Operations Management - Business

Process Reengineering - Example

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 Operations Management - Business
Process Reengineering Assignment
Notes:
● Wasteful and less value adding activities are the reason of slowing down process.
● The flowchart has to be in logical sequential steps.

Question: A patient visits clinic at 8 am in the morning and leaves after getting treated after 9:30 am.
Write down the process steps and draw a process flowchart. Allocate time to
activities(decision-making, breakpoints) and compute process time. Reengineer this process and
compute process time after reengineering.

Solution:
Example: Stomach ache at the right side of the patient.

Process steps before Reengineering:

1. 8:00 am - 8:01 am: The patient reaches the clinic and gets token (token for registration or
already registered patient) which takes about a minute.
2. If patient is already registered, the patient collects token for already registered member, straight
away proceeding to step 6.
3. 8:01 am - 8:06 am: The patient waits in the reception area for 5 minutes as there are other
patients waiting for registration before him.
4. 8:06 am - 8:11 am: He registers himself as he is first time to the clinic. All his personal details
are required for registration therefore it took 5 minutes to enter all details.
5. 8:11 am - 8:14 am: The receptionist checks whether the insurance card he is having covers the
medical expenses or not in this clinic. The computer where she is checking for the insurance
validity is slower than normal computers so it takes 3 minutes.
6. 8:14 am - 8:16 am: Once confirmed by the receptionist, the patient submits his insurance card to
her. If patient’s insurance card is not valid for the clinic, patient needs to fill form for payment
by cash/cheque after the treatment. Both of these process involves 2 minutes.
7. 8:16 am - 8:19 am: If the patient did not registered previously, receptionist and nurse produces a
database file for record after registration which takes up to 3 minutes.
8. 8:19 am - 8:20 am: Patient collects token for doctors examination and consultation.

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 9. 8:20 am - 8:25 am: One patient is undergoing pre-screen test by the nurses. So the patient have
to wait for 5 minutes.
10. 8:25 am - 8:35 am: Pre-screen tests performed by the nurses on the patient that includes
checking blood pressure, height, weight, body temperature etc. This process takes about 10
minutes.
11. 8:35 am - 8:45 am: Patient have to wait for another 10 minutes as the doctor is examining
another patient.
12. 8:45 am - 8:46 am: Patient enters the doctors cabin which takes about a minute.
13. 8:46 am - 8:51 am: Before examining the patient, the doctor talks to another patient or his family
members for 5 minutes.
14. 8:51 am - 9:03 am: Doctor examines the patient for 12 minutes.
15. 9:03 am - 9:08 am: It is assumed that the patient is suffering stomach ache in the right side. To
check if there is appendicitis, ultrasound test is performed so the patient waits for 5 minutes as
the nurses and clerks in charge for handling the lab equipments need this time to set up for
performing the test.
16. 9:08 am - 9:18 am: Doctor performs ultrasound test on the patient which takes about 10 minutes.
17. 9:18 am - 9:23 am: Doctor prescribes all the required medicines which takes about 5 minutes.
18. 9:23 am - 9:27 am: Nurse prepares insurance form for the medicine coverage by the insurance
which takes her 4 minutes.
19. 9:27 am - 9:29 am: Patient pays the minimum amount(10% of the medical fees as the rest is
covered by the insurance) to the counter and signs the bill which takes 2 minutes.
20. 9:29 am - 9:30 am: Patient leaves the clinic.

This process in form of flowchart is depicted in the next page.

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From the flowchart, it is identified that there are couple of wasteful and less value adding activities that
has been slowing down the business process in the clinic. Steps to reduce or eliminate these activities
i.e. Reengineering steps:

1. Implementation of official mobile application and website: Official mobile phone application
and website will be implemented such that it allows the patients to register themselves from their
homes and accordingly allows the user to select the insurance card they are using. If the
insurance card the patient holds is not in the application or website, then this card is not valid for
covering medical expenses. So, once the user enters all his details followed by selection of
insurance card he is holding or if he is non-insurance holder he have to fill other details for
payment in the app or website itself. Then app and website will automatically produce the
patient file and store in the clinic’s database electronically in the computer. It will also allow the
patient to book appointment in advance such that they do not have to wait for the doctor before
other patient(s). This step will reduce time by: 5+5+3+3+1 = 17 minutes as whole registration
process and other entry of details such as insurance card will be done in the home of the patient.
The registered patient will have unique id which is to be represented to the receptionist.
2. Replace old computers with new computers such that the processes are executed seamlessly.
3. Place automated machine that will automatically measure the patient's height, weight, body
temperature, blood pressure etc rather than nurse doing it manually using variety of equipments.
Initially pre-screen tests used to take 10 minutes. Now, by making use of the automated
machine, it will take only 2 minutes. And also the patient have to wait for 1 - 2 minute
maximum as patients came before will get pre-screen test faster. Therefore, this step will reduce
time by 11 minutes.
4. Rule must be imposed such that the doctors must be restricted to talk to other patients for only 2
minutes in presence of patients. Only when there is no patient, they can talk to other patients or
families for 5 minutes. Otherwise, they will be penalized or punished. Hence, time will be
reduced by 3 minutes.
5. The equipments for ultrasound must be setup in advance by the nurses and clerks before the
patient enters the laboratory area. This will reduce time by 3 minutes. 2 minutes will be taken by
the other doctor to reach the laboratory who will perform ultrasound test.
6. The application and the website will enable the nurse to enter only medicine details. Rest of the
details of insurance card will already be pre-written while preparing insurance paper as the

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 patient have entered the insurance card details before taking appointment. This will save time by
2 minutes.

Process steps after Reengineering and its flowchart and new times computed shown in the next page:

1. 8:00 am - 8:02 am: Patient reaches the clinic and goes to the reception to submit unique id.
2. 8:02 am - 8:03 am: If the patient is an insurance card holder, he submits his insurance card to the
receptionist which takes about a minute. Otherwise proceed to step 3 directly.
3. 8:03 am - 8:04 am: Patient then collects token for check-up.
4. 8:04 am - 8:06 am: Patient is waiting for other patients to get done.
5. 8:06 am - 8:08 am: Patient undergoes pre-screen tests via a single automated machine that
records body temperature, weight, height, blood pressure etc.
6. 8:08 am - 8:09 am or 8:08 am - 8:16 am: If patient doesn't take appointment via the application
or website, he will have to wait for 8 minutes else he will directly enter doctors cabin.
Note: assume he took appointment for the next steps.
7. 8:09 am - 8:11 am: Patient waits for the doctor to treat him in his cabin as he is in conversion
with other patient(s).
8. 8:11 am - 8:23 am: Doctor examines the patient suggests him to go for ultrasound test as he is
having pain in the right side of the stomach.
9. 8:23 am - 8:25 am: Patient waits for another doctor who will perform ultrasound test who takes
time about two minutes to reach to the laboratory.
10. 8:25 am - 8:35 am: Ultrasound test is performed on the patient.
11. 8:35 am - 8:40 am: After doctor sees the ultrasound test images directly on the computer itself,
doctor makes prescription to take certain medicines.
12. 8:40 am - 8:42 am: Nurse makes insurance paper for medicine coverage. She will take only 2
minutes in this scenario as most of the insurance details will be pre-written as the patient have
registered already before coming to clinic.
13. 8:42 am - 8:44 am: Patient proceeds to pay the required amount followed by signing on papers.
14. 8:44 am - 8:45 am: Patient leaves the clinic.

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