Service Design: Reliability Theory - Coursework Example

SERVICE DESIGN: RELIABILITY THEORY By Abuthamer [Sur Presented to [Your Presentation] Table of ContentsTable of Contents 2 Introduction 3 High Reliability Theory 5 Organisational Design 5 High Reliability Organisations 6 Designing an Organisation to Achieve High Reliability 7 Local Stage 7 Control Stage 8 Open Stage 8 Deep stage 9 Discussion 9 Conclusion 10 References 11 Introduction The conception and creation of value in different aspects of the economy require designs that enhance the promotion of the best outcomes. In this regard, it is important to ensure that the planning and organising of people, the infrastructure in an organisation, the communication system, and all the material components used in an organisation was foolproof. In effect, the achievement of these activities and their successful planning and organisation ensures that an organisation provides the best services to its clients. In addition, effective planning and organisation of these key elements in an organisation ensures that an organisation achieves customer satisfaction since it improves the interaction between customers and service providers. Importantly, this interaction ensures that a customer plays an important role in the services that an organisation offered. This role is crucial in helping an organisation achieve success in improving the quality of services that an organisation offered while ensuring that the services were suited to the customers’ needs. This systematic approach to providing services in the manner that fit a customer’s needs is service design (Bate and Robert, 2007). Significantly, this system of operation ensures that organisations manage customer service experiences by managing the key elements in an organisation. In line with this, it is important to point out that service design is one of the key elements that influence innovations in various organisations (Stamm and Trifilova, 2009). Service design encompasses various concepts and theories that guide its efficiency and effectiveness in various organisational settings. One important theory in service design is the reliability theory. In fact, the overall role and importance of service design is to ensure that organisations became reliable by responding to the needs of the customers in an approach that was efficient and effectively addressed their needs. In the healthcare setting, various stakeholders and players in the industry highlight the important role of ensuring that customers received the best quality of care every time they visited a healthcare facility or sought the services of other providers of healthcare services. This is a momentous challenge in an industry such as the healthcare industry with the need to improve on the safety and quality requiring a change in the system design and process, which improves reliability in the healthcare organisation (Hines, et al., 2008). The changes in these systems are important in addressing the essential elements that promote high reliability in an organisation and especially in the healthcare industry with the greatest concern being the need to improve the quality of care. In this regard, concern for quality of care given to patient has been the most important factor in healthcare with some researchers positing that it is as old as the field of medicine (Maxwell, 1984). In effect, various studies have been put in place in order to ensure that the quality of care improved. However, the definitional elements that indicate the presence of the quality of care are not sufficiently addressed. Case in point, the Institute of Medicine (2001) defined six elements in their definitional criteria of quality care. In this regard, the IOM noted that quality care should be available in a timely manner, which is consistent with clinical needs. Secondly, quality care should be patient centred with the patient participating in the process of care giving. Conversely, care should be effective based on current evidence in care giving and providing patients with the required benefits. Moreover, quality care should be efficient and provided without wastage of resources. In addition, there should be equitable provision of care to all people regardless of their gender, race, and social class. Finally, the IOM proposed the need for care to be safe with an intention to help patients. In line with this, the IOM failed to incorporate the importance of organisations to inculcate high reliability in healthcare as one of the key elements to providing quality care. In line with this, this expose investigates the reliability theory in healthcare. In doing this, the expose investigates key aspects of reliability such as the organisational design, high reliability organisations, stages in achieving high reliability, and finally provide practical applications and implications in practise. High Reliability Theory Organisational Design The strategy and goals of an organisation require support from various subparts in an organisation. In line with this, the design of an organisation should involve the important aspects of dividing tasks to different employees, assigning roles to departments, decision making on the choice of technology to integrate in an organisation, and most importantly the establishment of policies and procedures in an organisation. Therefore, a formal organisational design should focus on the division of the roles that an organisation can play and those that an organisation can hire from other organisations. For example, a hospital setting might be part of a larger system in the healthcare sector, private or public hospital, and many other aspects. In addition, the hospital can position expertise in various approaches such as service lines, geographical locations, information systems, and other functional departments (Charns and Tewksbury, 1993; Nadler, et al., 1997). Organisational