Contributed by Jx Tan

Technology companies are continuously borrowing lessons conceived within other industries such as retailers, financial institutions, and hospitals. As disparate as these fields may be, they share a key objective: meeting supply and demand while delivering a good experience.

This article presents key concepts of Hospital Emergency Department Management based on an interview with a frontline physician with 10 years’ worth of experience at Emergency Departments across various Singapore hospitals. These concepts, covering heavy workloads, prioritising different patients’ needs, risk assessment and crisis management, are quite applicable to technology companies when evaluating its aftersales service strategy.


Dr Lim with over 10 years of experience of working in Emergency Medicine shared why the concepts of “Input”, “Throughput” and “Output” matter when managing Hospital Emergency Departments. Dr Lim said that Emergency Medicine serves to identify and rescue patients’ lives. In Emergency Medicine, the doctor’s main goal is not to make 100% accurate diagnosis, but must not miss any potentially deadly situation, give treatment, and stabilise other conditions, and then transferred to the ward to observe. However, despite its life-saving focus, Dr Lim stressed that Emergency Departments did not turn away patients.

Patient (customer) Journey Highlights:

During an 8 to 12 hour shift, Emergency Departments in Singapore handle around 400 patients. With such a high patient volume (averaging 50 patients per hour for an 8-hour shift), Emergency Departments have developed a set of procedures (summarised in Chart 1 below) to ensure that assessment (Patients get a “P1”, “P2” or “P3” rating with “P1” being the patients with the most urgent needs) is done so that “P1” patients get seen first. In hospitals elsewhere, a similar prioritisation takes place as well.

Chart 1 – Emergency Department Procedures

chart 1.jpg

These procedures are based on the principles of Bona Diagnosis, bona curatio (Good Diagnosis, good cure). A well-trained Triage nurse is essential to this process and there is a check in the form of a senior physician double-checking priority of treatment. Adequate resourcing, experience, training, a well-designed work area for different specialisations and teamwork are essential ingredients to make these procedures work well.

In terms of inputs, Emergency Department will roster staff for a shift based on historical patient patterns as well as other factors, e.g. whether a marathon is taking place. Once a shift begins, Emergency Department staff track a dashboard of parameters (Changi General Hospital example shown in Chart 2 below) to track throughput and output and identify blockages that develop. As appropriate, staff can adjust to clear blockages, e.g. adjust resourcing between different specialisations in line with the patient mix (throughput) and investigate whether facilities such as Operating Theatres, can be turned around more quickly (output).

Chart 2 – Changi General Hospital Dashboard

chart 2

Emergency Departments also need to deal with unexpected surges in patients, e.g. crisis that produce many casualties. In such a scenario, Emergency Departments have a plan to call up staff from other wards and off-duty staff.

Despite planning, Dr Lim acknowledged that Emergency Departments required the support and understanding of its patients. Emergency Departments continue to undertake public education efforts to encourage non-critical patients to visit their regular doctors prior to consultation at an Emergency Department as this will enhance throughput. Summing up, Emergency Departments target to strike the right balance between patient well-being, efficiency, safety and staff morale.

Best Practices:

chart 3.jpg

Emergency Departments’ patients are its customers. Similarly, technology companies with B2C business models face customers facing unexpected problems of varying complexity and may seek their assistance at any time. Like Emergency Departments, technology companies cannot turn away its customers for simple queries.

Technology companies deliver digital products and may choose to digitally service its customer, unlike Emergency Departments. If customers are consuming a digital product like an app, it is possible to track their digital experience. Using a mobile analytics tool like Countly, it is possible to automatically trace a customer’s actions leading up to a service issue and view specific error messages. This is more efficient relative to Emergency Departments posing questions to customers and having to verify their answers.

Optimising customer service through digital channels require a plan. Therefore, if technology companies can incorporate the operational excellence of Emergency Departments (to deal with more idiosyncratic problems) with its inherent digital advantages, there is potential to deliver a brand of superior and robust customer service. However, McKinsey’s survey of over 4000 European companies confirms most of these companies lack strategic and detailed implementation programs. I have summarised potential Emergency Department best practices in the following table:

Segmenting based on aftersales support

Many technology companies segment users based on their potential Lifetime value or propensity to spend but not based on aftersales support. This may be a missed opportunity as the cost of obtaining new customers is 4-5 times relative to maintenance of existing customers. In addition, existing customers are 50% more likely to try new products and spend 31% more relative to new customers. Therefore, referring to Emergency Medicine department procedures has the potential to greatly enhance aftersales support. The good news is that technology companies, with the capability to automatically record user behaviour, have the potential to do even better than Emergency Medicine departments. Such commitment to operational excellence will separate technology companies from their competitors.

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About the Jx

Tan Jx.jpgJx Tan is Countly Analytics’ Chief Growth Officer (China & APAC). He is a MSc (Marketing & Consumer Insight) graduate from the Institute on Asian Consumer Insight at Nanyang Technological University, Singapore. Founded in 2012, Countly’s Open Source framework represents a new category of collaborative technology that answers difficult questions like segmenting customers’ need for aftersales support based on their digital behaviour and crash data.



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