Hospital Management System Requirements

Sheet
(Subject to further change)

This is an informal specification of what we as hospital administrators want from the

company designing a system to help us manage our hospital efficiently and effectively.

General Problem Statement

Due to budget cutbacks and general concern for providing the best service possible to the
public, we as a hospital would like to ensure that we are using our scarce hospital resources
in the most efficient manner possible. With this in mind we would like you to design a
system which will help us manage our hospital in an efficient, effective manner. Specifically
the system should help us schedule and monitor the various resources that we have at the
hospital. This includes keeping track of available beds, waiting lists for patients, patients
expected length of stay, scheduling of surgeries, patient notification and billing, scheduling
of nurses and doctors.

The following information provides a more detailed breakdown of how our hospital is
organized. The main hospital consists of one building with 10 floors. here are 7 wards
which occupy various floors of the hospital.

Ward Floors Beds

Obstetrics 8 50

Cardiology 7 50

Intensive Care 6 50

Recovery 4,5 100

Geriatrics 3 50

Pediatrics 9 50

Operating 2 20

DATA
The system must store the following information:

 For hospital (physical building):

 o # of wards
 For each ward:
o type of ward
o # of beds
 For each bed
o ward it's in
o whether or not it's occupied
o patient who's in it
o Date patient started occupying bed.

Scheduling of hospital staff must take the following information into account. Each floor
requires a supervising nurse and 5 regular nurses during the day and 1 supervising and 2
Regular nurse in the evenings. Obstetrics, Cardiology, Intensive care and Operating all
require nurses with that specialty. Two doctors with the appropriate specialty are required
during the day and one in the evening for each floor. two doctors and two nurses are
required for each operation.

For hospital staff:

 Name (Last Name, First Name)

 Address (Full Address, including city, province/state, country)
 Position (Doctor or Nurse)
 Level (Supervising, Regular)
 Specialty (Cardiology, Pediatrics...)
 Schedule to work:(which consists of the following entries)
 Date to work. (Month/Day/Year)
 Hour to start working (In military format e.g. 24:00)
 Hour to end working (In military format)
 Ward in which to work.

For doctors the following additional information:

 Operating schedule
 (all stuff from schedule above)
 type of operation
 patient to operate on

The system should also be able to keep track of certain patient information. The system
should generate a notification letter 2 week before a patient is admitted to the hospital as
well as lists of patients being admitted and discharged on the next day. Finally the system
should generate an invoice for the patients stay.

For patients:

 Name (Last Name, First Name)

  Address (Full Address, including city, province/state, country)
 Insurance number (SIN, whatever it is in the states)
 Type of treatment required.
 For patients on waiting list:
 Position on waiting list
 Priority
 Date (first on waiting list)
 For patients in bed:
 bed info
 The system should also:
 Keep track of past info.

e.g. Old schedule, patients who were there, whether or not operation was successful.

ACTIVITIES
The system must be able to perform the following actions. (JUST EXAMPLES!)

1. Must schedule hospital staff according to the following rules:

o Staff must not work too many consecutive shifts.
o Staff cannot be off work for too many consecutive shifts.
o The number of staff working must be as large as possible at
o all times.
o Doctors cannot be scheduled to work a ward and operate at the same time.
2. Manage the waiting list:
o Must be able to add patients to the waiting list
o Must be able to take patients off the waiting list:
 For those who got spontaneously better just remove from list.
 For those who got a bed, transfer patient info to bed.
 As patients removed from waiting list, positions must be updated
according to SOME rules. e.g. patients of higher priority move up list
faster.
3. Add and remove hospital staff:
o Note this may mean altering the schedule for every other staff member who is
working.

Information Required

The HMS must keep track of certain pieces of information required for operation of the hospital.
Namely:

Physical Layout of Hospital

The following information provides a more detailed breakdown of how our hospital is organized. The main
hospital consists of one building with 8 floors. There are 8 wards which occupy various floors of the hospital.
Each of the wards has certain # of beds for patients of that ward.