designs traditionally focus on the formal structures in an organisation. In line with this, it is important for an organisation to expand its focus on organisational design in order for the organisation to attain high reliability. In this case, the design should include a focus on important elements such as procedures, policies, and practises that are essential for making the structure of an organisation active (Carroll and Rudolph, 2006). For example, a study by Edmondson (2002) found contradictory results between surgical teams that learned the same techniques based on the different leadership techniques and communication approaches that the members of the surgical teams experienced. In effect, achieving high reliability in an organisation requires maintenance and sustenance of the efficiency of the structures in an organisation by ensuring that the organisation and planning of people and the culture in an organisation was efficient and effective. High Reliability Organisations The results of an organisation are essential in defining high reliability organisations. In this regard, high reliability organisations should operate in an environment that can be harmful to people in the organisations although these organisations provide predictable results that were effective (Weick, n.d.). Simplification and standardising of operational tasks in organisations is fundamental in achieving reliability (Reason, 1997). In addition, it is essential for organisations to anticipate and find approaches that dealt with the disruptions that may inhibit performance in an organisation (Wildavsky, 1988). The healthcare industry is multifaceted, volatile, interdependent, and full of unforgiving and evolving technologies challenged by the unpredictability of individual patients, shifts in financial patterns, and filled with incomplete evidence bases (Schulman, 2004). In effect, these factors prevent an organisation from relying on a service design that was traditional, but rely more on the aspects of the reliability theory. Staffs in a high reliability organisation are constantly wary about their roles in all levels. In addition, high reliability organisations exhibit prompt decision making in order to deal with urgent situations. In effect, high reliability theory offers an organisation a service design that integrated training services in an organisation, avoids bureaucracy during decision-making, and enhances flexibility in an organisation (Schulman, n.d). Nonetheless, it is essential to point out that these elements are challenging for managers and supervisors to comprehend, which makes their implementation in the organisational setting a challenge. In effect, a service design for high reliability should be an on-going process that involves various states that require various conditions to achieve success and make an organisation a high reliability organisation (Cardinal, et al., 2004). Designing an Organisation to Achieve High Reliability Service design for a high reliability organisation is a continuous process that involves four fundamental steps. These steps are local stage, control stage, open stage, and the deep stage, which is the final stage. Importantly, each stage has its own challenges although integrating some elements of the high reliability theory addresses these challenges. Local Stage An organisation operates in systems that are local as characterised by the organisation’s local variability and informal work practices, which vary among departments. In effect, this requires a reinvention of practises for an organisation in the healthcare sector instead of using the already established industry benchmarks, which might not work in the particular setting. Consequently, this enables local autonomy that fosters innovation, improvisation, and specialisation in different aspects, which improve the reliability in an organisation (Carroll and Rudolph, 2006). Control Stage In this stage, it is crucial to master the routine in an organisation while accompanying standardised clinical services with characteristics that are essential in inhibiting qualities that contradicted other qualities (Weick and Westney, n.d.). Nonetheless, the fundamental challenge in this stage is the approach that managers will use in order to maintain and sustain control while addressing the unique problems that an organisation faced (Rudolph and Repenning, 2002). In the healthcare sector, high reliability designs are achievable in the control stage by inculcating practises that were based on a factory model of service design. Case in point, a healthcare organisation can reduce the levels of nosocomial infections by using hand-washing practises within the healthcare facility. On the other hand, a healthcare facility can avoid wrong site surgery by using other procedures such as the ‘sign-your-site’ procedures (Rogers, et al., 2004). Open Stage In this stage, there are various elements of service design that support high reliability with these elements having an origin from processes and structures within an organisation known as ‘heedful interrelating’ (Weick and Roberts, 1993). By heedful interrelations, individual practitioners in the same healthcare facility attend to each other’s concerns while sharing their experiences with knowledge gained from the distinctive experiences and insights offered by each member in the organisation. In effect, this enables a healthcare facility to improve cooperation amongst its workforce and promote high reliability (Berwick and Nolan, 1998). Deep stage Linking the positive aspects of the local, control, and open stages in an organisation contributes to the deep stage in achieving high reliability in an organisation to systems thinking. In this case, a healthcare organisation will perceive interrelationships between conditions that identify patterns that are long-term in nature. In line with this, an