The health care system is faced with increasingly complex challenges related to patients' needs, management, and technology. Patient outcomes are given priority for the core purpose of healthcare organizations is to satisfy the needs of customers. However, achieving desirable patient outcomes is not a stand-alone need. Achieving these outcomes requires the input of management strategies that improve service delivery. Hence the need for technology in service delivery. Strategic management in healthcare encompasses internal and external policies that ensure the direction of the organization takes is angled towards improvement (Ginter, Duncan, & Swayne, 2018).
Part 1
Quality management in health care is focused on improving patient outcomes through processes that increase the effectiveness of services delivered in organizations. Large organizations are divided into sections and departments to enhance service delivery. Quality management ensures that these departments function efficiently. Hospital in the US is required to comply with various regulatory and quality assessment bodies and policies. Some of the policies include the HIPAA guidelines, Food and Drug Agency (FDA), Accreditation Agencies like the Joint Commission and other international regulations (Techtarget, 2018). Quality management is tied to compliance with the role of management to improve quality of services while at the same time adhering to regulations. Regulation protects patients from harmful practices thus contributing the quality of services that hospitals offer.
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Various quality management tools have been developed over the years to control and monitor management strategies in organizations. These tools are also useful in controlling processes in health care thus contributing to compliance efforts. Common management tools are flow charts which indicate the flow of the process in the organization (Lotich, 2015), checksheets which are data collecting tools, the fishbone which sheds light on the cause and effect of problems and Pareto charts which show data regarding occurrences from the most frequently occurring event to the least. Information from these tools is vital in making decisions that contribute to compliance programs of the hospital.
Selecting Pareto charts and check sheets for quality control management is suited for this case. Pareto charts are designed like bar graphs showing the number of frequencies from the highest to the lowest (Lotich, 2015). The left side of the graph is the most occurring event while the right is the least occurring.
A Pareto chart like the one illustrated above provides a visual representation of data on essential hospital activities. From the data, the management can assess the success of their decisions. Consequently, they can identify problems with the system and come up with solutions. Pareto charts also provide evidence of the effectiveness of the organization’s structure. From this knowledge, important decisions can be taken.
Flow charts, on the other hand, depict organizational [processes in a picturesque manner. They show the movement of work from one section to another in a simplified method (Lotich, 2015). This simplification enables the reader to have a clear picture of how the organization works and possible sources of problems or challenges.
This flow chart explains the stages that a patient goes through before entering the operating room. Each step has a specific purpose and cannot be overlooked. All the stages are necessary for the operating procedure.
Similar to the pre-operation flowchart, the flow of activities within an organization needs to be well defined. From the flow charts, bottlenecks are quickly identified and eliminated. The structure of the organization is also assessed from the flow of work. For the implementation of electronics records handling, flowcharts can contribute to decisions on how to use the systems to prevent a pile-up of work.
Part 2
The new EHR system aims to improve the hospital’s patient care. Therefore, the system needs to be assessed while in operation to confirm the improvement. Measuring performance of the system is crucial in determining its effectiveness. Benchmarking techniques are applied in measuring and managing performance. Benchmarking is the process of comparing the organization’s working systems and performance against others either within the organization or externally (Aparicio, Borras, Ortiz, & Pastor, 2014, p. 67). The new EHR system should meet the health care highest standards when compared to other trendsetters.
Report cards as benchmarking techniques are used to compare the organization's performance in specific areas like patients’ records keeping or overall activities against other hospitals. From the report card ranking, the hospital can gauge its performance against others.
Report Card from California Health Department
This sample report card assesses the performance of California hospitals on the period that sample is delivered after they are taken. The report card is an indicator of the hospital’s performance.
Dashboard benchmarking, on the other hand, measures the hospital’s performance using internal targets. Key indicators like gauges and limits ate set to assess the extent of the hospital against activities set targets. Compared to report cards, dashboards measure performance with comparison to expected levels of achievement.
Dashboard sample from HealthCatalyst.com
The hospital dashboard shown indicates waiting times and nurses ratio. Shorter waiting times are desirable.
External benchmarking involves comparison of the organization’s performance and activities with other organizations that are deemed to be performing better. Internal benchmarking may involve interdepartmental comparison. External benchmarking provides more advantages due to gains activity comparison and improvement. Through benchmarking, an organization can improve its compliance standards by gaining ideas of others are achieving the same. The same concepts may be used to improve performance either through discarding the older methods are coming up with a hybrid version of the new and the older idea.
