BUSINESS PROCESS REENGINEERING ASSIGNMENT

PRILLY PUTRI ADINDA

1406606272
Problem 3.5

A hospital emergency room (ER) is currently organized so that all patients

register through an initial check-in process. At his or her turn, each patient
is seen by a doctor and then exits the process, either with a prescription or
with admission to the hospital. Currently 50 people per hour arrive at the
ER, 10% of who are admitted to the hospital. On average, 7 people are
waiting to be registered and 34 are registered and waiting to see a doctor.
The registration process takes, on average, 2 minutes per patient. Among
patients who receive prescriptions, average time spent with a doctor is 5
minutes. Among those admitted to the hospital, average time is 30
minutes. On average, how long does a patient spend in the ER? On
average, how many patients are being examined by doctors? On average,
how many patients are in the ER?
 Answer

The Process Flow

10%
Potential
R = 50/hour T = 2 mins
Admits
= 0.833/mins

I = 30 I = 40
90%
Buffer 1 Registration Buffer 2 Doctor Simple
(waiting) (waiting) T1 = 5 mins Prescriptions
T2 = 30 mins
Answer
Using Formula
I=RxT

R I T
Buffer 1 50 30 36.14
Registration 50 1.66 2
Buffer 2 50 40 48.01
Doctor 50 6.2475 7.5
77.9075 93.65

How long, on average, does a patient stay in the ER? TD = 0.9(5) + 0.1(30) = 7.5
TER = 93.65 minutes
On average, how many patients are being examined by doctors?
IER = 6.2475 = 7
On average, how many patients are in the ER?
TER =77.9 = 78
Problem 3.6
A triage system has been proposed for the ER described in Exercise 3.5. As
mentioned earlier, 50 patients per hour arrive at the ER. Under the proposed
triage plan, entering patients will classify them as Simple Prescriptions or
Potential Admits. While Simple Prescriptions will move on to an area staffed
for regular care, Potential Admits will be taken to the emergency area.
Planners anticipate that the initial examination will take 3 minutes. They
expect that, on average, 20 patients will be waiting to register and 5 will be
waiting to be seen by the triage nurse. Recall that registration takes an
average of 2 minutes per patient. Planners expect eh Simple Prescriptions
area to have, on average, 15 patients waiting to be seen. As before, once a
patient’s turn come, each will take 5 minutes of a doctor’s time. The hospital
anticipates that, on average, the emergency area will have only 1 patient
waiting to be seen. As before, once that patient’s turn comes, he or she will
take 30 minutes of a doctor’s time. Assume that, as before, 90% of all patients
are Simple Prescriptions, assume, too, that the triage nurse is 100% accurate
in making classifications. Under the proposed plan, how long on average, will
a patient spend in the ER? On average, how long will a Potential Admit spend
in the ER? On average, how many patients will be in the ER?
 Answer
The Process Flow

Buffer 3 Potential
(waiting) Admits

R = 50/hour T = 2 mins
= 0.825/min

I = 30 I = 40

Buffer 1 Registration Buffer 2 Triage Nurse

(waiting) (waiting)
Simple
Buffer 4
Prescriptions
(waiting)
Answer

Using Formula
I=RxT

R I T
Buffer 1 50 20 24
Registration 50 1.666 2
Buffer 2 50 5 6
Triage Nurse 50 2.499 3
Buffer 3 5 1 12
Potential Admission 5 2.499 30
Buffer 4 45 15 20
Simple Prescription 45 3.75 5
51.414
How long, on average, will a patient stay in the ER?
TPA = 24 + 2 + 6 + 3 + 12 + 30 = 77 minutes
TSP = 24 + 2 + 6 + 3 + 20 + 5 = 60 minutes
TER = 77(0.9) + 60(0.1) = 75.3 minutes
On average, how long will a potential admit stay in the ER?
TPA = 24 + 2 + 6 + 3 + 12 + 30 = 77 minutes

On average, how many patients will be in the ER?

IER = 52 Hard
Skill
Problem 3.7
Refer again to Exercise 3.6. Once the triage system is put in place, it performs
quite close to expectations. All data conform to planners’ expectations except
for one set-the classifications made by the nurse practitioner. Assume that the
triage nurse has been sending 91% of all patients to the Simple Prescription
area when in fact only 90% should have been so classified. The remaining 1%
is discovered when transferred to the emergency area by a doctor. Assume all
other information from Exercise 3.5 to be valid. On average, how long does a
patient spend in the ER? On average, how long does a Potential Admit spend
in the ER? On average, how many patients are in the ER?
 Answer
The Process Flow

Buffer 3 Potential
(waiting) Admits

R = 50/hour T = 2 mins
= 0.825/min

I = 30 I = 40

Buffer 1 Registration Buffer 2 Triage Nurse

(waiting) (waiting)
Simple
Buffer 4
Prescriptions
(waiting)
Answer

Using Formula
I=RxT

R I T
Buffer 1 50 20 24.00960384
Registration 50 1.666 2
Buffer 2 50 5 6.00240096
Triage Nurse 50 2.499 3
Buffer 3 5 1 12.00480192
Potential Admission 5 2.499 30
Buffer 4 45.5 15 19.78
Simple Prescription 45.5 3.75 4.94
51.414 96.34
How long, on average, will a patient stay in the ER?
Common = 24 + 2 + 6 + 3 = 35 minutes
TSP = 35 + 19.78 + 4.94 = 59.72 minutes
T = 59.72 (0.9) + 79.9 (0.1) = 61.695 minutes
On average, how long will a potential admit stay in the ER?
TPA1 = 35 + 12 + 30 = 77 minutes
TPA2 = 77 + 19.78 + 4.94 = 101.72 minutes
TPA = 77(0.9) + 101.72(0.1) = 69.3 + 10.172 = 79.472 minutes
On average, how many patients will be in the ER?
Hard
IER = 52 Skill