Process Management and Process Improvement - Floyd Medical Center - Case Study Example

Process Management and Process Improvement Introduction Floyd Medical Center Floyd Medical Center is system of healthcare that has provided healthcare to the public for the last fifty years. The hospital is a Level II trauma center that provides healthcare for a large geographical location within United States in Floyd County, Georgia. The medical centre originally served only Floyd County in Georgia but has evolved to serve even larger locations within the United States. It now serves over 6 counties and has over 300 beds for acute care and also serves as a referral centre for many locations within which it operates. The hospital has an annual average patient throughput of over 400,000. It has over 300 beds for acute care which helps the hospital to deal with many thousands of outpatients as well as hospitalized patients every year. Floyd Medical Center and its many affiliates are managed by the Floyd Healthcare Management Inc. Floyd Healthcare Management Inc. is responsible for the success of the hospital in terms of its mission and its daily operations. Floyd Medical Center is also a Primary Stroke Center and its excellence in dealing with primary stroke can be seen in the fact that it has received gold seal for this from the joint committee. EXTERNAL ENVIRONMENT The external environment is a critical factor for success for Floyd Medical Center. With regard to implementing a hand hygiene best practice policy, the challenges that may come in are with regard to the following; Finances; it can be very expensive for such a big hospital like Floyd Medical Center to be able to implement this kind of strategy because a lot of money is involved. As the economy in the US is not exactly on its best footing today, it means that this has a significant impact on the hospital with regard to the fact to maintain a good hand hygiene best practice will need Floyd Medical Center to spend some money. The material and equipment needed to implement this in a hospital-wide way in such a big hospital will defiantly be a big issue. Number of services offered Competition from other hospitals in the region Competition from other hospitals in the region is also another factor that must be looked at. Although most hospitals are in the regions such as the Memorial Health University Medical Center are not for profit firms, the competition is nonetheless an important issue that must be considered. Patients want to go to a hospital where they can get the best healthcare at the least cost. This can have a fundamental impact on a hospital like Floyd Medical Center even if it is not profit oriented. Supply chain issues Although Floyd Medical Center does not have control over the supply chain, it affects the internal operations. For it to be able to efficiently manage its internal operations, the hospital has to be able to be served by a very good supply chain and this will mean that it will be necessary fro to be able to come up with a way to make it even easier for the supplies to reach the hospital. DISTINCTIVE COMPETENCIES Long history Although having a long history is not necessarily a positive strategic requirement, a long history for a hospital is necessary for the hospital to be able to learn from. This makes the hospital experienced in terms of the way it is able to deal with situations. Having been there since 1942, the hospital has been able to gain experienced in the way it deals with some of its operations. The hospital also serves a wide geographical area which makes it possible for it to be able to deal with some issues in market. Size According to Fraise (2012), a big organization has a better advantage in most areas with regard to issues such as economies of scale. Because of its size, the hospital is able to have economies of scale especially with regard to procurement. This has a two way advantage to the hospital. First, the hospital can manage to have a bargaining power over suppliers with regard to the unit cost. This means that Floyd Medical Center is able to come up with ways in which it can save on cots on many areas. This can also translate into the strategy for hand hygiene. Secondly, Floyd Medical Center can take advantage of its size with regard to the fact that is can use its size strategic advantage with regard to the fact that it can use that to control the suppliers. The suppliers in this case include the suppliers for the equipment needed such as soap dispensers, driers, and also soaps. This can be very useful for the organization. Its past performance and its crowning by the Joint Committee as a stroke primary care centre is also another important advantage that the Floyd Medical Center has. This can be very useful for the firm. Facilities The hospital has developed for many decades and has grown to have an amalgam of many facilities that can be used for the benefit of the hospital. This is very important in that it makes it possible for Floyd Medical Center to be able to have smooth operations.