Business Process and Flow
Business Process: Ordering a mattress for a patients with skin
breakdown on admission/ acquiring it during stay
Upon admission of a patient a skin assessment and risk assessment is done by the nurse.
The assessment involves a patient mobility test, excess moisture test, and a check of nutritional status.
Triggers are in the charting system, which is electronic, including what will trigger the need
for intervention which includes ordering a speciality mattress to avoid further skin breakdown.
If the patient already has skin breakdown then the nurse will call down the wound care team.
The wound care team will come down and assess the situation and decide which mattress
they will order. The patient's insurance is billed for the rental and then the bed is brought to
the nurse who then signs for it. The nurse must put the patient on the mattress and then chart
it on the risk assessment. They check the skin everyday to see if the skin is improving.
2. What is the purpose of the process? Is the process important strategically for the organization? In what ways?
The purpose of the business process is to prevent skin breakdown and improve the skin integrity, this is important to the overall
health of the patient. The process is important strategically to the organization
because the insurance company will not pay for any skin breakdown that happens
during the hospital stay. Also, the hospital receives ratings from CMS
(Centers for Medicare and Medicaid Services) based on quality indicators that affect
the rankings of the hospital, which ultimately affects the funding they will get.
3.Where does this process begin? Who triggers it to begin?
The process begins during the admission process when they assess the patient’s skin
and whether or not there are breakdown issues. The nurse is the first to start this process.
4. Where does the process end? How do we know the process has completed successfully?
The process ends when the patient is discharged. They asses if the mattress helped with the skin breakdown. If the the patient got
the breakdown during their stay then the hospital must pay for home care for the skin
breakdown when the patient is discharged. We know it has been successful when the
patient no longer has skin breaking down.
5. Who are the main stakeholders?
Patient, hospital, nurse, the wound care team and the insurance company
6. What critical activities does each stakeholder engage in?
Patient - experiencing the care
Hospital - gets the ratings and deals with the costs associated
Nurse- assesment, charting, signing for the bed, and the actual care. The nurse must put the mattress on the bed and make sure
the mattress is helping.
Insurance- Pays for the rental
Wound care- asses the situation and orders it
7. What critical decisions does each stakeholder need to make?
Nurse - Accurate assessment and the risks
Wound care - Speciality mattress for patients with skin breakdown, and choosing the correct bed for the patient.
Insurance- Coverage
Hospital - Trust to hire the employees who will do there job
Patient - Honesty about skin issues and pain
8. What critical does each stakeholder need to make good decisions?
Nurse - The nurse must assess the patient's mobility, moisture, assessment, tendencies, sweating or incontinence.
Wound care - Accurate assessment for the patient’s specific needs
Insurance - Was everything documented appropriately in the medical record and billed appropriately
Hospital - Hiring skilled nurses
9. What steps require paperwork and why?
The paperwork is done electronically. The nurses do charting of the risk assessment and the wound care team does paperwork
for the mattress order form that must be signed. There is also charting the
completion of the tasks for the speciality mattress noting that the patient is on it
and receiving treatment. It all must be documented for liability purposes.
10. What are some of the common problems or issues that prevent the stakeholders from functioning
effectively or efficiently?
The acuity of the illness as it’s hard to focus on skin assessment if other things more critical are going on with the patient.
There are only a couple of wound care team members working at a time so it's
sometimes hard to see each patient in a timely fashion. Equipment availability is
also a problem and sometimes things are on backorder. This makes it difficult to obtain a
mattress in a timely manner. The insurance companies are a problem at times as
they do not cover the mattress due to medical necessity.
This process flow describes the process taken by a nurse in regards to wound care management.
Wound care in a hospital setting can become quite complicated and dangerous for the patient.
According to NCBI explains some of the many clinical relevance issues in regards to wound
care and a clinical setting.
A process flow like the one above is important in creating an effective business process that
enables the organization to accomplish it's strategy. (Kroenke, 2015)
Sources:
1. Kroenke, D. M. (2015). MIS Essentials(4th ed.). Upper Saddle River, NJ: Pearson Education.
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