1. Admit/Emergency - floor 1 - 50 rooms

2. Operating - floor 2 - 20 rooms
3. Geriatrics - floor 3 - 50 rooms
4. Recovery - floor 4 - 100 rooms
5. Intensive Care - floor 5 - 50 rooms
6. Cardiology - floor 6 - 50 rooms
7. Obstetrics - floor 7 - 50 rooms
8. Pediatrics - floor 8 - 50 rooms

So the following information is needed:

For the Wards

1. Floor ward located on.

2. Type of ward (from types above)
3. Ward size ( = to number of rooms)
4. Names of doctors assigned to ward
5. Names of nurses assigned to ward

For each room

1. Room # (Must be unique for every room)

2. State of room (occupied/available)
3. Name of patient assigned to room
4. Assignment date
5. Expected date of release

Hospital Staff

The hospital staff is composed of doctors and nurses. Each of whom have a speciality in a certain field (same
as ward types). The hospital staff also have schedules at the hospital.

Information common to all hostipal staff:

 Name (Last Name, First Name)

 Address (Full Address, including city, province/state, country)
 Phone (Area code, Number)
 Staff number (9 digit number) (for payroll purposes)
 Schedule to work:(which consists of the following entries)
 Date to work. (Month/Day/Year)
 Hour to start working (In military format eg. 24:00)
 Hour to end working (In military format eg. 24:00)
 Ward in which to work
Nurses

In addition, nurses also have the following information:

 Level ( Supervising, Regular)

 Specialty (Cardiology, Pediatrics...)
 Operating schedule ( Note: all operations take place in the operating ward.)
 Date to work. (Month / Day / Year)
 Hour to start working (In military format eg. 24:00)
 Expected hour to end shift (In military format eg. 24:00)
 Type of operation
 Room # (to operate in)
 Patient(s) to operate on.

Doctors

In addition, nurses also have the following information:

 Specialty (Cardiology,Pediatrics...)
 Operating schedule (Note: all operations are in operating ward.)
 Date to work. (Month/Day/Year)
 Hour to start working (In military format eg. 24:00)
 Expected time of end of shift (In military format eg. 24:00)
 Type of operation
 Room # (to operate in)
 Patient(s) to operate on

Patient Information

The system should also be able to keep track of certain patient information.

Information common to all patients:

 Name (Last Name, First Name)

 Address (Full Address, including city, province/state, country)
 Phone (area code, local phone #)
 Insurance number (SIN, whatever it is in the states)
 Category (Emergency/Non-emergency)
 Type of treatment required (For simplicity, same as ward types).

For patients on a waiting list:

 Position on waiting list

 Priority(1...n)
 Date (when put on waiting list)
For patients in a room:

 Room #
 Date started in room.
 Date expected to leave.

Maintainence and Operations on Information

The following are operations peformed on the previous information. As well, as on retrieval of information.

1. Must schedule hospital staff according to the following rules:

o Staff must not work too many consecutive shifts.
o Staff cannot be off work for too many consecutive shifts.
o One supervising nurse must be present for each ward at all times and that
supervising nurse must have speciality of that ward.
o During the day each ward must have 5 regular nurses of which 3 must have
speciality of that ward. As well 2 doctors of that speciality must be present.
o During the night each ward must have 2 regular nurses of which 1 must have
speciality of that ward. As well 1 doctor of that speciality.
o Staff cannot be scheduled to work a ward and operate at the same time.
2. For the operations and operating schedule
o 2 doctors of appropriate speciality of operation must be present.
o 2 nurses of appropriate speciality of operation must be present.
3. Manage the waiting list:
o Must be able to add patients to the waiting list
o Must be able to take patients off the waiting list:
o For those who got spontaneously better just remove from list
o For those who got a room, transfer patient info to room.
o As patients removed from waiting list, positions must be updated as follows the
priority of the patient is how many positions the patient moves in the list.
4. Add and remove hospital staff:
o Note this may mean altering the schedule for every other staff member who is
working.
5. Changing any detail of a patient or staff member.

