HEALTHCARE STRATEGIC MANAGEMENT TECHNIQUES AND TOOLS

In order to provide high-quality services while also completely complying with rules, a new EHR system has been developed. This section focuses on the strategies that can be utilized to assure the scheme's successful implementation, as well as its significance to the hospital's processes and structure. Adoption of the new system necessitates appropriate planning, early training of staff employees, and ongoing system development.

Quality management is the method through which the hospital ensures that the services it provides meet acceptable quality standards. Regulation compliance, on the other hand, is a series of measures taken to the hospital to meet the compliance demands set by regulating bodies such as the FDA (food and drug administration) and the Department of Health and Human Services (Tricker, 2012). Compliance and quality management are very much interlinked. It is through proper quality control that you can always ensure that there is compliance with the set regulations. In other words, by controlling the quality of the services rendered, the hospital can meet the regulations that have been set. To control this process, you can use various management tools. Here, I discuss the use of Pareto charts and cause-and-effect or “fishbone” diagram.

A cause-and-effect diagram identifies the causative factors that lead to a greater overall effect (Tricker, 2012). Through the identification of the causes that lead to a bigger problem, a fishbone diagram paves the way for the systematic solution of each of the problems which finally leads to the complete solution of the more significant problem. In the hospital environment, a fishbone approach can be taken to observe issues and then solve from the bottom of the organizational structure up to the top. By considering the various causes of a bigger problem, the hospital can then come up with policies to address each of these individual purposes. An example of a fishbone diagram is shown below:

tools The article titled “Treating severe malaria in pregnancy: a review of the evidence” aggregates different studies carried out for the treatment of severe malaria in pregnant women and comes up with an informed conclusion and gives recommendation dysfunction and often progresses from a case of uncomplicated malaria. Severe malaria during a pregnancy primarily contributes to both maternal and neonatal mortality. Pregnant

A Pareto diagram, on the other hand, helps to visually show the frequency of occurrence of a problem classified according to the cause and the cumulative effect of each of the problems as they are arranged in descending order (Tricker, 2012). This arrangement helps to prioritize particular problems to be solved first. An example of a Pareto figure is shown below:

A miscarriage, a stillbirth, premature birth or the baby having little weight. It is also associated with anemia, hypoglycemia, and parasitemia.Severe malaria is, therefore, a huge risk to the lives of pregnant women.

The world health organization in its guidelines guides that both quinine and artesunate can be used to treat severe malaria during the first trimester of pregnancy, while intravenous artesunate should be utilized over quinine in the second and third quarters. WHO further recommends that priority should be given to the life of the mother during treatment of severe malaria chosen should be able. The Pareto diagram above helps analyze the frequency of occurrence of patient deaths due to different reasons and gives an insight on what areas have a greater operational impact hence must be addressed first. This can be useful in other sections of the hospital as well. About the adoption of the enactment of the new system, such a diagram could help determine the procedure followed in successfully adopting the system.

Due to the importance of accountability for performance, it is necessary that as the new EHR system is implemented, the hospital should monitor certain aspects of its operations including collecting data on systems and processes in core areas such as finance and clinical care. An excellent performance measurement plan would involve keeping track of quantified feedback on the quality of service given to a patient either by the patient himself/herself or on his or her behalf. Quantifying the level of improvement of the healthcare of patients passing through the system as well as watching and balancing the effects of change in one sector of other areas within the hospital. An aggregated value from these quantities would indicate the performance of the hospital. To manage performance, the hospital should keep a scorecard to track improvements in various aspects of its service delivery. The hospital should do a monthly analysis of performance indicators and make changes until there is a definite improvement in the process of performance measurement. This should be accompanied by the management of performance by setting occasional goals and regularly checking the progress made in achieving these aims.

One of the ways to perform continuous progressive performance management is through benchmarking. This is done by identifying, learning and using exceptional practices and processes employed by similar organizations to improve performance (Rostaldas, 2013). It may also be achieved by the internal reaction to performance indicators. To track performance, the hospital may use either report card or a dashboard. A dashboard is a repository tool which presents information on performance as told by the various indicators in a simple and easily understandable format. The dashboard tracks performance indicators in real time especially in where new dashboard software is used. A dash is usually in the form of pictures and charts and therefore offers a quick interpretation of the situation. An example of a panel is shown below. The dashboard tracks indicators of patient satisfaction which would enable the hospital to make improvements on that end.