\ Technology Floyd Medical Center has been a major development in the Floyd Medical Center. Floyd Medical Center has been one of the hospitals that have been able to acquire the state of the art technology in healthcare. This makes it possible for Floyd Medical Center to be able to be able to serve its patients in a better way. Technology and equipment are some of the factors that determine the success of a hospital and any hospital of healthcare centre that is able to provide high quality care to its patient. Technology also makes healthcare employees to not only be productive and effective in their jobs. This is also very important in that it makes it possible to achieve operational effectiveness. COMPETITIVE PRIORITIES Cost versus quality In almost any organization, whether for-profit or profit oriented firm, the need to balance between cost and quality is always a critical issue. This is because for the organization to keep the quality at its highest, they have to incur more and more cost. Cost and quality have a direct relationship where if one increases, the other also increases. Yet, organizations need to keep the costs down while at the same time continuously increasing their quality of service or product. This dilemma is faced by every organization. However, for hospital such as Floyd Medical Center, this is even harder because this is a nonprofit organization. It is also even harder for Floyd Medical Center as a public healthcare provider because they have to give the best healthcare service while at the same time keeping the costs down. For Floyd Medical Center, this is a major competitive priority for the firm in order to ensure that they are operationally fit to continue providing the many hundreds of thousands of patients with the best quality service. Quality and service The quality of service is one of the areas where Floyd Medical Center seeks t make sure that it achieves the highest. Floyd Medical Center has always taken pride in making sure that it provides the patients and their families who come to the hospital always get the best service and that they can recover as fast as as possible, not only in terms of their physiological health but also in terms of their mental well being. When Floyd Medical Center performs well in this area, it has done its duty to the public. Efficiency While efficiency in terms of cost management is an important factor for Floyd Medical Center, efficiency in terms of treating patients is also another area that Floyd Medical Center considers to be important for its long term success. This hospital serves over 400,000 patients every year. Failing to be swift in the way these patients, most of whom are acute care patients, can lead to a big bottleneck for the hospital and it is absolutely necessary for Floyd Medical Center to be able to serve these patients in the most efficient way in terms of time. OPERATIONS MANAGEMENT ISSUE As has been discussed, Floyd Medical Center serves over 400,000 patients every day. This introduces an issue with regard to how patents are handles by the hospital staff, especially with regard to hand hygiene. In particular, the management operations issue at Floyd Medical Center is with regard to hand hygiene. This is because Floyd Medical Center does not meet the threshold with regard to hand hygiene standards. The problem with this is that that lack of proper hand hygiene leads to increased patient risk. Most of infectious disease can easily be transmitted by hospital staff from one patient to another through hand contact and this means that proper observation of hand hygiene can and does reduce this risk by a very high percentage. However, at Floyd Medical Center, the level of hand hygiene is too low which leaves patients at an increased high danger of being infected by diseases from other patient through the nurses or clinicians who are taking care of them. The reason why the level of hand hygiene at Floyd Medical Center is too low is with regard to the fact that there seems to be no clear policy as to how the staff are empowered and sensitized to observe the right hand hygiene practices. This lack of best practice has been caused by a number of important factors. These factors include; Lack of proper logistics with regard to how hand hygiene is implemented in the hospital This is very important because without this, there is no way that the staff can be able to adhere to best practices with regard to hand hygiene in the hospital. In this regard, logistics refers to the issue of how available the materials and equipment need for hand hygiene are for the hospital staff. Floyd Medical Center does not have these resources at the right positions within the hospital so as to make it more possible for the staff to adhere to best practice for hand hygiene. The other issue with regard to logistics is with regard to how these materials are provides. Not only are these materials not provided at the right locations, they are also not provided in the best way. For instance, the use of soap dispensers is not well utilized in order to make sure members of staff can and will be able to use this in a an effective way. Most of these staff such as doctors and nurses are always too busy running up and down to meet the needs of the many patients that come in. This leaves them with little time to wash their hands and carry out other activities that are related to hand hygiene, such as scrubbing their hands and arms with alcohol based handrubs. Lack of education to members of staff with regard to this issue Although medical professionals are trained at college level about the need for hand hygiene, they do not really get to appreciate this in the work place and any hospital needs to have a training program with regard to the need for hand hygiene (Lippincott Williams & Wilkins, 2007). Floyd Medical Center does not have a training and sensitization program as to the importance of the hand hygiene in the context of healthcare. This means that there is a lax between theory and practice of hand hygiene. Lack of role models who are able to inspire the other staff to be able to adhere to the proper hygiene standards Studies show that the use of role models is important in making sure that the rest of the staff stick to best practice (World