The evaluation of Mid Staffordshire NHS Foundation Trust - Coursework Example

?542575 work/Business Medical services demand total quality management and standard performance of its human resources and of the institution to strategically manage healthcare services in accordance to nationally upheld regulations and to their professional oath. This document will reexamine and review the recommendations based on performance evaluation of Mid Staffordshire NHS Foundation Trust made by Healthcare Commission (HCC) and the Department of Health (DoH) from 2005 to 2009 following alarming reports of high patients’ mortality rate under its care. Using post-investigation developments, this essay will attempt to draw lessons from this experience in the light of strategic business management principles in health care. The Trust Case MSNHSFT provides healthcare for 300,000 residents and targeted to deliver high level and culture of care by following regulations and aiding its staff to perform their duties responsibly and accountability. However, the last four years proved the institution’s failure to exhibit these themes and the increasing death toll of patients was appalling. A full independent investigation of MSNHSFT was done to hear, review, appraise and evaluate the capacity of administrators and its human resource about poor professional services, how it negatively impact to patients and eroded the institution’s credibility (Francis, 2010). Investigating team were mandated to look into the culture, systems, processes, or the general performance of management to understand how it miserably failed to meet the expectation of excellent service. The investigation gathered 966 persons and 82 staff of the Trust as respondents. Such encouraged review of the Department of Health (DoH) too and periodic monitoring since then. Recommendations were thereafter formulated for immediate actions (Francis, 2010 & Care Quality Commission, 2010). Investigation and recommendations The investigation covered reports relating to diagnoses and medication, health and sanitation, patients’ care and management, safety and risk mitigation in its facilities, nutrition and patients diet, cleanliness and infection prevention, reporting and documentation, as well as on its flow of communication (Francis, 2010 & CQC, N. and Care Quality Commission, 2010). The investigation’s results summarily pointed: failure in operations management, failures in business processes and failure in customer/patient handling aspects. a. Failures in Operations management—is illustrated with issues on (a) administration’s so much focus on processes but not on outcomes; (b) gaps between management and staff which resulted to the latter’s exclusion in management; and (c) negligence to increasing figure of mortality rate of patients (Francis, 2010 & CQC, N. and Care Quality Commission, 2010). b. Failures in Business processes -- The institution failed to maintain professional standard in the absence of genuine performance appraisal, supervision assessment and professional development. MSNHSFT has weak management decisions and was not transparent on its accountability. It also relied on false guarantees from external assessments. (Francis, 2010 & and Care Quality Commission, 2010). c. Failures in Customer/patient handling aspects—The hospital staff failed to maintain professional standard as depicted in their (a) inability to fully listen diligently to patients’ complaints; (b) failure to respond to challenges on geriatrics care; and (c) absence of concern to increasing statistics of patients’ who died while under care (Francis, 2010 & Care Quality Commission, 2010). Considering all of these problems, the investigating team and the DoH made 18 recommendations, on top of which is for the Secretary of Health to consider asking the Monitor to enforce its de-authorization over MSNHSFT, or if it will be sustained of its operation, to enforce professional standard managing this hospital foremost. Recommendations also demanded from the institution to live out professional leadership (Francis, 2010), hence must review its capability programs for staff professional development in partnership with possible stakeholders at Staffordshire University (Francis, 2010). The Board must improve its audit processes in all clinical departments based on standards and make it on a regular basis. It must professionally develop prompt response mechanism to patients’ complaints and incidents as well as resolve issues to minimize deficiency and recurrence of problems. It must follow laws and regulations to meet expectations, satisfy customers and develop social acceptance from the public by extolling credibility (Francis, 2010). The institutions’ policies, procedures and practice must be reviewed to instill discipline and inculcate the value of professionalism. In such way, constructive feedback mechanism will be appreciated between management and staff. To upgrade the capacity of its staffs, the Secretary of State and Monitor must moreover review the Trust’s training, appointment, support and accountability of executive and non-executive directors and provide disciplinary sanction in case of omission and non-performance of duties (Francis, 2010). They also needed to review the organizational structure to ensure that clinical staff and their views are engaged at all levels of decision-makings. They must thoroughly review their geriatric care for elderly patients and must have consultant’s medical inputs every week. Nurses must work with set of principles and focus on patient care (Francis, 2010). There numbers should be scaled up. To restudy the uncertain causes of death and exceedingly high mortality statistics in the hospital, DoH organized an independent working group to examine the medical and procedural methods applied to patients including collection, analysis and publication of information to promote public confidence and understanding. The DoH was also asked to examine those who are commissioned to conduct monitoring roles at Stafford Hospital but were unable to reflect the real situation of the institution. The Implication of the Investigation & Measures Based on reports, the hospitals poor performance is attributed to mismanagement of its Executive Board that is supposedly imbued with authority and mandates to exercise governance over hospital’s operation in accordance to legal standards and professional code of medical care and services. It neglected quality performance and total quality management. It failed to consider that the medical institution should be sensitive to the expectations of its stakeholders: patient, its human resources, the management, the government and the general public. Medical standard is perceived to be a level of expectation that defines the structures and processes ought to be practiced by an organization to enhance quality care. To such effect, the managers and human resources in medical field