.③Reengineering program, appointment system is suggested to be applied in registration and other parts which normally need to wait for long time. Charging can be done through a united card in the places where the items are implemented. The new flow is realized and fixed by OPD information system, which includes six subsystems of registration, clinic charging, clinic doctor workstation, clinic pharmacy, queue management and system management. The research work conducted is of some innovation and practicality, and the methods applied are of feasibility and theory guidance. The paper is ready to be offered as reference in hospital management.