organisation is able to integrate tools that map out causal relationships and find hidden factors that inhibit success in an organisation (Senge, 1990). In effect, these tools are crucial for promoting high reliability in an organisation. Discussion It is evident that service design that promote high reliability necessitate balancing and integration of goals and objectives of an organisation, or individuals in an organisation, that were different and often conflicting. In each of the stages provided, a healthcare facility can inculcate practical service design elements that were appropriate in managing different conflicts and challenges that are unique within an organisation. Healthcare systems and facilities can move towards achieving high reliability by engaging the previous three steps in the process, which culminate to the deep stage in order for these organisations to achieve reliability. In order to achieve, improve, and maintain high reliability, it is crucial for organisations in the healthcare sector to manage the conflicts that arise from strict bureaucratic controls and recurrent improvisational adjustments. Nonetheless, these organisations can only exercise control partially by compromising between the rules and the chain of command within the organisation on one hand, and professional culture and the aspect of local leadership within the healthcare organisation on the other hand. In effect, this concept of striking a compromise between these two differing elements is an essential step towards ensuring an integrated approach that achieves high reliability within an organisation. In effect, service design that promotes high reliability in a healthcare organisation improves the practices within the organisation while addressing the issues of innovativeness and the routine followed in the organisation. Conclusion Based on the foregoing, it is evident that achieving high reliability in the healthcare system is a challenging task and organisations should undergo a process in order to achieve this level of reliability. In line with this, high reliability organisations observe the most stringent conditions that enhance the safety of the employees. For the healthcare system however, achieving high reliability requires organisations to ensure safety and delivery of quality care to clients. In effect, it is pertinent for organisations in the healthcare sector to ensure that their operations, structures, and process were designed in an approach that aligned the most important elements that will ensure achievement of high reliability in an organisation. In this case, various elements of the service design in the reliability theory ensure the achievement of high reliability within an organisation in the healthcare sector. References Bate, P. and Robert, G. B., 2007. Bringing User Experience to Healthcare Improvement: The Concepts, Methods and Practices of Experience-Based Design. Abingdon: Radcliffe Publishing. Berwick, D. M. and Nolan, T. W., 1998. Physicians as leaders in improving health care: a new series in Annals of Internal Medicine. Annals of Internal Medicine, 128, 289–292. Cardinal, L., Sitkin, S. and Long, C., 2004. Balancing and rebalancing in the creation and evolution of organizational control. Organisation Science, 15, 411–31. Carroll, J. S. and Rudolph, J. W., 2006. Design of high reliability organizations in health care. Quality and Safety in Health Care, 15, 4-9. Charns, M. P. and Tewksbury, L., 1993. Collaborative management in health care: managing the integrative organization. San Francisco: Jossey-Bass. Edmondson, A., 2002. Disrupted routines: team learning and new technology implementation in hospitals. Administration Science, 46, 685–716. Hines, S., et al., 2008. Becoming a High Reliability Organization: Operational Advice for Hospital Leaders. Rockville: Agency for Healthcare Research and Quality. Institute of Medicine (IOM)., 2001. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington: National Academies Press. Maxwell, R. J., 1988. Perspectives in NHS Management: Quality assessment in health. British Journal of Medicine, 288, 1470-1472. Nadler, D., Tushman, M. L. and Nadler, M. B., 1997. Competing by design: the power of organizational architecture. New York: Oxford University Press. Reason, J., 1997. Managing the risks of organizational accidents. Aldershot: Ashgate. Rogers, M., et al. (2004). Barriers to implementing wrong site surgery guidelines: a cognitive work analysis. IEEE Transactions on Systems, Man, and Cybernetics, 34, 757–63. Rudolph, J. W. and Repenning, N. P., 2002. Disaster dynamics: understanding the role of quantity in organizational collapse. Administrative Science, 47, 1–30. Schulman, P. R., 2004. General attributes of safe organizations. Quality and Safety in Health Care, 13(Suppl II), 39–44. Schulman, P. R., n.d. The analysis of high-reliability organizations: a comparative framework. In: K. H. Roberts. Ed., 1993. New challenges to understanding organizations. New York: Macmillan, pp.33–53. Senge, P. M., 1990. The fifth discipline: the art and practice of the learning organization. New York: Doubleday. Stamm, B. V. and Trifilova, A., 2009. The Future of Innovation. Surrey: Gower Publishing Limited. Weick, K. E. and Roberts, K. H., 1993. Collective mind in organizations: heedful interrelating on flight decks. Administrative Science, 38, 356–381. Weick, K. E., Sutcliffe, K. M. and Obstfeld, D., n.d. Organizing for high reliability: processes of collective mindfulness. In: R. I. Sutton, and B. M. Staw, eds., 1999. Research in organizational behavior. Stamford, CT: JAI Press, pp.81–123. Weick, K. E. and Westney, E., n.d. Organizational learning: affirming an oxymoron. In S. R. Clegg, C. Stewart, and W. R. Nord. Eds. The handbook of organization studies. Thousand Oaks: Sage, pp.440–58. Wildavsky, A., 1988. Searching for safety. New Bruswick: Transaction Books. Read More