liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Mapping of the referral management at the Department of Internal Medicine
Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
2015 (English)Independent thesis Basic level (degree of Bachelor), 20 credits / 30 HE creditsStudent thesisAlternative title
Kartläggning av remisshanteringen på Medicinklinikens mottagningar (Swedish)
Abstract [sv]

På Medicinkliniken, på Vrinnevisjukhuset, finns det ett behov av att kartlägga remisshanteringen på deras mottagningar. Därför avser denna rapport till att kartlägga dessa och ge rekommendationer på vilka problemområden som skulle kunna förbättras.

Informationsinsamlingen skedde genom observationer och intervjuer med läkare, sjuksköterskor, undersköterskor och läkarsekreterare. Utöver detta användes även historisk data från år 2014, på hur många remisser som anländer till respektive mottagning samt hur lång tid respektive mottagnings bedömningsprocess tar. Det erhölls även historisk data från januari till april år 2015 som redovisade ledtiden från mottagen till färdigbedömd remiss.

Kartläggningarna visar på att remisshanteringen skiljer sig mottagningarna emellan, där de största skillnaderna är huruvida remisserna bedöms enskilt eller i team, om mottagningarna hanterar remisser i pappersform eller digitalt samt vilken yrkesgrupp som utför de administrativa arbetssysslorna.

De identifierade slöserierna är överproduktion, väntan, felaktiga processer, utnyttjande av personal samt onödiga rörelser. Överproduktion uppstår då dubbelarbete sker när läkare arbetar i team, till följd av att den slutgiltiga bedömningen görs av läkare enskilt vid ett senare tillfälle. Till detta hör även slöseriet väntan då denna skulle kunna minskas om bedömningen utfördes direkt vid teambedömningen. Slöserierna överproduktion och felaktiga processer uppstår vid bearbetning av remisser med bristande kvalitet. Slutligen identifierades slöserierna utnyttjande av personal samt onödiga rörelser, till följd av att vissa sysslor utförs av fel yrkesgrupp.

De slutgiltiga rekommendationerna är att mottagningarna ska bedöma remisser i team, förutsatt att de har tid att skriva in bedömningen direkt i Cosmic och inte vid ett senare tillfälle. Administrativa arbetsuppgifter som inte kräver medicinsk utbildning bör utföras av läkarsekreterare. Mottagningarna bör utnyttja Cosmic i största möjliga mån och sköta remisshanteringen digitalt istället för i pappersform. Det bör även undersökas om en mall eller checklista kan skapas till de remitterande enheterna för att höja kvalitén på de inkommande remisserna till Medicinkliniken.

Abstract [en]

At the Department of Internal Medicine, Vrinnevisjukhuset, there is a need to map the referral management system at all of their divisions. This report intends to map these and provide recommendations for where there is room for improvement.

Data was collected by performing observations and interviews with doctors, nurses, assistant nurses and medical secretaries. Historical data from the year 2014 was also used to investigate how many referrals each department receives and how much time is needed for the assessment process. Historical data from January to April year 2015 was used to investigate how long the lead-time is from the referral has been received to the point where it has been assessed.

After the mapping process was completed, emails were sent to the staff that had been observed and interviewed in order to validate its correctness. These maps illustrate the differences between the departments, where the most distinct differences were whether they work alone or in groups, if they handled the referrals digitally or on paper and which profession that handle the administrative tasks.

The problem areas that have been identified and within the principles of Lean are called wastes, is over production, waiting, defects, skills and motion. Over production occurs when doctors work in groups to do the assessment, but the responsible doctor does the final assessment at a later date. Connected to this is also the waste waiting because of the extra time spent, since the assessment could have been done directly at the group assessment. The wastes over production and defects appear when processing inadequate referrals. Finally the wastes skills and motion were identified, because of some tasks being performed by the wrong profession.

The final recommendations are that the divisions should do the assessment of the referrals in groups, provided that they have time to document the assessment directly in Cosmic and not at a later date. Medical secretaries should perform administrative tasks that do not require a medical education. The divisions should exploit Cosmic and handle the referrals digitally instead of doing it on paper. The Department of Internal Medicine should also investigate whether it is possible to create a template that the referring doctors can use when sending referrals to the Department of Internal Medicines divisions, in order to increase the quality of the ingoing referrals.

Place, publisher, year, edition, pages
2015. , 52 p.
National Category
Transport Systems and Logistics
Identifiers
URN: urn:nbn:se:liu:diva-119991ISRN: LiU-ITN-TEK-G--15/060--SEOAI: oai:DiVA.org:liu-119991DiVA: diva2:838974
Subject / course
Logistics Management
Uppsok
Technology
Supervisors
Examiners
Available from: 2015-07-01 Created: 2015-07-01 Last updated: 2015-07-01Bibliographically approved

Open Access in DiVA

fulltext(1887 kB)160 downloads
File information
File name FULLTEXT01.pdfFile size 1887 kBChecksum SHA-512
0faf0643ee12f93d6db6930ec6d136e0948a43954bdb58b81f6ef390be5d83fc479263bca47625fb74f772d8deb4c41bd52b85c37690038a0a7c10b1f541a61d
Type fulltextMimetype application/pdf

Search in DiVA

By author/editor
Kajfalk, RebeccaTaylor, Robert
By organisation
Communications and Transport SystemsThe Institute of Technology
Transport Systems and Logistics

Search outside of DiVA

GoogleGoogle Scholar
Total: 160 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

urn-nbn

Altmetric score

urn-nbn
Total: 228 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf