Mid Staffordshire NHS Hospital: Performance Management - Assignment Example

? Management t Report on Mid Staffordshire NHS Hospital on performance management Mid Staffordshire NHS Hospital Report on performance measurement system Introduction According to Robert Francis report, the quality of healthcare should form part of the organisational culture at the Mid Staffordshire NHS hospital. The hospital needs new approaches of organizational and managerial performance in order to enhance patient health care outcomes. Performance management is a process that increases entire organisational effectiveness through linking individual employee performance to the overall strategic goals of the organisation (Niven, 2005). Managing performance is an ongoing activity that involves identification of performance measures, implementation of the performance management system, evaluation of performance outcomes and provision of feedback for improvement purposes (Kammerer, 2009). Importance of measures of organizational and managerial performance of Mid Staffordshire Hospital Trust Organisational performance measures assess how well the organisation contributes to the attainment of its vision, mission and strategic goals. Managerial performance measures focus on how well the management plans, organises and allocates limited resources in an efficient and effective manner towards the attainment of organisational goals (Kammerer, 2009). Measures of organisational and managerial performance are importance since they enable the organization to meet the demands of external accountability and foster strong sense of internal accountability. Measures of performance provide the basis of implementing organisational strategies through identifying the expected performance goals. The measures allow for collaboration through integrating the objectives of the organisation with the key performance indicators (Kammerer, 2009). The measures enable organisations like Mid Staffordshire to meet the demands of the customers and ensure efficiency in the working processes. The measures of performance are used to ensure fairness in the organisation through linking individual employee performance to the rewards. Accordingly, performance measures improve internal communications among employees and externally with other stakeholders. The measures will enable Mid Staffordshire NHS hospital to improve communication with external stakeholders such as suppliers of medical equipment and government regulatory agencies. The measures of performance justify expenditure and costs in the organisation through ensuring cost-effectiveness and identifying the value for money committed towards improvement of organisational processes (Niven, 2005). Advantages and disadvantages of using balanced scorecard approach to organizational and managerial performance Balanced scorecard was developed by Robert Kaplan in early 1990s, but has certain advantages and disadvantages as a measure of both organizational and managerial performance. Balanced scorecard translates the mission and business strategy in to a comprehensive set of performance measures that cater for the overall organization. In addition, the performance measurement tool acts as a communication tool since it outlines the employee expectations and aims at ensuring periodic evaluation of the performance standards (Christensen, 2008). According to Daft (2010), the tool integrates both short-term and long-term measures of performance and forms the basis of employee compensation. Ideally, balanced scorecard offers an advantage as performance management system since it breaks down strategic measures to the bottom level units such as department, clinical units, and individual staff within the organization. Balanced scorecard enhances creativity and innovation in the organisation through continuous learning and growth opportunities for the staff and improvement of the processes (Ginter, Duncan & Swayne, 2013). Lastly, the performance management tool leads to unique competitive advantage through improved decision-making and improved processes in the entire organisation. However, balanced scorecard has several disadvantages since it is not easy to implement compared with other performance management systems. Another weakness of the tool is the subjectivity in the measurement of non-financial outcomes such as employee and staff satisfaction levels in the organization. According to Ginter, Duncan & Swayne (2013), balanced scorecard ignores unique situations such as the nature of the industry, the existing organizational structures and economic environment. There are difficulties in measurement of the performance outcomes due to lack of benchmarking. Lastly, implementation of the balanced scorecard is time-consuming since it requires commitment from all stakeholders, changes to business processes, training of staff and alignment of the business strategies with the performance measures (Niven, 2005). Recommendations to Senior Management Team on appropriate measures of performance The Senior management team must measure performance from four different perspectives that include financial perspective, patients perspective, internal business processes perspective and finally learning and growth perspective. From the financial perspective, the Senior Management team must identify the growth in net revenues, the revenues generated from new patients, the level of fund-raising activities and donations made towards assisting the hospital, the research grants advanced to the hospital, the market share attained by the hospital, the patient census, and overall profitability of the hospital (Marcinko and Hetico, 2012). The management must also measure the return on investments, cost-efficiency in serving patients, and economic values added in the hospital. The management should also focus on internal measures that deal with different departmental units such as pharmacy revenues, surgical unit revenues, personnel costs and administration costs (Marcinko and Hetico, 2012). Short-term measures such as increase in revenues and market share are essential in attaining long-term measures such as increase in profitability in the hospital. The financial perspective entails important measures since the survival of the hospital operations depends on the ability to cover the operating costs. The second category of measures of performance that should be implemented by the Senior Management team is the customer/patient perspective measures that aim at creating positive organisational image and ensuring customer satisfaction. These are critical measures since the profitability of the hospital and patient numbers will depend on the ability to deliver high quality services and meet the expectations of patients (Marcinko and Hetico, 2012). Some of the measures include level of patient satisfaction, rate of new patient acquisition and rate of patient retention. In order to measure the level of patient satisfaction, the management will focus on the service waiting time, the number of medical errors in diagnosis, the added services such as food and drinks, the incidents of patient falls, and rate of unanticipated readmissions (Marcinko and Hetico, 2012). Accordingly, the management must consider the satisfaction of other stakeholders such as government regulatory agencies like the Department of health and public opinion on the services offered to patients. The management must measure the changes in community support, the increase in donations due to favourable press coverage (Marcinko and Hetico, 2012). The Senior Management Team must also implement measures to assess the efficiency of the internal processes. The internal process perspective of Mid Staffordshire NHS should aim at ensuring efficiency of processes, cost reduction and enhancement of the health care services. The internal perspective contains important measures that lead to high patient satisfaction and retention thus leading to positive financial outcomes in the organisation. The internal business process measures must aim at reducing medical errors, reducing occupational injuries, and patient complaints. The management must measure the success of operation cycle and post-service cycle through measures such as service time taken to attend to one patient, the rate of innovativeness in patient diagnosis, and patient relationships management (Marcinko and Hetico, 2012). The Senior Management Team must also implement measures that aim at sustaining and improving the quality of the healthcare services in the long-turn. These measures should focus on the learning and growth perspective of the organisation. In this case, the management must enhance the quality of the intangible assets such as human capital and informational capital.The organisational must have lead indicators that will measure the attainment of employee satisfaction and rate of employee training and development in the organisation (Niven, 2005). In this case, the management must measure the increase in number of training opportunities, the continuing education credits attained by the doctors and nurses, and the amount spend on tuition reimbursements (Marcinko and Hetico, 2012). Accordingly, the above indicators will provide essential measures for the rate of employee turnover, the staff retention rates, absenteeism, employee motivation improvement and empowerment, level of job collaboration and employee job satisfaction level. The attainment of the measures will ultimately lead to high job productivity, efficiency and overall increase in the profitability of the hospital due to reduction in hospital medical errors, reduction in patient waiting time and improvement in the quality of healthcare services (Marcinko and Hetico, 2012). At the same time, the measures will enhance patient satisfaction and contribute to efficiency in processes due to acceptance of innovative working technologies. Implementation, review and evaluation of the measures of performance The Senior Management Team of Mid Staffordshire NHS hospital will have to translate the organisational strategy in to operational unit and mobilize change through transformational leadership skills. The management must deal with stakeholder resistance through articulating a shared vision and communicating how the new performance measures will benefit the hospital (Niven, 2005). The management must quantify the expected performance measures such as the desired profitability in the next on year, the expected increase in net revenues, the desired return on investments, the training costs to be incurred, and the expected employee retention ratio (Marcinko and Hetico, 2012). For instance, the management can target a profit increase of 5 percent in the next six months and long-term profitability increase of 20 percent after full implementation of the performance management system. At the monitoring stage, the management must track the attainment of key indicators, outputs and outcomes of the performance measures. The management must rely on quantitative methods that aim at analysing the financial outcomes and qualitative surveys that will provide necessary information on patient satisfaction levels and employee job satisfaction (Niven, 2005). The review process should be conducted on an ongoing basis in order to identify the progress in the attainment of critical success indicators. The findings of the review process must be used to improve the implementation process and take corrective actions in case of variances in the expected progress of implementation (Marcinko and Hetico, 2012). The management must evaluate the performance outcomes to determine their relevance, effectiveness and efficiency. The management must focus on sustainability and improvement of the current performance in order to entrench a culture of high patient health care services among the employees (Niven, 2005). The evaluation steps must identify the causal relationships between certain measures of performance, the unintended results and determine the reasons for variance between the expected performance and actual performance. For instance, the management must identify how high job satisfaction has contributed to increased profitability and how efficient technologies and training contributes to improved patient satisfaction and quality services. Lastly, the management must provide feedback to all stakeholders especially employees on the attainment of their specific job performance expectations and implement corrective actions that will enhance future organisational performance (Niven, 2005). Doctors as only stakeholders with legitimate views on performance of the hospital It would be misleading to claim that doctors are the only stakeholders with legitimate views on performance of the hospital. There are various stakeholders that have interest in the successful performance of the hospital such as patients, nurses, doctors, the management, the community, government regulatory agencies, suppliers of drugs and medical equipments, medical research institutions (Niven, 2005). The patients are interested in quality health services while suppliers like pharmaceutical companies are interested in the ability of the hospital to pay for the suppliers on timely basis. Insurance companies are interested in the ability of the hospital to control medical costs and enhance patient treatment outcomes while regulatory bodies like Department of Health is interested in the proper management and enhancement of services at the hospital. Professional associations and health sciences students are interested on the ability of the hospital to foster health related research and evidence-based treatment practices. In addition, the employees need better remuneration and safe working environment while the community is interested in the survival of the hospital (Marcinko and Hetico, 2012). Conclusion The Senior management must focus on both financial and non-financial measures of performance. The financial measures include profitability, return on investment, cost reduction while the patient focused measures include the increase in patient numbers, patient retention ratios, and patient satisfaction. The management must also implement measures that consider the staff such as the staff satisfaction levels, staff retention and their productivity. The management must measure the efficiency of internal processes and rate of learning and growth in the hospital. Reference list: Christensen, D.A. 2008. The impact of balanced scorecard usage on organization performance. New Jersey: ProQuest. Daft, R.L. 2010. Organization theory and design. Mason: South-Western Cengage Learning. Ginter, P.M., Duncan, W.J & Swayne, L.E. 2013. Strategic management of health care organizations. San Francisco: Jossey-Bass. Kammerer, M. 2009. The balanced scorecard- advantages and disadvantages. Muchen: GRIN Verlag. Kaplan, R.S & Norton, D.P. 2001. The strategy-focused organization: how balanced scorecard companies thrive in the business environment. Boston: Harvard Business School Press. Marcinko, D.E and Hetico, H.R. 2012. Hospitals & health care organizations: management strategies, operational techniques, tools, templates, and case studies. New York: CRC Press. Niven, P.R. 2005. Balanced Scorecard diagnosis: maintaining maximum performance. Hoboken: John Wiley & Sons. Read More