A study of organizational alignment at a Boston area hospital and its effects on patient throughput in the peri-operative areas

Abstract

Capacity is an ongoing issue when managing hospital resources. Looking at the hospital as a supply chain of care services provided to the patient enables us to better evaluate problems such as delays on a systems level. A Boston Area Hospital has been experiencing delays in the operating rooms when moving patients into the post-anesthesia care unit (PACU). As the different services of the hospital are inherently reliant upon each other, this issue cannot be isolated and resolved in this one hospital area. As this is the initial year of this research collaboration, the purpose of this work is to serve as a map of the surgical patient's pathway through the hospital, with emphasis on the patients that move through the PACU, and identify areas that merit further research and study. Reasons behind delaying factors have been identified through interviews of different members of the organization and direct observation. Applying a the congruence model in evaluating the alignment of objectives, resources, critical tasks and vision is a useful model for identifying potential areas of disconnect in the system.

(cont.) A pilot social networking survey was also conducted in the PACU and produced data that showed it is a useful tool in evaluating the informal communication structure and organization it relates to accomplishing critical tasks. Applying these tools and models will be useful in evaluating different areas of the hospital, identifying problem areas, and aligning the objectives of the different units, departments and professions to a more unified, strategic vision that fosters change.