Healthcare process analysis and improvement at the department of abdominal surgery, University medical centre Ljubljana.

Background: Healthcare processes in hospitals, like processes in companies or governmental organizations, may accumulate problems and obstacles over time, which consequently cause the processes to become ineffective. BPM is an approach for process modeling, improvement and automating, which has been used with great success for process improvement. Methods: This work was to examine the possibility of carrying out healthcare process improvement using BPM. To implement BPM ideas, a revised TAD methodology was developed, representing an important contribution to the BPM. The first three phases of the TAD methodology were introduced in a step-by-step approach. The first phase deals with process identification, the second develops the "as-is" model, and the third phase discusses process improvement by developing the "to-be" model. Results: We found that (a) the Surgery process is efficient and well organized; (b) patient stay in the clinic could be shortened; however for humane and social reasons the leadership prefers to leave the residence time as it is; (c) the process is connected to some time-consuming activities which are perfrmed in other departments and represent the bottleneck of the process. Conclusions: The following were concluded (a) BPM proved to be a suitable approach for carrying out healthcare process improvement; (b) the revised TAD methodology showed to be consistent and efficient in performing BPM approach; (c) The Surgery process discussed was found to be an effective one and no changes or improvements are needed; (d) Concerning time-consuming activities, the leadership decided to discuss this problem with the management of the departments where the activities are executed.