Lab Turnaround Time and Delayed Discharges:A Systems-Based Action Research Investigation

摘要

This paper reports an action research study in which we applied Edgar Schein’s processconsultation approach to a cross-functional problem in a large academic teachinghospital. The project task force was charged with investigating a hypothesized effect ofpoor lab turnaround time on the risk of probable discharges being postponed until thefollowing day, thereby increasing average length of stay and associated hospital operatingcosts. The tools we used at different stages of our process included group facilitation,interviews, process flowcharts, systems thinking with causal loop diagrams, and what-ifanalysis with a system dynamics simulation model. Through facilitation of the taskforce’s work, we were able to reorient each constituent group’s perspective from aparochial to a systemic view, greatly improving the task force’s functioning and chances for successful sustainable improvement.