Retrieval of Informaton

The following must be able to be quickly retrieved from system:

1. Complete individual information for patients, doctors and nurses.

2. Be able to extract lists of:
o Waiting list (all of it)
o Nurses/doctors according to ward number,date level and specialty.
o Patients according to ward(which they occupy), date of entry n hospital, and
expected date of departure.
o Roms according to status and/or ward.
 3. System must generate a notification of admittance to patient on waiting list 2 weeks
before date of admittance. Note: the notice of admit. states: - date of admittance
o Ward of admittance
o Floor of ward
o Room # of admittance
4. System must generate an invoice when a patient leaves. Note: Invoice contains following
information: - date of admittance
o Date of departure
o Total length of stay
o Ward stayed in
o Room #

1.1 Background - Problem statement:

A significant part of the operation of any hospital involves the acquisition, management and
timely retrieval of great volumes of information. This information typically involves; patient
personal information and medical history, staff information, room and ward scheduling, staff
scheduling, operating theater scheduling and various facilities waiting lists. All of this
information must be managed in an efficient and costwise fashion so that an institution's
resources may be effectively utilized.

The City Hospital currently uses a manual system for the management and maintenance of
critical information. The current system requires numerous paper forms, with data stores spread
throughout the hospital management infrastructure. There is a fair bit of initial training required
for staff to become familiar with the paperwork and a fair bit of time is required to physically
complete and manage/organize the forms correctly.

A major problem with the current system is that often information [on forms] is incomplete, or
does not follow management standards. This requires corrections either at billing time, or worse,
after a bill has been rejected by AHC or an insurance company. For these reasons payments are
often late (some being delayed by many months). Forms are often lost in transit between
departments requiring a comprehensive auditing process to ensure that no vital information is
lost.

Multiple copies of the same information exist in the hospital. It is not uncommon for patient
information to be updated on some but not all data stores. This lag between the request for a
change and the actual change may result in a potentially damaging misinformation of staff.

Finally, staff scheduling for both the wards and the operating rooms is difficult and fraught with
errors under the current system. Staff scheduling conflicts are common, causing havoc when a
ward is either understaffed or overstaffed. Sometimes, staff with the wrong skills are scheduled,
or staff are required to work too many consecutive hours.
It is clear that the present manual system is quite cumbersome and inefficient. While the current
system is functional, the hospital's human and capital resources are not being utilized in an
efficient fashion.

1.2 Proposed Solution - the Hospital Management System:

The City Hospital has requested that Sirius Software Products design and implement an
automated Hospital Management System (HMS) to replace their existing manual, paper based
system. The new system is to control the following information; patient information, room
availability, staff and operating room schedules, and patient invoices. These services are to be
provided in an efficient, cost effective manner, with the goal of reducing the time and resources
currently required for such tasks.

The proposed HMS will increase staff productivity and efficiency by:

 standardizing data, resulting in fewer corrections and significantly lowering the incidence
of missing or incorrect data
 consolidating data stores into one location ensuring data integrity and providing a
database for future statistical and management reporting
 reducing the time spent by staff filling out forms, freeing resources for more critical tasks
 speeding up the billing process by having accurate, timely data, resulting in quicker
payments and a better cash flow
 increased error checking to reduce errors made in scheduling, making schedules more
reliable, increasing staff morale, and reducing the amount of time spent by administration
creating and publishing schedules

1.3 Users of the HMS:

Any person on staff at the hospital will be able to use the system. Normally, clerks and admitting
nurses will input patient information and print invoices, while administration staff will prepare
and enter schedules. Doctors and nurses will also be able to access the information in the HMS.
In short, the people involved with implementing the current manual system will be the end users
of the HMS.