The cyclical process of Performance improvement
Performance improvement is a process through which an organization monitors its performance and ways of working using several methods. It also helps the organization’s management and staff to periodically change the way they work with the aim of improving service delivery and customer satisfaction. In other words, performance improvement involves monitoring the output and performance of a certain procedure or process. Thereafter, necessary and regular improvements are made so as to increase the output, efficiency and effectiveness of the organization. Performance improvement is a process and it involves a series of steps where each step is carefully thought out before being implemented. These steps should occur in a sequence to allow for close monitoring rather than randomly where an activity happens after a long period of no activity. Performance improvement can, therefore, be referred to as a cycle where events are recurrent after the completion of a series of steps that were performed previously.
In healthcare, quality management is crucial to performance improvement. Quality management that is aimed at improving the performance of a healthcare organization includes monitoring several aspects such as inputs, outputs and processes. Inputs are the materials and/or resources used or required in the provision of healthcare. They include people, infrastructure, and capital investment, materials like drugs, vaccines and information technology. However, these inputs require a process and a way of putting the resources into use. Such processes show the processes that should be done and the manner in which the processes should be done. It is imperative that members of the relevant class of personnel to monitor the execution of process keenly; otherwise the resources will not be put to maximum use. Output is a result that is visible and includes changes in the status of health care, patient satisfaction in health service delivery and the elimination of diseases .
The process of performance improvement, as mentioned above, is cyclical in nature. It starts with the identification of where an organization is so far, by comparing the goals and objectives it had set and evaluating what it has achieved so far. By evaluating the goals and objectives, it will be easier to identify the shortcomings, problems or challenges that have prevented the objectives to be achieved. From there on, a work plan can be developed on how to solve resolve the situation and hence accomplishing performance improvement. Performance improvement can be achieved at different levels in a health system. It could be at an individual level, an organizational level, team work or the whole organization itself. At the individual level, an employee might be self motivated to do a better job. Similarly, an organization may strive to perform better in terms of improving customer satisfaction or the need for improved healthcare in the industry.
With the mission, vision and the laid down objectives as a guide, the process of performance improvement should involve identifying a problem and defining its scope, analyzing the problem, coming up with alternative ways to solve the problem, selecting the best alternative, defining possible consequences that result from previous decisions and finally, the implementation of the best alternative.
The first step of performance improvement i.e. the identification the root problem, is particularly crucial in solving the problems that face an organization. It is crucial to know what the exact problem is; otherwise one might end up diagnosing the symptoms of the problem. For example, if a hospital has a problem of delay when entering orders and retrieving patient records, the real symptom is the delayed work schedule and the real problem lies with the information technology system. The system could either be malfunctioning or it has been installed incorrectly. The manager responsible for such a system should, therefore, repair the system instead of forcing the staff to work faster. In other words, this process may involve the development of a viable hypothesis of what might be causing the problem. It is possible that there may be more than one hypothesis in regards to the cause of an organizational problem.
After identifying what the real problem is, further analysis and interpretation is required. This step focuses on the problem in detail so as to identify the cause of the problem and how best it can be diagnosed. This will require the manager or a health expert to be called in to assist in the collection of enough evidence, data and materials to validate the source of the problem. This will allow other people to understand the problem better and to get a chance to keenly evaluate the options available for solving the problem. This will also help in the confirmation or rejection of the hypotheses that had been developed. Identifying and analyzing a problem enables the actualization of a subsequent step that involves the implementation of the problem solving technique. With a viable, working hypothesis, it is possible to figure out several solutions. Among the available solutions, one that will work the best will be chosen.
Selecting a particular course of action has consequences. This means that your solution will either work, or fail. The need for putting down possible outcomes is to allow for the existence of a contingency or backup plan in case it fails. If a further problem arises, it will be anticipated and solved since almost all possible outcomes had been identified. With that in place, all that remains is to implement the best decision. Implementation requires constant monitoring at the initial stages to determine if the plan is working. Implementation cannot be successful without monitoring and evaluation. This eventually means we go back to the exact initial process. If the problem is not solved or otherwise needs improvement, the best option is to go back to the beginning to start over the process. Therefore, this process is continuous and cyclical in nature since we will always revisit the same procedure in a series of small steps at a time.
Use of Team work in Performance Improvement
Doctors did not consider teamwork as the best method of accomplishing performance improvement but rather preferred supervision and authority (hierarchy). However, they have gradually proved that team work has maximum benefits when it comes to accomplishing continuous objectives like those present in healthcare. Everyone has something to contribute and a role to play in the achievement of set objectives.
The first step is to create a team or teams that will work together to improve the overall performance of an organization. Team selection is dependent on the task ahead. They may be for a specific task or project that has arisen or in this case a continuous process of improving service delivery in the health sector. A well rounded team consists of experts in certain areas with a deeper understanding for the processes, technical and support staff, suppliers of the process who contribute knowledge while at the same time assessing inputs and outputs of the work at various stages.
After selecting the teams and developing them by putting specific team members together, the process of performance improvement will be underway. Maximizing the teams’ performance is particularly essential, because some teams will be performing better while others at a slower pace. In my opinion, application of the following will bring out the maximum possible performance in each team’s potential:
Constant monitoring and evaluation will enable the management to give suggestions to improvements. Motivation can also help in maximizing team work, through offering sufficient resources and giving each team a chance to feel part of the process. Finally, creating healthy competition amongst teams will strengthen the zeal for each team to work together with its members so as to emerge the best .
Following all these steps, in my opinion, will create a better way of assessing the quality of management and services produced in the health sector; hence performance improvement will be possible.
