Turkiye Klinikleri Journal of Health Sciences

.: REVIEW
Systematic Review on Reengineering Digital Processes of Healthcare Institutions
Sağlık Kurumlarının Dijital Süreçlerin Yeniden Yapılandırılması Üzerine Sistematik Derleme
Mustafa ORHANa, Mustafa KAFESb
aDepartment of Health Management, İzmir Bakırçay University Faculty of Health Sciences, İzmir, TURKEY
bDepartment of Health Management, Necmettin Erbakan University Faculty of Health Sciences, Konya, TURKEY
Turkiye Klinikleri J Health Sci. 2021;6(4):973-84
doi: 10.5336/healthsci.2020-80883
Article Language: EN
Full Text
ABSTRACT
 Objective: Organizations make changes on their processes in order to keep their costs under control while continuing their activities effectively and efficiently. This research has been carried out to evaluate the results of reengineering practices carried out within hospitals, based on cost and benefit themes. Material and Methods: Systematic review is an important method for revealing best practices and implementation results. The systematic review method was used to analyze and interpret the data of the research and to present the findings. The systematic review was made using the PRISMA flow chart. As a result of the first examination, 1931 studies were found and 13 studies that were suitable for the inclusion criteria were evaluated within the scope of the study. Results: Reengineering practices carried out in hospitals were examined under the themes of benefit and cost and it was seen that results were obtained from various perspectives. When considered in terms of benefit; while there are studies that have shown positive results such as ease of use, health output, increase in satisfaction and productivity, it is also seen that there are studies that have not shown any benefit. In terms of cost perspective, it has been observed that there are studies showing positive results in efficiency increase and saving. Conclusion: Although the investigated studies indicate efficiency, user-friendliness, increasing satisfaction, saving or increasing income as the main objective, multiple outputs have been obtained in one study. The systematic compile review study has revealed the best practice results, and it also provides suggestive for the reengineering studies to be carried out. With the studies examined, it can be said that the reengineering studies performed in technological processes yielded positive results.

Keywords: Reengineering; hospital; change; business process redesign
ÖZET
 Amaç: Organizasyonlar, faaliyetlerini etkili ve verimli şekilde sürdürürken aynı zamanda maliyetlerini de kontrol altına almak için süreçleri üzerinde değişiklik yapmaktadır. Bu araştırma, hastanelerde gerçekleştirilen değişim mühendisliği uygulamalarının sonuçlarını maliyet ve fayda temalarına göre değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntemler: Sistematik derleme, en iyi uygulamaların ve uygulama sonuçlarının ortaya koyulması için önemli bir yöntemdir. Araştırmanın verilerini analiz etmek, yorumlamak ve bulguları sunmak için sistematik derleme yöntemi kullanılmıştır. Sistematik derleme yapılırken PRISMA akış şemasından faydalanılmıştır. İlk inceleme sonucunda 1931 araştırma bulunmuş ve dâhil edilme kriterlerine uygun 13 çalışma değerlendirilmiştir. Bulgular: Hastanelerde yürütülen değişim mühendisliği uygulamaları fayda ve maliyet temaları altında incelenmiş ve çeşitli perspektiflerde sonuçlar elde edildiği görülmüştür. Fayda teması açısından bakıldığında; kullanım kolaylığı, sağlık çıktısı, memnuniyet ve verimlilik artışı gibi olumlu sonuçlar veren çalışmalar bulunmasına karşın fayda üretemeyen değişim mühendisliği çalışmaları olduğu da görülmektedir. Maliyet açısından bakıldığında ise verimlilik artışı ve tasarruf konusunda olumlu sonuçlar veren çalışmalar olduğu görülmüştür. Sonuç: İncelenen çalışmalar, ana hedef olarak verimlilik, kullanıcı dostu olma, memnuniyet artışı, tasarruf veya gelir artışı göstermesine rağmen bir çalışmada birden çok çıktı elde edilmiştir. Sistematik derleme çalışması, en iyi uygulama sonuçlarını ortaya koymakta ve aynı zamanda yürütülecek değişim mühendisliği çalışmaları için de fikir vermektedir. İncelenen çalışmalar ile birlikte, teknolojik süreçlerde yapılan değişim mühendisliği çalışmalarının olumlu sonuçlar verdiği söylenebilir.