Health Organization, 2013). The role models are important in making sure that the other follow with regard to observing best practice. In Floyd Medical Center, there are no role models, (at least not official ones) who can inspire the other members of staff to adhere to hand hygiene while they are going about their business. This is a very big issue for Floyd Medical Center and there is a need to ensure that the members of staff can have role models in order inspire and encourage them to adhere to hand hygiene best practices. Lack of involvement of leadership in terms of implementing a best-practices for hygiene guideline Like in almost any good operational or strategic issues, the involvement of the senior management is important for implementing best practices. The involvement of managers helps in at least two ways. To begin with, this makes it easier for any budgetary issues to be well covered (Soule, 2012). When managers are included and aware of the problem that needs to be solved, they are likely to support the solution in term of financing it. Secondly, the leaders act as role models and as has been seen in this article, lack of role examples models has been one of the issues that make it hard for Floyd Medical Center to be able to have the right levels of best practice with regard to the issue of hand hygiene in the healthcare context. When people in leadership positions are involved in the process, they act as role models to encourage the other employees to be involved in the process. However, this has not been seen in Floyd Medical Center and there is a need to ensure that the leaders are involved so that the two advantages that come with involving leaders will be achieved. SOLVING THE OPERATIONS MANAGEMENT PROBLEM Goals To increase the level of best practice with regard to staff adherence to hand hygiene To increase patient safety and protect them from unnecessary contraction of infectious diseases Objectives To make it more convenient for staff to use hand hygiene methods To increase patient awareness and participation To provide Floyd Medical Center with a strategy to increase the adherence of its staff to the best practice with regard to hand hygiene Proposed Alternative Strategies Increase availability of equipment and resources (such as hand wash soaps, alcohol based handrubs, paper towels etc.) Increase availability of explicit hand hygiene policies and guidelines in the hospital. Involve the leaders Create role models to be emulated in the hospital by other members of staff Create mechanism for accountability Involve the staff in crating further strategies Analysis of Proposed Alternative Strategies Strategy: Increase availability of equipment and resources (such as hand wash soaps, alcohol based handrubs, paper towels etc Data indicates that when these resources are made available at the right place, this increases the chance of doctors and nurses and even other support staff to adhere to hand hygiene standards. The fact that Floyd Medical Center does not have these resources located at the place where they are convenient for the members of staff to use them to adhere to the hand hygiene means that this discourages hand hygiene. Implementation This will be easy to implement except for the cost. To implement this strategy, there will be a need to ask for financing in order to make sure that these resources are procured. An analysis will be done in order to see where it is necessary to have these items and then from there a budget can be developed. These resources will be strategically located around the hospital to help the people to easily access them. Strategy #2: Increase availability of explicit hand hygiene policies and guidelines in the hospital. Past studies have indicated that the lack of a clear guideline is one of the strongest factors that make it hard hospital staff to adhere to hand hygiene standards. In Floyd Medical Center, there are no clear guidelines for maintaining high levels of hand hygiene at the hospital. Implementation A committee will to be made in order to develop best standards and guidelines for the members of staff to be following. This will help in making sure that all members of staff are aware of what is required from them with regard hand hygiene. The other problems that should be highlighted with regard to this strategy is the fact that just having a good policy does not necessarily mean that things will happen by themselves. As a result, this policy, once developed, will have to be published and the employees will also have to be sensitized with regard to the issue of hand hygiene. The use of visual aids will also be important in order to help the members of staff to always remember to use the resources identified in strategy one. These visual aids will be strategically placed where it will be easier for the members of staff to see them. They will be located in locations where the doctors meet the patient in order for the doctors to always remember to apply hand hygiene before and after handing a patient. This will be very useful in reducing the risk of transferring infectious disease from one patient to another. Strategy 3: Involve the leaders Floyd Medical Center definitely needs leaders to be in the first line to see that the best practice for hand hygiene has been achieved. This will make it possible for the hospital to not only achieve strategy 2 as discussed above, but will also be a big step towards making sure that the hospital has been able to protect its patients. Having he leaders involved will create a basis for a best practice environment where all people can come together and work as a team to make hand hygiene best