A Study on Emergency Department Service Quality from the Viewpoint of Operational Management
Date Issued
2009
Date
2009
Author(s)
Lin, Yi-Ting
Abstract
With the increasing number of patients at Emergency Department (ED), not only is ED being regarded as the battlefront of hospital as a whole, the ever-rising significance of EDs in the medical system can also be observed. Especially for EDs in large and renowned hospitals, over-crowdedness occurs all the time. While the impressive records of those EDs are assured by the overwhelming number of patients, difficulties concerning the overall management are augmented, more inconvenience are experienced by patients and their families, and as a result, satisfaction towards the hospitals as well as the EDs drop dramatically.he study was based on our research target, Emergency Department in National Taiwan University Hospital (NTUH). From the satisfaction survey in 2007 and 2008, it can be concluded that “Waiting time” and “Environment/Facility” were the items with lowest satisfaction, and the problems currently faced by ED in NTUH could in turn be consolidated into 2 factors, “Operation process” and “Environmental arrangement”. Followed by an on-site survey conducted in order to reveal the priority of expectation elements for EDs sorted out from literature reviews, the result showed that “Waiting time” as well as “Environment/facility” were of relatively low priorities, reflecting the fact that the problems NTUH needs to deal with now are those in lower level of importance.n order to understand the root causes of “Operation process” and “Environmental arrangement” factors, a series of research on service process and environmental dimensions were conducted following the result of relative importance. Regarding “Operation process” factor, after a thorough diagnosis by the tool of Flowchart and Process chart, “Waiting time for doctors” was found to be longer than other sample EDs, thus categorized as the abnormal condition. And the subsequent root causes for that were analyzed to be the low contribution rate of emergency observation beds as well as the low productivity of doctors in EDs, despite the fact that absolute number of patients for NTUH was equal to or even less than others, resulting in longer stay for each patient in EDs, thus longer average wait for doctors.s to “Environmental Arrangement” factor, a research was conducted to analyze the possible influences of ambient conditions, space/function, and signs, symbols, & artifacts, on patients, families, and employees in each of the sample EDs. Result showed that ED in NTUH elicits unpleasant feelings from noisiness, dim lighting, lobby occupied with observation beds, lack of privacy, not enough chairs, and etc. Probing the root causes revealed that on top of the environmental design factor, lack of asset and employee efficiency lengthened patents’ average stay in EDs, thus creating negative impressions.ome suggestions raised to eradicate above root causes, “Lack of asset and employee efficiency” and “Inferior facility design”, were reinforcement of interface management to improve observation condition in EDs and promote operation efficiency, site expansion and rearrangement of EDs to enhance patients’ pleasant feelings, and lastly, reconstruction of hardware and software to raise the satisfaction of inevitable waits.
Subjects
Emergency satisfaction
Waiting time
Environment/facility
Operation process
Environmental arrangement
Type
thesis
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