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Research at AIIMS (2 weeks)
Different perspectives of the emergency department, all of it leads to one goal - to save peoples lives. How all of it is connected and leads to one another is what our rich picture is all about!
Guided by: Tarun Sharma
Team: Advaith MA, Neel Deshmukh, Nihalkrishna NB, Parth Kathare & Prerana Maria Alok. Special thanks to AIIMS Mangalgiri for their co-operation.
AIIMS Mangalgiri's Emergency Department experiences an average patient footfall of 50-60 everyday.
Context:
During disasters, accidents or peak hours, there is an unpredictable spike in the patient footfall which increases commotion and patient waiting time in the premises.
Objective:
This case study aims to understand the Emergency Department (EMD) of AIIMS Mangalgiri and its system, narrowing down to drivers which ultimately improves patient care and increase staff efficiency.
Understanding & developing our rich picture.
Different perspectives of the emergency department, from patients & nurses in the front-end, to the staff and administration in the back-end, all of it leads to one goal - to save peoples lives. How all of it is connected and leads to one another is what our rich picture is all about!
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The following Iceberg Model, Component map, Inter-relation Diagraph & Causal Loop
aptly represents our understanding of the system at the Emergency department.
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Problem Identification.
We observed from the Causal loop that few factors such as excess workload, unavailability of staff, stand-by time and supply depletion are the major drivers that directly or indirectly affect patient care. Factors causing this shift were highlighted via the root cause analysis. Inefficient communication and manual form-filling/documentation, a common factor which influences majority of the causal loop was observed.
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Delay in form filling and briefing.
Expanding the Reinforced loop (R1) further to get Reinforced loop (R3) where the workload keeps on increasing - a vicious cycle affected by the form filling process.
This manual process causes confusion, increasing workload and slows down tasks, harming patient care and staff morale. Incomplete records also add administrative burden, reducing efficiency - only nurses & doctors fill out these forms.
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What is wrong with existing forms at the EMD?
Intervention: Automatic form filling system.
​A digital system where nurses and doctors can fill out patient forms using tablets or computers directly at the patient's bedside or at strategic points in the EMD. These systems should be connected to a central database for real-time access by all medical staff.
Speculated impact of the intervention.
The existing scenarios where the manual form filling is practised takes an average 15 minutes off the staffs work schedule. The improved form filling system can cut the time to half, to an average 7.5 minutes.
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Speculated change in the Causal Loop.
The Reinforced Loop (R3) is now a Balancing Loop (B5) - Better availability of Staff, Reduced Workload, Increased patient care & Reduced stand-by time of patients.
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Learnings & Challenges.
There are some external factors or challenges that would occur due to the automatic form filling system.
As this interventions seems very adaptive, going for a creative or a generative solution with a much larger leverage & impact is always preferable. The field work and this case study is what made me grow passionate towards design research, systems thinking and innovation for social impact & well-being.
“Efficient & happy staff lead to better patient care.”
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