Sample dashboard.

A report card, on the other hand, gives cyclic information of the performance of the hospital based on the different indicators providing more detailed information and comparing the information to the set benchmark (Rostaldas, 2013). This would then inform the decisions made by the hospital management to improve on each of the indicators. An example of a report card representing the performance of care providers is shown below.

Sample report card

External benchmarking differs from internal benchmarking in that it focuses on trying to match the standards set by the similar external organization. Internal benchmarking on its part tends to focus on the continuous improvement of performance using internally set goals. Benchmarking enables the hospital to observe various indicators of performance and quickly spot changes in the quality delivery of services. The hospital can then adjust accordingly to improve the quality of its services and ensure that it offers services within the set regulations.

A good transition must involve creating a frame of the process, a good understanding of the current process and use of the right design for the new system. A workflow plan is required to determine what happens and at what time it occurs during the transition to the use of the new EHR system to ensure that the process of development works well with all the people at the hospital.

This plan may involve a “top-down” representation or a swimlane diagram representation of the current system and a use case analysis to design the new system. A swimlane diagram represents the whole process in clear steps from start to end, indicating the different variables of the existing system (Sharp & McDermott, 2009). A swimlane diagram always shows the parties who perform the various steps. This means as the process is being analyzed, when the management comes up with policies to enhance different aspects of the process, the actors of various steps in the process can be easily identified and individually addressed to change certain aspects of the process. An example of a swimlane diagram is shown below.

A top-down diagram, on the other hand, stresses on the various steps followed by the existing system and does not indicate the different parties were performing the different steps. This model is fundamental when determining the efficiency of the measures supported by any system used in the hospital and helps identify and reduce redundancy. An example of a top-down diagram is shown below.

To ensure a smooth transition which does not affect operations of the hospital the move to the use of the electronic health records system must be carefully planned. A good plan would involve engaging all the members of staff to ensure that they are all ready for the change. An implementation timeline for the project would then be set and made available to all employees. The staff must be properly trained on how to use the new system to ensure that the new system does not affect service delivery to patients who would risk patient safety and risk making the hospital incompliant with set regulations and standards. To create a real project timeline, a Gantt hart comes in handy. It illustrates the schedule of the project including showing the precedence to be followed. It indicates complete tasks, ongoing tasks as well as upcoming tasks (Bartlett, 2004). An example of a Gantt diagram is shown below.

A risk analysis of the EHR implementation project must also be done to make sure that the EHR system does not in any way risk the safety of patients to ensure that the hospital does not disregard patient the set patient safety regulations. A risk analysis tries to identify any possible risks that may arise from the use of EHRs. The repercussions of these risks are then determined to see if the risks are within acceptable levels (Youngberg, 2010). A plan to mitigate the effect of these risks can then be developed, and this information is then represented in a table like the one shown below.

In conclusion, the study affirmed that without the proper planning of the implementation of an EHR system, standard processes in the hospital would be interfered with. This would affect the mood and motivation of the doctors, nurses and other employees. Worse still, it would influence the care of patients thus risking their safety. All this would affect the state of compliance of the hospital to the governing rules and regulations. However, this can be avoided through a well planned and preferably phased transition.

References

Tricker, R. (2012). MDD Compliance Using Quality Management Techniques. London, UK: Routledge.

Rostaldas, A. (Ed.). (2013). Benchmarking-theory and practice. New York, NY: Springer.

Sharp, A., & McDermott, P. (2009). Workflow modeling: tools for process improvement and applications development. Norwood, MA: Artech House.

Youngberg, B. J. (Ed.). (2010). Principles of risk management and patient safety. Burlington, MA: Jones & Barlett Publishers.

Bartlett, J. (2004). Project risk analysis and management guide. Princes Risborough, UK: APM Publishing Limited.