should diligently pursue its tasks following Quality Improvement and Patient Safety (QPS) through standards of Prevention and Control of Infection (PCI), Governance, Leadership & Direction (GLD), Facility Management & Safety (FMS), Staff Qualifications & Management (SQE), and Information Management (MOI). The hospital must submit to an accreditation process to institute comprehensive quality improvement. This is to ensure that hospital’s services will be patient-focused and so that its systems are structured in accordance to culture and legal framework of the country viz-a-viz healthcare. It must set core and endeavor to attain better practice standards for all to achieve. As a medical institution, it must be result-oriented and put extra-ordinary care to all patients by following professional optimum health care practices. Hence, it must inculcate and imbibe positive values to increase efficiency and effectiveness by being process-and-outcome oriented. It must exercise High Impact Actions to Care and other benchmarking tools. It must uphold dignity in the exercise of their profession and institutional mandates. Through this, the hospital will be able to reduce risks, improve its health services, enhance its system of governance, and strengthen public confidence. Table 1. Five facets of performance prism (Neely,Adams and Kennerly 2002) To sum this up, the management must likewise practice business strategic management by reviewing and redefining its purpose, core and key values, vision, mission, goals, performance objectives, key performance indicators, tactics, actions, planning issues, quality, core processes and its improvement, systems thinking, and operating principles in decision-making (Douglas, 2011, p.1 & Greasly, 2009). All stakeholders must be considered in defined strategies, process and capabilities (Neely, 2002). Its must not only focus its discussion on financial matters. While the institution is indeed holding economic responsibilities for its human resources’ remuneration, its operational expenses and for its patients care, the management should not forget that their corporate responsibilities include legal and ethical directives too. Hence, it is vital that it has its own corporate foundational philosophy to define its purposiveness whilst confronting its political, environmental, logistical, legal, technological and social concerns. Lessons Learned While the hospital is continuously upgrading its system, improving its governance and endeavoring to practice strategic management in health care, it is worth noting that all the lessons learned from the sad experience can evolved in a Hegelian dialectics to scale up healthcare service: from negative to positive. Table 2. Mortality from all activities from March 2010-2011. There is a relative decline of mortality although relative risk is observed bit high in the month of March and October of 2010. (Mid Stanffordshire NHS Foundation Trust, 2011) It should be affirmed that corporate management require vision, mission, goals, plans, performance appraisals, assessments, submission to accrediting bodies and religiously performing duties with dedication. By following standards in strategic management and keeping up to upheld values, the Trust can improve its staff recruitment, retention and satisfaction, develop networks, and follow best practices in health care. They can ably systematize its operations by working as teams to stimulate quality culture within the organization and by conduct of periodic performance evaluation against standards. Using models and guides, the hospital can demonstrate commitment to quality care, enhance its professional staff development through education, quality leadership, and by increasing its accountability (Marx, 2004). By engaging all employees in decision-makings, the management will be able to involve them in quality activities and be able to measure their level of satisfaction. Furthermore, the institution should develop access safety-focused networks to improve its care decisions and processes. State regulations should also be observed by improving a safe and low-risk facility, by developing competent staff, by quality culture of its leaders and managers, and by the use of standards and guidelines to sustainably improve its safety and quality care (Marx, 2004). Periodic performance appraisal should be conducted to also validate if services is maintained within the threshold of medical standards and rules. It must follow legally demandable regulation of the government for hospital and medical services because afterall, what are held sacred under its care are lives of people who submitted themselves for medication and it’s them, as customers, who provide the backbone for this hospital’s existence. Records and documents should also be analyzed and publicized for public’s access, including reports of death toll. By following all this, it is not impossible for this hospital to demonstrate excellence in customer service by being patient-centered through coordinated and efficient care processes. The current changes being instituted is a welcome development as it undergo transformation to engender positive impact to its goals and to its clients. Monitoring should however be sustained and for potential issues that may arise, the appropriate response philosophy should be chosen. REFERENCES Marx, David (2004). Hospital Accreditation and Patient Safety. Joint Commission International. Illinois, USA. Douglas, Eric (2011). Strategic Management. Leading at Light Speed. Leading Resources. Sacramento, USA. Francis, R. (2010a) The House of Commons Independent Inquiry into Care Provided by Mid Staffordshire Nhs Foundation Trust: January 2005 - March 2009 (HC) Volume.1. 1st edn. HMSO: Her Majesty's Stationery Office Francis, R. (2010b) The House of Commons Independent Inquiry into Care Provided by Mid Staffordshire Nhs Foundation Trust: January 2005 - March 2009 (HC) Volume.2. 1st edn. HMSO: Her Majesty's Stationery Office CQC, N. and Care Quality Commission (2010) Care Quality Commission Publishes Progress Report on Mid Staffordshire NHS Foundation Trust [online] available from < http://www.cqc.org.uk/_db/_documents/20100712_Mid_Staffs_draft__12_Month_Follow_Up_Report_edited_v5.pdf Accessed June 8, 2011 http://www.cqc.org.uk//newsandevents/pressreleases.cfm?cit_id=35769&FAArea1=customWidgets.content_view_1&usecache=false Accessed June 8, 2011. Greasley, A. (2009). Operations Management. 2nd edn. Chichester: Wiley. Slack, N., Chambers, S., and Johnston, R., (2009). Operations Management. 6th edn. Harlow: Financial Times Prentice Hall. Mid Stanffordshire NHS Foundation Trust (2011) Why are mortality rates measured? http://www.midstaffs.nhs.uk/forpatients/mortality/index.asp Accessed June 12, 2011. Neely, A.D., Adams, C. and Kennerley, M. (2002). The Performance Prism, the Scorecard for Measuring and Managing Business Success, FT Prentice Hall, London. Read More