The process of outpatient care of children and adolescents in a tertiary‐level hospital specializing in pediatrics: A case study focused on identifying opportunities for improvement with the aid of modeling using BPMN

• Author: Rui Rijo,Domingos Alves,Silvia Inês Dallavalle Pádua,Francisco Barbosa,André Luiz Teixeira Vinci
• Date: 01 July 2018
• DOI: http://doi.org/10.1002/kpm.1571
• Published date: 01 July 2018

CASE STUDY

The process of outpatient care of children and adolescents in a

tertiary‐level hospital specializing in pediatrics: A case study

focused on identifying opportunities for improvement with the

aid of modeling using BPMN

André Luiz Teixeira Vinci

1,6

|Francisco Barbosa Júnior

1

|Silvia Inês Dallavalle de Pádua

2

|

Rui Rijo

3,4,5,6

|Domingos Alves

1,6

1

Ribeirão Preto Medical School, University of

São Paulo, Ribeirão Preto, Brazil

2

College of Economics, Business and

Accounting, University of São Paulo, Ribeirão

Preto, Brazil

3

School of Technology and Management,

Polytechnic Institute of Leiria, Leiria, Portugal

4

Center for Research in Health Technologies

and Information Systems (CINTESIS),

University of Porto, Porto, Portugal

5

Institute for Systems Engineering and

Computers at Coimbra (INESC Coimbra),

University of Coimbra, Coimbra, Portugal

6

Intelligence Laboratory in Health, Ribeirão

Preto Medical School, University of São Paulo,

Ribeirão Preto, Brazil

Correspondence

André Luiz Teixeira Vinci, Ribeirão Preto

Medical School, University of São Paulo,

Ribeirão Preto, Brazil.

Email: altvinci@usp.br

Introduction: Business process management has gained importance in organiza-

tions for providing improved productivity and cost reduction, with process modeling

being the central role. Usually, with reduced resources, the health area can benefit

from good management of its processes.

Objective: To identify proposals for improvements in the process of outpatient care

of children and adolescents in a tertiary‐level—the most specialized and complex—

pediatric hospital.

Methods: A bibliographic survey on the subject and a case study with in loco

observation of the processes with semistructured interviews with the professionals

involved were carried out. Alpha Hospital was chosen for this study, and the model-

ing of the process was performed using Business Process Model and Notation.

Results: Twelve relevant articles were identified. The “AS‐IS”model of the process was

obtained as a result and presents the existing 4 subprocesses (patient reception,

preconsultation, consultation, and postconsultation). Specifically, the following improve-

ment opportunities were identified: (a) process monitoring through indicators; (b) adequacy

of the information system; (c) creation of service evaluation mechanisms; and (d) definition

and application of training sessions for whenever a new professional begins working in a

specific sector. The problem with the waiting time for patient care was also identified,

but with no obvious solution; further studies should be carried to solve the problem.

Conclusion: The use of the business process modeling approach and process

analysis allowed the hospital team awareness of the process and the identification

of an improved set that can be helpful to Alpha Hospital or be used by other hospitals.

1|INTRODUCTION

Business process management (BPM) combines knowledge from

information technology and management paradigms (van der Aalst,

2004; Weske, 2007) and uses them to identify, design, execute,

document, measure, and monitor business processes so that the

desired results can be achieved (Association of Business Process

Management Professionals [ABPMP], 2013).

Currently, BPM has gained importance in organizations because of

its potential for improving productivity and reducing costs (van der

Aalst, 2013). For the correct and efficient use of BPM, it is necessary

to obtain an understanding of the processes, how they are applied in

the context in which they are inserted, how many resources they con-

sume, and whichwill be the expected results (Harrison‐Broninski,2010).

The combination of information technology with BPM paradigms

can lead to large gains, such as time, input savings, and satisfaction,

Received: 1 February 2017 Accepted: 20 April 2018

DOI: 10.1002/kpm.1571

Knowl Process Manag. 2018;25:193–206. Copyright © 2018 John Wiley & Sons, Ltd.wileyonlinelibrary.com/journal/kpm 193