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Achieving Timely and Processed Handling of TPA Cases

  • Tuhina Bhown
  • Agency : TPA Cases, Processed Handling of TPA, Gap Analyses
  • Objective : To identifying and to do GAP analysis of the process, To identify better practices and suggesting best implementable solutions
  • Background : The patient care services department presently is facing the problem of delayed and slow processing of TPA cases, henceforth the hospital has involved me to carry out a study and achieve timely and simple processing for TPA cases.
  • Methodology : The project work begun by initially studying the whole IPD and OPD process of TPA cases from patient  getting  authorization  form filled  that  from TPA desk to patient being handed authorization along with final bill discharge summary when the patient going out of hospital with all the formalities and paper work done. Methodology adopted consists of the following: Understanding the authorization process. Preparation and implementation of process flow.
  • Findings : Incomplete information to TPA” is major reason for most of queries, non streamlined process, extra labor and most importantly time wastage. The copy of approval is not pasted and informed to PCS, which delays discharge process many times. The format of excel sheet in use is inconvenient which leads to time wastage. Doctor's don't know if there patient’s approval has come until they ask and enquire. Incorrect estimate prepared at TPA desk as it misses to take information from Patient regarding room category.   HIS system is not linked with GNID due to which  others  cannot  know  the  status.  Instead  an  excel sheet is maintained which is accessible to all respective .The TPA does not send the running bill on its own, generally the patient informs TPA desk or bed managers do it once a week. As per hospital policy there are few priority patients also, but they are not discriminated and if done not informed to all. Patient/attendant take the form himself to the doctor to get it filled due to which the forms get misplaced and patient feels annoyed. The prescription is not sent with the form, though most of the medical queries occur due to this
  • Recommendations : Forms should be only filled at TPA desk, no forms to be taken from OPD/ IPD or if taken with incomplete information they should be asked to get the complete information so as to avoid repetition. Continuous monitoring of doctors can be done, name of doctors who don't  fill  complete  information  should  be revealed randomly  so  that  they  out  of  self  consciousness  are cautious and they should be trained for the same. Documented procedures for working of TPA can be there which states that no form to be processed without the relevant documents, the same could be strictly followed on ground.  
To identifying and to do GAP analysis of the process, To identify better practices and suggesting best implementable solutions