University of Twente Student Theses


Developing a tool to address bottlenecks in the current practice of the TCT

Bekkering, N.D. (2015) Developing a tool to address bottlenecks in the current practice of the TCT.

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Abstract:Background: Inappropriate patient stay can be defined as an inefficient and ineffective overstay of patients that is not tailored to their needs. This can include waiting for a diagnosis or an intervention as well as recovering from the intervention or waiting for an available bed at a nursing home for further recovery. Through realising a decrease in the inappropriate patient stay of patients in the hospital, the bed availability will increase and the lead time of the process a patient goes through decrease. This results in a more efficient and more effective system. Since the hospital of Enschede (Medisch Spectrum Twente) moves to a new building and does not fit into the new building with their current usage of beds, mapping the bottlenecks becomes very important. In addition it is preferred to provide a solution for the bottlenecks to realize successful moving. This thesis focuses on mapping the bottlenecks in the current practice of the Thorax Centre Twente, to improve the continuous flow of cardiac surgery patients. Approach: This individual assignment starts with a broad analysis of the current processes within the Thorax Centre Twente. Different categories of patients that are related to this medical specialty, as for example patients from other hospitals or emergency cases are identified and many different related and unrelated bottlenecks are discovered. The related departments are mapped and their current practice is summarized. Hereafter, the scope of the assignment can be defined in more detail. The focus for further development will be on cardiac surgery patients. Together with the involved stakeholders the underlying causes of the bottlenecks are discovered. The approach results in an unstructured list of related as well as unrelated bottlenecks, which vary in their importance. To realise more structure, an architecture of the system is used as a framework. This architecture is created by reverse architecting. Results: After going through all the previously stated steps, it became clear that solving one single bottleneck does not result in global optimization of the process. Therefore, the decision was made to design a tool that provides support when solving one after the other bottleneck. To begin with, a morphological chart is used to structure the bottlenecks that were the outcome of the analysis. Hereafter, clustering is used to select the most promising bottleneck for continuing. For the next step, A3 Architecture overviews are used to map the interests of the key stakeholders. The usage of the A3 Architecture Overview resulted in the development of a new tool that supports the investigator and designer to evaluate possible solutions and modifying it until an ideal solution is evolved. A case study is used to verify and improve the usability of the developed tool. In addition it provides an example to clarify the adopted approach used to solve bottlenecks.
Item Type:Essay (Bachelor)
Faculty:ET: Engineering Technology
Subject:20 art studies
Programme:Industrial Design BSc (56955)
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