University of Twente Student Theses


Process Mining in Healthcare: Gaps between protocol and clinical practice of critical side findings in radiology

Quak, Remi (2020) Process Mining in Healthcare: Gaps between protocol and clinical practice of critical side findings in radiology.

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Abstract:All hospitals are forced to reduce costs while improving the quality of healthcare. Protocols have been drawn up in order to improve healthcare processes based on the most advanced knowledge and practice. According to the literature, various factors cause deviations from the protocol, but to date, there is no research into these deviations within the process of critical side findings in radiology. Therefore, the following research question has been formulated: What is the adherence to protocols in critical side findings processes in radiology? The processes are divided into acute and semi-acute, and in non-acute critical side findings. To analyze these deviations, a case study was conducted at two Dutch hospitals. This research is conducted according to the FRAM method and uses three data sources. The work-as-imagined was based on the protocols and guidelines. Subsequently, process mining analyzed the adherence to the protocol. Ultimately, the influencing factors were identified by semi-structured interviews. Process mining shows that the protocol deviations are workarounds. The documentation of communication is omitted, and many findings are not followed up. Process mining shows a global view of the processes but does not show the causes and consequences. Therefore, process mining cannot be used as a sole method for gaining an in-depth view of healthcare processes. To optimize healthcare processes, it is crucial to conduct qualitative research. Various factors explain workarounds. Medical practitioners omit the documentation, as they do not consider it relevant to patient care. The confirmation of communication is also interpreted differently by each polyclinic. Problems that appear in the follow-up of critical side findings are mainly caused by the lack of a protocol and the fact that medical practitioners perceive no clear responsibilities. The factors lead to a model, which visualize the relationships between the factors and the workarounds. The factors are divided into organizational, personal, and patient-related. The organizational factor, lack of personnel, causes that activities are carried out by unauthorized medical practitioners. The second organizational factor is the lack of the polyclinic’s understanding of the IT applications. This dearth of knowledge obstructs the third organizational factor; the adoption of IT. In addition, the personal factor, lack of perceived relationship between the protocol and patient health, causes workarounds to bypass administrative activities. The patient-related factor, exceptional patient symptoms, causes those critical side findings are not communicated if follow-up does not stimulate health. The results of this study emphasize the importance of a reduction in the administrative burden on medical practitioners: identify the critical activities and eliminate unnecessary activities. Future research should focus on smart technologies for administrative activities to reduce effort.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:54 computer science, 58 process technology, 85 business administration, organizational science
Programme:Business Administration MSc (60644)
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