The challenges are many given the health situation in the world today, and; therefore, decision making by the stakeholders has to be in-time and in real-time. Quality healthcare is that which serves patients in the best way possible, and that which has an affordable cost. People should pay for quality health care, but the costs of such health care should be reasonably low. For the management to make sound decisions on how to curb the challenges in health facilities, identification and definition of the problem is crucial as the first step of addressing the problem.
Defining the problem
The implementation of health information systems goes a long way in solving problems associated with healthcare in general. Every health organization must have some form of communication system where different departments communicate to ensure that patients are served in the best way possible. These systems sometimes malfunction or some simply become redundant. Systems that cannot perform in full capacity ought to be replaced to enable health facilities to work objectively, and, therefore, deliver quality services at reasonable costs.
At Elliott, Shaw, Isaacson, and Murphy health facility, workers in different departments seem to have a problem in coordination. The information system used at the hospital does not provide the required integration with potentially wide networking needs. The installation of a health information system (HIS) should be universally viewed by all stakeholders as a necessary step towards the integration of information which guarantees better service delivery. The main problem at Elliott, Shaw, Isaacson, and Murphy is a health information system that is not integrated hence leading to poor coordination and unnecessary delays, which is a possible cause of fatalities. It is evident that coordination is poor in this facility. The nurses complain that transferring a patient from one section to another takes hours implying that the flow of information is somehow distorted along the way.
Analysis of the problem
The health sector is a complex, large scale, highly adaptive and evolving system. As such, experiencing challenges is in evitable, and it is up to the management and other stakeholders in the sector to adapt to the system in order to be able to tackle the imminent challenges. Due its natural vastness, health care has multiple, interlocking practices and policies whereby modification of one or more parts of the system would create unprecedented effects, costs, and inconsistencies. These ripples could cause a devastating damage on the whole process of service delivery. A health information system (HIS) in a health institution should, in reference to this, take into consideration all aspects and issues on the ground.
At Elliott, Shaw, Isaacson, and Murphy health facility, the main problem is a system that does not show maximum efficiency leading to poor coordination and unnecessary delays in patient care activities. Introduction of a new system is a new solution which should be mixed and integrated with the existing practice for better results. Simulation of changes has to be fully understood before the management carries out deployment of the system.
Implementation of the problem-solving, decision making process
If a health institution such as Elliott, Shaw, Isaacson, and Murphy health facility faces a challenge in coordination and service delivery, it is the duty of management to come up with mechanisms to curb the problem as soon as possible.
The problem at Eliot is essentially a system malfunction that has impeded proper coordination between departments and possible inconsistencies from the human resource. In order to achieve their objectives, the management at Eliot should consider these alternatives:
- Assess the overall performance and the efficiency of the HIS and determine where the hitch comes from. This will enable the management to come up with relevant corrective measures. This is a crucial decision to make since it would give the management an insight of what the problem actually is. This action is as highly practical as it is easy to effect.
- Train the staff on how to more effectively use the ACIS in service delivery and encourage them to be dedicated and committed to their jobs. Members of staff should also be encouraged to dispatch their duties honestly, and stop the “blame game” since there is always someone to blame in case of a problem and this never solves the problem. Human resource is a vital in quality service delivery. The health institution could be suffering from staff inconsistencies and laxity. The management should encourage nurses and doctors from different departments to stick to their jobs with the commitment that is required.
- The management should replace the information system with a more efficient system. This would mean uninstallation of the existing system and the installation of a new one.
Evaluation of the alternatives
The process of decision making involves intense analysis and elimination of implausible options. Implausible options are those alternatives that the decision maker cannot afford to put in practice without experiencing devastating setbacks. From the above alternatives, the uninstallation of the existing information system is implausible. This is because it is too expensive to overhaul the existing system. This is because the decision maker would also be uncertain whether the new system would have the same problems or not.
Selecting the best alternative
Considering the remaining alternatives, what the decision maker needs to do is to critically examine the alternatives at his/her disposal; to come up with one that would give maximum results with minimum chances of failure. Critical analysis of the system by technicians to detect the possible hitches in the system could be a way forward. From experience, systems are always a small part of the problem; in case of a hitch in the system, it has always been easy to fix it considering the modern technology. If the hitch or malfunction in the system is eliminated, quality service in health institutions is not guaranteed in the sense that an effective system only cannot deliver quality services.
Therefore, the best alternative is to dwell on staff; encourage them to dispatch their duties honestly without resorting to blaming anyone or any system in case of problems. There is always someone or something to blame in case of a problem. However, it is the duty and responsibility of the management, to ensure that the ACIS or the health information system is in perfect condition. It is also imperative to ensure that the employees are well motivated; sometimes morale is all it takes achieve quality service.
Possible results/consequences of the ‘best decision”
A well motivated staff will do all it takes to ensure that patients, in a health institution, are well catered for. Morale in human resource is vital for quality performance. Implementation of this decision means that there would be a more informed staff; a type of staff that fully understands how the existing system works besides the full dedication to delivering quality work. This is all an institution of health requires to optimize its service delivery.
However, as some people would argue, an efficient system is the key to coherence and consistency in service delivery in a health institution. This is technically true to some small extent. What the proponents of the decision should know is that an efficient ACIS or health information system, which does not have dedicated staff, will result to poor quality services in the health institution. Human resources are the most important input in service delivery, in healthcare, and this is where the management has to put emphasis.
Implementation of my decision
The implementation of my best decision is not a complex process. It only involves making necessary adjustment in the staff by encouraging them and reminding them the vitality of commitment in service delivery. Having ensured that the health information is working well, quality health care delivery is assured as long as nurses and doctors are committed and dedicated to doing their jobs with minimum supervision. With all these variables in effect, health care has never had a better chance to perform. Therefore, managers in the health sector need to understand the importance of a dedicated staff as a matter of necessity to realize quality results.
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