Middleville Regional Healthcare: The role of governing board in strategic initiatives

The governing body of Middleville hospital has an overall responsibility to oversee and supervise the running and the operation of the hospital. It has put in place the necessary policy required to enable the staff in the organization to carry out reforms and improve the hospital overall. However, there are no parameters in place to evaluate the staff for progress in the area of maintaining quality healthcare for patients. An additional clause in the policy should be implemented to outline fully defined performance indexes for medical personnel. This should be developed in partnership with the staff so that it is both realistic and possible. The growing team should include representatives from Human Resource departments, accounting, and a staff member from each medical area. This includes doctors, nurses, laboratory attendants, diagnostic staff, physiotherapy, support staff, and security ( Barr & Dowding, 2016). 

There are plans in place to improve the innovation of the institution. It would be better to break down the ideas into different steps or stages. These measures can then be implemented within specific periods that the board has stipulated. This makes it easier to identify which areas are more challenging to implement and where success has been achieved. This is because there are currently no long or short term goals that the staff can focus on. The members of the governing body are also facing an accountability challenge. The roles of the individual members are not defined. Work is carried out communally, so it is impossible to pinpoint who is not playing their part. This can be improved by implementing the structure put in place by the existing bylaws. Alternately, roles can view defined by dividing staff members into committees that are mandated to carry out specific activities ( Buchbinder & Shanks, 2017). 

The Middleville hospital board is doing well in minimizing the conflict of interests within the institution. This has been managed well in the handling of procurement as staff members have been eliminated. This has resulted in a workforce that is focused on their roles as employees. It has also reduced the internal animosity between interested parties. This has been a major challenge that has been resolved by completely changing the policy of the hospital. Some procurement officials had to be removed because of the frequent attempts to circumvent the policy in place. Currently, no staff member is actively involved in the supply chain of the hospital. 

Performance 

Physician hours per resident 

This is one of the indicators used to measure the quality of healthcare provided. The amount of time an attendant allocates to patients under admission is documented. A member of the support staff must confirm it. It is also cross referenced with the physician's shift and the patient's needs. The rate of repeat admissions is also noted especially in the case of avoidable or would be one time admissions. Feedback is further collected from patients anonymously so that their inpatient care is evaluated. This is accomplished by administering a questionnaire. The ease of access to a physician is also documented as part of the evaluation. This determines how the patient will receive instructions and advice as they recuperate (Lighter, 2011). 

The token system 

There is a token system in place at the reception area that gives a patient the time they arrived. The same system can determine the time that the patient was able to see an attending physician. This system traces an outpatient all through the hospital. This includes services received at the pharmacy, laboratory or even radiation or other diagnostic facilities. This enables the hospital to see where there is a delay because of personnel or equipment. The amount of time a patient spends waiting in the hospital is often an indicator of customer satisfaction. This may influence a decision to return to this facility or go elsewhere. Waiting time is then used to fill the gaps in the system within the shortest time possible (Lighter, 2011). 

Admission and referral rates 

This is the last indicator of performance. Health care is a business like any other, and it relies on word of mouth for its success. This indicator has had the most varying results. For example, the pediatric wing has a large percentage of admissions from referrals. This partnership with other health care professionals and bodies has been strengthened by offering them incentives such as access to general data that can be used for research. An emphasis has also been placed on making the pediatric department more child-friendly. The area that has had a decline in referral rates was the dialysis unit because of the long waiting time experienced by patients. Plans are underway to increase the machinery and staff in the department (Lighter, 2011). 

Marketing 

Middleville hospital already has an advantage over its competitors because of the larger number of beds. They should capitalize on this by strengthening the inpatient care system. This can be done by getting feedback from the patients admitted. Their complaints should be addressed, and their compliments emphasized. An example here was a complaint from a patient who wanted to have a private bathroom but was forced to share one with another patient. The solution would have been to move her to the wing with private rooms because bed space is not an issue. Another way to improve hospital stays for patients was the inclusion of entertainment such as TV, wifi, and music ( Barr & Dowding, 2016). 

There are also a larger number of births recorded here as opposed to the competition. This could be boosted further by improving the antenatal services available. The aggressive advertisement is needed to create awareness of the programs available. This can also be done by incorporating recreational activities such as exercise sessions. Additional birthing options should also be included to accommodate the mothers who want unconventional delivery methods. This includes water births and other spousal participation. After birth support for both mother and child also ensures repeat visits and cements the relationship with the patient (International Conference on Human Factors and Ergonomics in Healthcare, 2016). 