Anahtar Kelimeler: Değişim mühendisliği; hastane; değişim; iş sürecinin yeniden tasarımı
REFERENCES:
  1. Barjis J, Verbraeck A, Shim SJ, Kumar A. Simulation for emergency care process reengineering in hospitals. Business Process Management Journal. 2010;16(5):795-805. [Crossref] 
  2. Aktan CC. Organizasyonlarda insan yönetimi: İnsan mühendisliği [Human resources management in organizations]. Organizasyon ve Yönetim Bilimleri Dergisi. 2011;3(2):387-406. [Link] 
  3. Stanton S, Hammer M, Power B. Reengineering: getting everyone on board. IT Magazine. 1993;25(4):22-7.
  4. Hammer M, Stanton SA. The reengineering revolution: A handbook. 1st ed. New York: HarperBusiness; 1995. [Link] 
  5. Certo SC, Certo ST. Modern management: Concepts and skills. 13th ed. USA: Pearson Higher Ed; 2013. [Link] 
  6. Aromataris E, Pearson A. The systematic review: an overview. Am J Nurs. 2014;114(3):53-8. [Crossref]  [PubMed] 
  7. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8(5):336-41. Erratum in: Int J Surg. 2010;8(8):658. [Crossref]  [PubMed] 
  8. Leggat SG, Bartram T, Stanton P, Bamber GJ, Sohal AS. Have process redesign methods, such as Lean, been successful in changing care delivery in hospitals? A systematic review. Public Money & Management. 2015;35(2):161-8. [Crossref] 
  9. Polit DF, Beck CT. Essentials of nursing research: Appraising evidence for nursing practice. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. [Link] 
  10. De Ramón Fernández A, Ruiz Fernández D, Marcos-Jorquera D, Gilart Iglesias V. Support system for early diagnosis of chronic obstructive pulmonary disease based on the service-oriented architecture paradigm and business process management strategy: Development and usability survey among patients and health care providers. J Med Internet Res. 2020;22(3):e17161. [Crossref]  [PubMed]  [PMC] 
  11. Rungvivatjarus T, Kuelbs CL, Miller L, Perham J, Sanderson K, Billman G, et al. Medication reconciliation improvement utilizing process redesign and clinical decision support. Jt Comm J Qual Patient Saf. 2020;46(1):27-36. [Crossref]  [PubMed] 
  12. Menon A, Fatehi F, Bird D, Darssan D, Karunanithi M, Russell A, et al. Rethinking models of outpatient specialist care in Type 2 diabetes using ehealth: Study protocol for a pilot randomised controlled trial. Int J Environ Res Public Health. 2019;16(6):959. [Crossref]  [PubMed]  [PMC] 
  13. Huynh N, Snyder R, Vidal JM, Sharif O, Cai B, Parsons B, et al. Assessment of the nurse medication administration workflow process. J Healthc Eng. 2016;2016. [Crossref]  [PubMed]  [PMC] 
  14. Melton BL, Zillich AJ, Russell SA, Weiner M, McManus MS, Spina JR, et al. Reducing prescribing errors through creatinine clearance alert redesign. Am J Med. 2015;128(10):1117-25. [Crossref]  [PubMed] 
  15. Venkatesh AK, Hajdasz D, Rothenberg C, Dashevsky M, Parwani V, Sevilla M, et al. Reducing unnecessary blood chemistry testing in the emergency department: Implementation of choosing wisely. Am J Med Qual. 2018;33(1):81-5. [Crossref]  [PubMed] 
  16. Fisher AM, Mtonga TM, Espino JU, Jonkman LJ, Connor SE, Cappella NK, et al. User-centered design and usability testing of RxMAGIC: a prescription management and general inventory control system for free clinic dispensaries. BMC Health Serv Res. 2018;18(1):703. [Crossref]  [PubMed]  [PMC] 
  17. Pérez-Benito FJ, Sáez C, Conejero JA, Tortajada S, Valdivieso B, García-Gómez JM. Temporal variability analysis reveals biases in electronic health records due to hospital process reengineering interventions over seven years. PLoS One. 2019;14(8): e0220369. [Crossref]  [PubMed]  [PMC] 
  18. Baysari MT, Del Gigante J, Moran M, Sandaradura I, Li L, Richardson KL, et al. Redesign of computerized decision support to improve antimicrobial prescribing. A controlled before-and-after study. Appl Clin Inform. 2017;8(3):949-63. [Crossref]  [PubMed]  [PMC] 
  19. Federman A, Sarzynski E, Brach C, Francaviglia P, Jacques J, Jandorf L, et al. Challenges optimizing the after visit summary. Int J Med Inform. 2018;120:14-9. [Crossref]  [PubMed]  [PMC] 
  20. Jafar AJ, Fletcher RJ. Using field hospital simulation to demonstrate changes in completion rates of a UK emergency medical team (EMT) medical record. Progress in Disaster Science. 2020:100072. [Crossref] 
  21. Liu W, Walsh T. The impact of implementation of a clinically integrated problem-based neonatal electronic health record on documentation metrics, provider satisfaction, and hospital reimbursement: A quality improvement project. JMIR Med Inform. 2018;6(2): e40. [Crossref]  [PubMed]  [PMC] 
  22. Luna DR, Rizzato Lede DA, Otero CM, Risk MR, González Bernaldo de Quirós F. User-centered design improves the usability of drug-drug interaction alerts: Experimental comparison of interfaces. J Biomed Inform. 2017;66:204-13. doi: [Crossref]  [PubMed] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com