Reengineering the Admission Process to the Clinic of a Military Hospital in Tehran in 2017-2018

Admission to the clinic is a key process from the patient referral to the doctor until he/she hospitalizes in the wards. In the reengineering approach, with the aim of continually improving processes and improving quality, existing processes are replaced by new ones. The purpose of this study was to reengineer the admission process from the clinic of a military hospital in Tehran in 2017.

This was a qualitative case study that was conducted in a military hospital in Tehran from October 2017 to March 2018. Interviews were conducted with 12 staff and stakeholders involved in the admission process. Purposeful sampling was used for process owners and available sampling for patients. Data were collected through semi-structured interviews and focus group sessions. Edraw Max7 software and MAXQDA11 software were used for data analysis

Initially, the current admission process of the clinic was drawn up with 29 main activities, 14 procedure steps and 5 decision stages. Out of 109 codes extracted for the challenges in the process, seven general challenges (main theme) were taken: costs, deficiencies and disadvantages, training, inadequate utilization of the hospital information system, overcrowding, lengthy process and time taken. Finally, the process of charting the admission workflow diagram from the clinic was drawn with 29 main activities, 14 procedural cases, 3 decision-making steps, and elimination of the stopping and archiving phases, thereby reducing the new process time from 5 to 4 hours.

Reducing the admission process steps, increasing the process of action and reducing decision-making and eliminating the delays and archive lead to reduce the time and improved satisfaction and drawing of new flowcharts for the admission process. The new process is more agile and efficient, improving hospital admission performance and ultimately increasing productivity.