Part 3
Every organization has its activities and a framework of the tasks undertaken to complete the activities. Thus, the workflow defines these activities and the manpower together with machines used to achieve these activities. Examples of processes in hospitals that define workflows include the transfer of patient medical records, procurement procedures, pre-operation and post-operation procedures among others. Basic workflow concepts that will be applied in ensuring the success of the EHR system are top-down diagrams and use cases.
Top-down diagrams are framed like flowcharts. They define hospital activities through the breakdown of significant activities in increasingly smaller tasks with definitions of how they will be handled. The sample top-down diagram shows the procedure for discharging a patient. From the diagram’ it is clear that discharging is procedural involving the clearing of pending bills after determination of total costs. Issuance of drugs is also defined. The process ensures that the hospital's internal policies are followed. Additionally, it is more comfortable for the management to make decisions if a challenge is noticed.
Sample Top-Down Chart from HealthCatalyst.com
Use cases follow the analytics approach to define and organize the requirements of an organization’s activities (Levy, 2014) . All possible paths of the workflow are explored and the most appropriate path selected. Additionally, the concept ensures that vital steps and paths are not overlooked.
Sample Case Use from HealthCatalyst.com
The sample case use above defines the processes the patient goes through from the receptionist until they reach the specialized area of service. The case use follows the hospital structure by separating patients according to their unique requirements. Furthermore, informed decision making is possible through follow up on each path of the case use.
Part 4
Project management is the series of processes that a project undergoes from the initial stages until its completion. The HER system project has to undergo the five stages of project management beginning with initiation, planning and followed by execution then control and finally closure. Project management techniques act as a guide on how the project is undertaken in a given time frame with the controls that are required to ensure projects are successful (Sholarin & Awange, 2015). The EHR project is sensitive considering the resources input and the expected outcome. Therefore the Gantt chart and risk analysis techniques are well suited (Sholarin & Awange, 2015).
The Gant Chart is suited for monitoring the time of the HER project. Time is crucial for any project since it ensures that the project is kept within the budget plan and completed on time to for the benefit of all stakeholders. In the Gantt, activities are given specific timeframes for completion. If the HER project is completed within the specified time, the organization will be capable of electronically keeping and retrieving patient information in compliance with HIPAA requirements.
Sample Gantt Chart for the EHR Project
For any project, the risk of things going wrong on the course of the project always exists. Risk analysis ensures that the project manager is knowledgeable on the risk potential of the project takes measures to avoid or minimize the risk (Van Doren, 2014). Such dangers are always costly and may lead to stalling of the project. A risk analysis report assesses the risks involved and measures the risks involved in a particular project and measures that will be taken to avoid the occurrence of the danger or if the danger has already occurred, measures that project managers will take to minimize losses. For the EHR Project, risk analysis will provide a cushion against stalling and also avoidance of inflation of costs. Risk analysis will enable timely completion. Hence the organization will comply with regulations on electronic health record keeping.
References
Aparicio, J., Borras, F., Ortiz, L., & Pastor, J. T. (2014). Benchmarking in healthcare: An approach based on closest targets. Managing service productivity , 67-91.
Ginter, P. M., Duncan, J., & Swayne, L. (2018). The strategic management of healthcare organizations. John Wiley & Sons.
Levy, D. (2014). Use cases examples . Gatherspace.com. Retrieved on 27 February 2018, from http://www.gatherspace.com/static/use_case_example.html.
Lotich, P. (2015). Seven management tools for quality control . Thethrivingsmallbusiness.com. Retrieved on 27 February 2018, from https://thethrivingsmallbusiness.com/seven-management-tools-for-quality-control/.
Sholarin, E. A., & Awange, J. L. (2015). Project management techniques. Environmental Project Management , 335-366.
Techtarget. (2018). Guide to healthcare compliance resources and agencies . Techtarget.com. Retrieved on 27 February 2018, from http://searchhealthit.techtarget.com/essentialguide/Guide-to-healthcare-compliance-resources-and-agencies.
Van Doren, P. (2014). Risk analysis. Journal of Risk Assessment, 37(4) , 77-85.
Weaver, C. A., Ball, M. J., Kim, G. R., & Kiel, J. M. (2016). Healthcare information management systems. Cham: Springer International Publishing.
