To: The CEO, Twilight Clinic
From: The Matron, Twilight Clinic
Date:
RE: Performance Improvement
Dear Sir/Madam,
Following the recent cases of the development of wounds and reinfection of the patients who have undergone surgery, and their subsequent prolonged healing, it has come to the attention of the nursing department that most of these cases are due to the negligence of aftercare. These patients have reported to less nursing during the post-surgery period. When these people are not carefully cared for at this critical stage, it not only hinders their recovery process but leaves them vulnerable to infections of the opened parts. Therefore, it is crucial that the facility management developed a strategy upon which it can take direct responsibility of caring for the patients. And it is not just about randomly assigning nurses to these patients, but it takes more than just frequent check-ups to facilitate the healing process and attend to the medical concerns that may emerge. Therefore, it is crucial that the entire fraternity changes the perception it has on aftercare, and develop a strategy that will go a long way in improving the recovery process.
To do this effectively, it is essential that we reconsider our performance in that sector. By evaluating some of the factors at play, we will be in a better position to identify what strategies have not been working out well for the institution, develop and try out a different approach, and if it works out effectively adopt it for the model on aftercare. Having said this, it leads to the proposed solution for the issue at hand, which is the adoption of the Six Sigma Improvement models. It is true that other rapid-cycle improvement models could come in handy for our organization, but I settle on the Six Sigma because of its flexibility and ease of adoption.
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The Six Sigma model adopts the DMAIC approach, which is a five-step approach that includes Defining the problem, improvement activity, and opportunity for improvement. The second step is Measuring the process performance, then Analysing the process to determine causes of defects, this creates room for Improving by addressing and eliminating the root causes. Finally, it Controls the improved method and future process performance (Raisinghani et al., 2005). Concerning the issue at hand, this model helps us in defining the problem of the alleged negligent aftercare. In improving the activities already in place, it evaluates some of the strategies that we have running, like some of the services employed by the hospital in caring for those who have undergone surgery. By doing so, they can discover precisely why the systems seem to be ineffective and open up the opportunities for improvement. By building on these opportunities, and adopting a strategy to answer to them, the model gives us the second insight of measuring or monitoring. For a minute or two we will be able to have these improved measures under close surveillance to note how effective, or ineffective they are in providing answers. After closely monitoring the systems, we will be able to analyze the process to determine the defects it possesses. By highlighting some of the flaws, we will be able to improve on them. Not all of the strategies that we will adopt will be sure to give a positive outcome, as such we will be presented with an opportunity to correct parts of the policy that are defective before finally adopting by controlling the improved method and future process performance. The advantage of this process is the fact that as compared to the others that seem to provide a ‘lasting' solution, this model creates the opportunity for consistent monitoring with open possibilities for improvements at any given time.
In pointing out how much improving aftercare services help in enhancing hospital charge, Hesselink et al., (2014) state that there is a growing impetus to reorganize the hospital discharge process to reduce avoidable readmissions and prolonged hospitalization. The study, whose aim was to provide insight into hospital discharge problems, points out that improvements regarding intervention outcomes, performance objectives, and change objectives are vital in meeting these changes. What this analysis points out is the fact that a lot of factors come into play when dealing with the factors of delayed discharges, which in our case is caused by developed infections. It is not just the negligence on the part of the nursing fraternity, but instead, it takes the combined efforts of the various departments to answer this question. In as much as it entails changes in performance objectives on the part of the primary caregiver, interventions by the management, as well as changed goals for the fraternity are vital to realizing the desired outcome. In ensuring the smooth operational and managerial changes needed thereof, the Six Sigma model provides a strategy that builds on and monitors each of these players individually and keenly. The end result would be improved services championed for by the relevant stakeholders on an even ground, not one more than the other.
The main advantage of this model is the fact that it is customer-driven. By focusing on pleasing the customer, who in our case is the patient, it helps us develop an approach that is fully approved by the patients. The nature of the model is such that anything that is not acceptable to the consumer is considered a defect (De Mast, 2006). What this implies in our situations is the fact the strategy adopted will be geared towards patient satisfaction. And since it is their health that is at stake, it is essential that they are treated and care for through policies they are comfortable with. This peace and satisfaction is a psychological pathway to healing, and as such facilitates healing on a highly effective and satisfactory scale. The other advantage is that it allows for multiple strategies to be tried, rather than concentrating on a fixed approach, the monitoring and evaluation process leaves room for the consideration of other viable options. This implies that it is easy to arrive at a more conventional decision through the account and possible application of different strategies that lead to the creation of better approach that benefits both the internal quality-control measures as well as the patients.
Another essential feature of this model is its adaptability to feature changes. This is one of the most significant features of the model, the fact that is open to emerging issues (Bendell, 2006). There are a lot of factors for the cases of infections noticed in the facility. By developing solutions eventually, the management will be able to know what strategies work and which ones do not work. The other side to this observation is the fact that we may be able to realize factors that we had no idea existed or even contributed to the issue at hand. By leaving open the model for future changes, we are better placed and readily prepared to tackle those emerging issues as they unveil over time. And through the flexibility of the model, it becomes easier to develop and try out process performances in good time and adopt the ones favorable without necessarily having to remodel the entire program in place, compared to other models that would require complete remodeling to accommodate the changes in place.
References
Bendell, T. (2006). A review and comparison of six sigma and the lean organisations. The TQM magazine , 18 (3), 255-262.
De Mast, J. (2006). Six Sigma and competitive advantage. Total Quality Management and Business Excellence , 17 (04), 455-464.
Hesselink, G., Zegers, M., Vernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M., ... & Suñol, R. (2014). Improving patient discharge and reducing hospital readmissions by using Intervention Mapping. BMC health services research , 14 (1), 389.
Raisinghani, M. S., Ette, H., Pierce, R., Cannon, G., & Daripaly, P. (2005). Six Sigma: concepts, tools, and applications. Industrial management & Data systems , 105 (4), 491-505.