There is a significant difference in the number of staff at Middleville hospital, and its competitors. They are disadvantaged because the personnel is fewer than the hospital capacity. This gap is most felt in the nursing department and the support staff. It should be bridged to maintain goodwill with the staff and avoid over working them. Some services such as laundry may also be outsourced to private companies to reduce the work load of the cleaning staff if they cannot be increased shortly. The hiring of additional staff is recommended as a long term solution. 

The costs and benefits associated with implementing EMR 

The EMR systems offer hospitals a greater ease of doing business. This is because they save a lot of time and money on functions that could have been carried out manually. They also minimize the risk of human error by streamlining the services of the personnel. Data is also accessed quickly in this system. Dissemination of information between hospital departments will be easier and faster and overall more useful. These systems though beneficial are expensive to implement. Private not for profit organizations like Middleville hospital have to dig deeper into their budget to set off the initial cost of the system. Plans are underway to enlist government support as well as the financial input of stakeholders. Additionally, the system will require a large workforce to initially transition the system to one fully functioning on an EMR system Kanstrup et al., 2017). 

Patients also worry that this transfer could expose their private medical information. A mechanism to safeguard this is currently being developed by a focus group composed of interested stakeholders. Training of personnel who are expected to use this system is also anticipated to be a challenge. This is especially for health workers who are accustomed to the old system of doing this. When coupled with the fear of job losses that such systems trigger, it may be a rough transition period. The last problem envisioned is the lack of standardization across the board. The EMR systems available are not structured in the same way. It is therefore difficult to transfer data from one system to another without investing a lot of time and money. Some data may be lost in the process. The result is a cumbersome activity that most organizations shun. Health care organizations should rally together to mobilize manufacturers ancient government into providing a standardized version that will work in different health care organizations. Backup systems should also be put in place to safe guarding the vital data (Wager et al., 2017). 

An Electronic Medical Records system can be implemented by following the following steps. 

 Select an EMR system that is suitable for the organization. Consider factors such as the condition of the existing system, the provision for upgrading the system and the budget allocated to the system. 

 Involve the relevant members of staff in the selection process as this will avoid problems in future. This includes administrators and IT personnel. If necessary, constitute a selection committee. 

 Establish your requirements and acquire the system that meets your goals. Ensure that your provider has satisfactorily answered your Request For Information before you commit 

 The budget for the training and maintenance costs and then incorporate all the staff into the system. 

Employee satisfaction and retention 

Safe working conditions, medical covers, and real retirement plans boost the overall morale of a work force. However, a personal reward is the most efficient way to retain personnel. HR should adopt a recommendation to allocate a small percentage of its budget to financial incentives. Performing individuals should be rewarded with a pre-determined financial benefit. This could be based on overall performance for a set period. For example, the highest response time bi-annually gets a cash prize. This incentive should target areas that personnel are most likely to avoid or disregard. Additional financial incentives could include generous allowances for travel, hardship, accommodation, and childcare. There should also be subsidized prices for food and drinks sold in the institution (Buchbinder & Shanks, 2017). 

Another recommended incentive would be the provision of support for further studies. This could be as simple as giving time off without pay cuts or discrimination. Other staff that are not enrolled in structured studies outside the institution could also benefit from this incentive. Organization of training sessions in the workplace could be of great benefit. This includes updates on use of technological advances in the industry and introduction of new medical support equipment. This incentive could be boosted by a chance of career advancement if the training goes well. This will see a greater emphasis on educational progress if it is linked to promotion. This incentive can only work when HR closely consults other departments to avoid a conflict due to time constraints. 

References 

Barr, J., & Dowding, L. (2016). Leadership in health care. London: Sage Publications. 

Buchbinder, S. B., & In Shanks, N. H. (2017). Introduction to health care management. Burlington, Massachusetts: Jones & Bartlett Learning Publishers. 

International Conference on Human Factors and Ergonomics in Healthcare. (2016). Advances in human factors and ergonomics in healthcare: Proceedings of the AHFE 2016 International Conference on Human Factors and Ergonomics in Healthcare, July 27-31, 2016, Walt Disney World, Florida, USA. 

Kanstrup, A. M., In Bygholm, A., In Bertelsen, P., & In Nøhr, C. (2017). Participatory design & health information technology. San Francisco, CA: Jossey-Bass Publishers. 

Lighter, D. E. (2011). Advanced performance improvement in health care: Principles and method. Sudbury, Mass: Jones and Bartlett Publishers. 

Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: A practical aproach for health care management.