Process Mapping: HospitalResponse Chain (A Question for the course of Introduction toInformation System)

When someone calls 9‐1‐1, there are aseries of actions and responses that get triggered, collectivelyknown as the pre‐hospital response chain. This chain is describedbelow.

The Call for Help

When an individual experiences amedical, they typically call 9‐1‐1 for help. It is important thatthe patient stays on the phone to provide the necessary informationabout the emergency situation. The patient relays importantinformation to both 9‐1‐1 and the healthcommunication centre.

9‐1‐1 EmergencyService

The 9‐1‐1 dispatcher's responsibilityis to take the 9‐1‐1 call for help and determine if the situationrequires police, firefighters or ambulance services. In someemergency situations, more than one service can be dispatched2. The9‐1‐1 dispatcher also needs to identify the patient’s location sothat the appropriate type of ambulance can be dispatched (land, airor water)3. To make these assessments, there are a series ofquestions that are asked. The patient plays an important role inanswering these questions. The 9‐1‐1 dispatcher collects all of theinformation needed to make these assessments and enters it into the9‐1‐1 system. Once all the pertinent information has beencollected, the information and   call  are   then   immediately  transferred   to   the  health   communication   centre.  Otherwise,   the dispatcher continues to work with thepatient on understanding the situation.

Health CommunicationCentre

The health communication centre’s(HCC) responsibility is to review the information sent by the 9‐1‐1dispatcher and speak to the patient to assess the nature of thesituation and, most importantly, prioritize the response of theambulance services. Additional information from the patient istypically required to do so. Prioritization is key in situationswhere there are multiple emergency situations. If the HCCdispatcher determines that the situation is urgent, the medical andemergency information, as captured in the HCC system, istransferred to the ambulance service, and the required number ofambulances dispatched to the scene. In situations that are notconsidered urgent, alternative methods of transportation are thenarranged.

Ambulance Service

An ambulance service has a series ofresponsibilities when they are dispatched. The ambulance service isalerted to the emergency via their on‐boardsystem.    Using the location information provided,the ambulance service is then responsible for ensuring theappropriate route is taken using the navigational component oftheir on‐board system. Depending on the weather conditions,location, and time of day, the best route may change. Once theambulance service arrives at the scene, they are responsible forassessing the situation and determining whether the patient needsto be stabilized at the scene first. Depending on location,assessment, and priority, the ambulance service first determineswhich hospital is best suited for the patient. If the patientrequires stabilization, the ambulance service will work with thathospital to stabilize the patient. Specifically, they speak withthe doctors at the hospital using their hands‐free mobile phones torelay the status of the patient and to receive stabilizationinstructions. The patient is not transported until they are in astable condition. Once the patient is stabilized, the ambulanceservice continues to work with the doctors to determine whether thepatient’s situation is still critical and requires hospital care.If that is no longer the case, the ambulance service will return totheir dispatch station and complete a vehicle and supply report anda scene report.

On route to the hospital, the ambulanceservice will relay all critical information to the destinationhospital using their on‐board system as well as calling them toprovide an updated patient status and estimated time of arrival.This enables the hospital to complete all the necessarypreparations. When the ambulance service arrives at the hospitalwith the patient, the patient’s status is verbally transferred tothe receiving physician at that hospital. At this point, thephysician and team of health professionals assess and care for thepatient.

After the patient transfer is complete,there are a series of reports that need to be written and submittedby the ambulance services: 1, Patient Care and Transfer Report; 2,Scene Report (if needed) 3, Patient Invoice 4, Vehicle and SupplyReport

The patient care and transfer report isused by the hospital to fill in the patient chart and can be usedto determine on‐going treatment. The ambulance service completesthis report before leaving the hospital using their on‐board systemand electronically submits it to the hospital. When this report iscreated, a scene report is not needed. A scene report is onlycreated when the patient is not transferred to a local hospital,but assessment and care are provided at the scene. The scene reportis for internal tracking purposes.

A patient invoice will be sent to thepatient through the mail by the ambulance service: the typical costfor an ambulance service is $45 but if the receiving physiciandeemed the trip to be unnecessary, the bill will increase to $240.This information is provided by the physician in his verbal reportto the ambulance service before they leave the hospital.

Finally, a vehicle and supply reportwill be created, for internal purposes, to track vehicle mileage,gas along with wear and tear. If there are any concerns with thevehicle or if maintenance is required the vehicle is sent to thefleet garage along with a paper report documenting the concerns.The vehicle is returned to the ambulance service when the repairsor maintenance are completed.

An inventory of the supplies on boardthe ambulance is taken and a list of the items needed to bereplenished is electronically sent to the medical supplieswarehouse via EDI for restocking. It is essential that those itemsare shipped quickly so that the ambulance is prepared for the nextemergency.   The ambulance always has reserves on board,but keeping those reserves replenished ensures they will not runout of supplies in an emergency situation.

Requirement: Draw the ProcessMap for the Hospital Chain Scenario

(Note: 1, Assume thatthe individual can call for 9‐1‐1 on their own. 2 In assignment weonly have to focus on the land ambulance service; sub‐processes forthe other services do not need to be elaborated on.)