BOTTLENECK ANALYSIS FOR PELVIC EXAMS

The bottleneck that exists for pelvic exams quickly translates to a department wide slow down. It starts with a patient being assigned to a room or piece of equipment that is not necessarily used for the condition that is presented by a patient. For instance, a male patient is lying on a stretcher designed for GYN exams because there were no other stretchers available. A woman entering the ED right after he has been lifted onto the stretcher expresses pain in her abdomen and must either wait for the GYN stretcher or occupy a regular stretcher. If the male is waiting to be admitted to the hospital, the woman could have a very long wait for an exam that should take only about five minutes. This leaves the woman on the regular stretcher waiting, thereby reducing the capacity of the ED instantaneously.

In a related scenario, the GYN stretcher or room is left unoccupied until there is a case to fill it. This immediately reduces the capacity of the ED by creating specialized treatment areas, capable of handling only one kind of medical problem. At some point of overcrowding, the GYN stretcher or room is assigned to a patient not requiring its special functions. Then the cycle begins again as described above.