Business process re-engineering of the emergency treatment unit at the Colombo South Teaching Hospital

Abstract

With the emergence of information and communication technology (ICT), health care institutions too, commenced incorporating new technologies, aimed at efficient delivery of health services. Initiatives of this nature, categorized as 'e -health'- have become an important activity area, resulting in many advanced total software solutions, for health care institutions worldwide. Unfortunately the acquisition costs of such solutions are too high, for developing countries such as Sri Lanka, and they continue to be challenged, in trying to overcome this financial barrier. Furthermore, most such solutions are not tailored for the specific needs of health care institutions in developing countries, which themselves, have evolved towards providing affordable health care, with highly limited resources in challenging environments. In response, developing countries could consider adopting alternate approaches to achieve the efficiency goals of e- health, by first, systematically studying and identifying the unique features associated with the hospital sectors in these countries and then, by providing innovative e- health solutions that would specifically address the challenges and issues common to health care systems in developing countries. The objective of this research was to find a practical methodology to systematically study a Sri Lankan health care institution with the view of re-engineering the related processes by utilizing the same limited resources in an efficient and effective manner. A clinical unit - the Emergency Treatment Unit (ETU) of the Colombo South Teaching Hospital - which is one of the largest teaching hospitals in Sri Lanka, was chosen as the sample space to test the theories generated by this research. Following an extensive study to identify the essential processes required for the functioning of the ETU, the researchers formulated a well-structured and iter atively applicable framework to re-engineer the processes in Sri Lankan health care institutions. The proposed framework, defines a methodology to perform a detailed analysis of the existing workflows, in a clinical unit and to then re-engineer, those process-level as well as policy-level workflows. Since every clinical unit of hospitals in Sri Lanka carry out more or less the same functions in different contexts, the fundamental Coriperts- KL the Sri Lanka. The model features built-in iterations and feedback loops which enables systematic analysis of operational effectiveness, thereby enabling the implementation of timely corrective measures leading to continuous improvement and enhanced positive operational impact of the E Government solutions. Furthermore, since the model was conceptualized and designed with Sri Lankan government organizations as the focus, it is highly relevant in the local context in comparison to the existing evaluation models that are in use elsewhere in the world. Clearly, this model would also be useful in other developing countries with government organization and government process profiles that are similar to Sri Lanka, for the purpose of evaluating their E Government projects systematically in order to improve their solution effectiveness. iii