Process Analysis:

Arnold Palmer Hospital

Background
● Arnold Palmer Hospital is one of the largest and most respected
hospital for treating women and children.
● 4th busiest labor and delivery hospital in the U.S
● One of the largest neonatal intensive care units
● Ranks in the top 10% of hospitals nationwide for patient satisfaction
● Goal is for a 100% patient satisfaction rate
Statement of the
Problem
What can the company do to help retain a high
satisfaction rate for patients?
Flow of Maternity Patients

1. Enter APH’s Labor & Delivery (L&D) check-in desk entrance.

2. If the baby is born en route or if birth is imminent, the mother and baby are
taken directly to Labor & Delivery on the second floor and registered and
admitted directly at the bedside. If there are no complications, the mother and
baby go to Step 6.

3. If the baby is not yet born, the front desk asks if the mother is pre-registered.
(Most do preregister at the 28- to 30-week pregnancy mark.) If she is not, she
goes to the registration office on the first floor.
Flow of Maternity Patients

4. The pregnant woman is then taken to L&D Triage on the 8th floor for assessment. If
she is in active labor, she is taken to an L&D room on the 2nd floor until the baby is
born. If she is not ready, she goes to Step 5.

5. Pregnant women not ready to deliver (i.e., no contractions or false alarms) are either
sent home to return on a later date and reenter the system at that time, or if
contractions are not yet close enough, they are sent to walk around the hospital
grounds (to encourage progress) and then return to L&D Triage at a prescribed time.

6. When the baby is born, if there are no complications, after 2 hours the mother and
baby are transferred to a “mother– baby care unit” room on floors 3, 4, or 5 for an
average of 40–44 hours.
Flow of Maternity Patients

7. If there are complications with the mother, she goes to an operating room
and/or intensive care unit. From there, she goes back to a mother–baby care
room upon stabilization—or is discharged at another time if not stabilized.
Complications for the baby may result in a stay in the neonatal intensive care unit
(NICU) before transfer to the baby nursery near the mother’s room. If the baby is
not stable enough for discharge with the mother, the baby is discharged later.

8. Mother and/or baby, when ready, are discharged and taken by wheelchair to
the discharge exit for pickup to travel home
 1) As Diane’s new assistant, you need to
Discussion Questions flowchart this process. Explain how
the process might be improved once
you have completed the chart
2) If a mother is scheduled for a
Caesarean-section birth (i.e, the baby
is removed from the womb surgically),
how would this flowchart change?
3) If all mothers were electronically (or
manually pre registered, how would
the flowchart change? Redraw the
chart to show your changes
4) Describe in detail a process that the
hospital could analyze, besides the
ones mentioned in this case
 APH Labor &
Delivery Check-in

Is/was baby’s birth

Yes No
imminent?
Is the mother
Admittance preregistered?
No

Registration
Birth 1st floor
Yes
Assessment
Yes
Complications?
Yes
Active
Baby Labor? Walk around
No Mother or return at
another date
NICU
Nursery No
Mother/Baby ICU
Care Unit

Discharge

Flowchart
 1. To start, it would be advisable to consolidate
Answers to the registration process at a singular place,
regardless of whether the the child is en route
Discussion or not. It also does not seem to include several
possibilities, like if the mother requests for a
Questions C-section birth, or if baby was born on the way
to the hospital.
#1 As Diane’s new assistant, you need to
flowchart this process. Explain how the
process might be improved once you have
completed the chart.
 Check in desk

Answers to yes

Discussion
Imminent Birth?

Is admitted to a Is pre
bed? registered?

Questions yes
no

no ye
s

Registration
yes Office
#2 If a mother is scheduled for a Birth
Has a schedule for a
Caesarian Section

Caesarean-section birth (i.e, the baby is yes

Taken to
Triage
removed from the womb surgically), how
would this flowchart change? Any Issues? no
Is fit for
no birth?
Wait in the premises
/ go home
yes

Return Child
Baby
to mother Mother or Baby?
Mother NICU

Operating nursery
room / ICU
Discharge
 Check in Desk

Answers to Enroute/ Imminent

yes no
Discussion Admitted at
bedside
birth?
Scheduled for
C-section?

Questions Birth
yes
no

Taken to
Triage Return at
#3 If all mothers were electronically (or yes prescribed
Complications? time
manually pre registered, how would the
Active Go home or
flowchart change? Redraw the chart to yes
Labor? no wait ‘til ready
no
show your changes With
mother or
Sent to
baby? baby
Mother/
baby care mother
unit NICU
Operating
room/ ICU
Nursery
The order of the flowchart would
change with step 3 becoming step 1 Discharge
and the rest would follow.
 Process that companies could analyse that
Answers to were not mention:
Discussion ● What specific instructions could be
Questions given to the patients if they were sent
home
#4 Describe in detail a process that the ● Which patients would be put on
hospital could analyze, besides the ones
mentioned in this case priority for treatment
● Specific list of treatments that would
occur if complications were to arise
Answer to the As seen earlier, the company uses a flow for
the smooth process for the patients. A flow
Statement of the chart will help organize the process, so less

problem incidents will occur. It must also be

constantly updated to different scenarios
that may arise to avoid any confusion in the
future.
Alternative Courses
of Actions
The use of Service
Blueprints
Interaction with Customers
The use of Value
Stream Map
Customer x Suppliers
 Design and
Constant change of

Structure Processes
Global Focus with one
Common Goal
Corporate Social Responsibility (CSR)

● Compliance and Ethics Program

○ Assists the organization with its commitment to conducting its
business in full compliance with applicable federal and state
statutes, regulations, the Code of Conduct and corporate policy
○ Aids in the prevention, detection, and resolution of deviations from
expected behavior
○ Compliance Hotline - simple, risk-free way for team members to
report compliance concerns
Corporate Social Responsibility (CSR)

Healing Beyond the Hospital Walls

● Safety and Injury Protection

○ Clinics on bike, car seat, and pedestrian safety.
● Healthy Families Programs
○ Local outreach to prevent child abuse and neglect, increase the rate of
childhood immunizations, reduce family stress levels and reduce the
incidence of repeat teen pregnancy in targeted communities
● Teen Xpress
○ Mobile health unit that provides free medical and mental health care for
at-risk youth