practices to be practice at all times. Implementation Those concerned will ask for a meeting with managers in order for this to be communicated. A proposal will be developed that will be given to the managers and directors in order for them to have an understanding as to why this is necessary for Floyd Medical Center, both in the short time as well as in the long run. It is necessary to note that most of the leaders may not even medical practitioners and this will mean that they may not appreciate or understand the need for this. As a result, a proposal that will clearly outline the benefits of having all the leaders in the implementation will be put down. Strategy #4: Create role models to be emulated in the hospital by other members of staff This strategy will be combined with the strategy number 3 because they are very similar. However, extra caution will have to be taken in order to make sure that Floyd Medical Center will have the role models to set examples. It must also be appreciated that there will be difficulties with regard to creating role models because role models are supposed to occur by default instead of a few people being chosen to be role models. Strategy# 5: Create mechanism for accountability This strategy will not be considered for now due to the fact that it is a complex matter than may need a long term process. Creating accountability mechanism to identify how members of staff are adhering to hand hygiene practices can be a challenging process because of the fact that it may have to involve monitoring them and the members of staff may be uncomfortable with this kind of strategy. However this is not something that it completely new and in fact even the World Health Organization suggests that direct monitoring can be one of the most effective ways to increase staff adherence to hand hygiene practices. However, to be able to create accountability, there are some measures that can be used to measure hand hygiene. These are; Direct observation Direct observation can be a very effective way to monitor the staff in regard to whether they are adhering to best practices of the guidelines that have been laid. However, as identified above, this can bring in ethical issues that may need to be looked at. Product use monitoring Challenges of using product use hygiene; There is no method to tell if the professionals are using he right methods or whether they are doing it the right way. There is no way to determine that they are doing at the right time. For instance, the workers may be using the amount of soap that is deemed to be indicative of the right level of hygiene, but if they are not using the soap just before handing a patient or before handing a new patient, it will mean that they are not adhering to the guidelines (Joint Commission, 2009). This means that this method may need to be used together with another method such as the direct observations. Surveys These will be important in getting data about perceptions and attitudes towards hand hygiene. This can be done directly or indirectly through the phone. Strategy# 6: Involve the staff in crating further strategies This strategy will be merged with strategy number 2 which is about creating a guideline for hand hygiene best practices. Involving the member of staff in implementing strategy that will be important in that the staff is more able to adhere to this strategy is they were involved in creating it in the first place. Conclusion It is highly crucial to ensure that the hand hygiene is improved in Floyd Medical Center. The problem that was identified is that Floyd Medical Center does not have a proper hand hygiene strategy and this is a problem because it puts the patients and their families at increased risk of getting infectious disease transmitted to them from other patients through the hands of the doctor. Various strategies were identified that can be used to solve this issue and make sure that high level of hand hygiene is achieved in Floyd Medical Center. These strategies include increasing the availability of equipment and resources (such as hand wash soaps, alcohol based handrubs, paper towels etc). At the same time creating an explicit hand hygiene policies and guidelines in the hospital will also help in increasing the rate of adherence to the hand hygiene in the people. It was also identified that leaders should also be involved in making and creating the strategy to improve hand hygiene in the hospital. As it was identified, creating mechanism for accountability for all staff was also another important strategy that can be used for increasing hand hygiene practice adherence by medical staff. While any of these strategies can be used alone, they could be more successful if they were used together all of them or just a number of them. Flowchart to enhance hand hygiene at the hospital References: Fraise, A. (2012). Russell, Hugo and Ayliffes Principles and Practice of Disinfection, Preservation and Sterilization. New York, NY: John Wiley & Sons. Joint Commission. (2009). Measuring Hand Hygiene Adherence: Overcoming the Challenges. New York, NY: Joint Commission. Lippincott Williams & Wilkins. (2007). Best Practices: Evidence-based Nursing Procedures. London, UK: Lippincott Williams & Wilkins. Soule, B. (2012). Best Practices in Infection Prevention and Control: An International Perspective. New York, NY: Joint Commission Resources. World Health Organization. (2013, August 23). WHO hand hygiene strategy feasible and sustainable for health-care settings around the world. Retrieved January 9, 2015, from World Health Organization: http://www.who.int/mediacentre/news/notes/2013/hand_hygiene_20130823/en/ Read More