Introduction
The successful implementation of any change in an organization hinges on how well employees have been prepared for the change. When an organization fails to adequately prepare their employees, challenges are bound to arise. On the other hand, readying employees allow organizations to implement changes without hitches. Education and training are some of the methods that can be used to prepare employees for change (Al-Abri, 2007). This is particularly true for the healthcare industry where changes are introduced routinely. In this paper, the case of an organization that wished to adopt an electronic health record (EHR) management system is considered. The position of a lead project manager who has been assigned the responsibility of providing information that will facilitate the implementation of the system is assumed. Some of the issues that the paper addresses include the tools that will be used for managing quality and performance measures.
Quality management tools
The implementation of any project could go wrong. To ensure that this does not happen, it is suggested that organizations should embrace quality management (Nohe, 2009). Basically, quality management involves constant monitoring to ensure that progress is being made and the objectives remain within reach. There are a number of quality management tools that have been developed to facilitate project evaluation. Control charts, Pareto charts and fishbone diagrams are among these (“Total Quality Management”, 2011). As the name suggests, a control chart is a tool used to determine that a process is under control. It tests for any variations and offers insights into the state of a process. A Pareto chart is another quality control tool that allows for defects and sources of errors to be identified. A fishbone diagram is a tool that is used to visually represent the causes of a given effect. Given below are visual representations and interpretations of each of these tools:
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Control chart
The chart above shows two variables represented by the red and the blue lines. The cost of treatment and the length of hospital stay are among the factors that these variables could represent. It can be taken that the 10-90% range represents the normal range for the EHR system. Any readings outside this range represent an unusual behavior and should be cause for concern. The chart above can be used by the organization to ensure that the cost of care and the length of stay remain within the acceptable limits.
Pareto chart
The diagram above shows the number of patients who report different diseases. The graph above can be used to determine patient populations based on infections. It is a vital quality control tool as it ensures that the organization is able to keep the numbers within manageable limits.
Fishbone diagram
Cause Effect
Equipment People Process
Poor adoption of EHR system
Management Environment Materials
In the image above, some of the problems that may cause the adoption of the EHR system to fail have been highlighted. These problems range from ineffective equipment to ill-trained people and lack of oversight from the management. The fishbone diagram above can be used as a quality control tool that allows the leadership of the organization to identify problems before they result in catastrophe.
Quality management and changes in healthcare regulations
As they manage the quality of their processes, healthcare organizations need to consider the changes that are made to healthcare regulations. In the United States, the government routinely introduces changes that are intended to streamline the delivery of medical services. Quality management and the healthcare regulation reforms have an impact on such issues as internal policies, organizational structure and processes. Quality management forces an organization to tailor its policies, processes and structures so that they are aligned to the objectives that the organization wishes to achieve (Peris-Ortiz & Alvarez-Garcia, 2014). Changes in healthcare regulations have a similar effect. For instance, new regulation could require organizations to train their employees. To comply with this regulation, an organization will be forced to redefine its policies, processes and structure.
Performance management measures
Once a change has been introduced, it is important to institute measures for managing how they perform. There are various tools that organizations rely on for the purpose of measuring performance management. Benchmarking techniques are some of these tools. Essentially, benchmarking is concerned with the establishment of standards and guidelines that must be adhered to. Report cards and dashboards are among the benchmarking tools that are used. A visual representation of each of these tools is given below.
Report card
The red line represents the actual performance of the EHR system while the blue one represents the desired performance. The actual performance measured against the optimal performance to understand how well the system is functioning. At points where the red line exceeds the blue line, it means that the system is delivering beyond expectations. Otherwise, the system is underperforming.
Dashboard
1
The image above depicts the dashboard for a typical system. It offers quick facts about the performance of a system. A similar dashboard for the EHR system can be generated. It would allow the organization to gain insights into such issues as the amount of records stored in the system and the number of system crashes that have occurred, among others.
Benchmarking and changes in healthcare regulations
As is true for quality management, benchmarking has an impact on the internal policies of an organization, its structure and its processes. The changes in healthcare regulations also shape these issues. Benchmarking compels an organization to ensure that its processes and policies are in line with the set standards (Zairi, 2010). The organization may also be forced to ensure that is structure allows for compliance with standards. For instance, benchmarking may require that an organization eliminate the boundaries that separate the different positions held by officials. This would mean that benchmarking has forced the organization to change its structure. Healthcare regulation reform also affects policies, processes and structure as already discussed earlier. The chief relationship between the impacts of regulation reform and benchmarking is that they both force an organization to adapt is systems, structure, policies and processes to be in line with the changes.
Workflow concepts
For it to derive benefit from the electronic health record system that it wishes to implement, the healthcare organization needs to align its workforce properly. There are various concepts regarding workflow that can facilitate this. Top-down diagrams and swimlane diagrams are just some of these. As is suggested by the name, top-down diagrams outline the workflow process in a hierarchal fashion (Sharp & McDemott, 2009). It defines the relationship between the different parties involved in the execution of a given project. As it adopts the top-down approach, the organization will be able to ensure smooth flow of direction. This is because this approach allows the top leadership to communicate smoothly with their subordinates. Additionally, the top-down approach outlines the activities and their relationship (Sharp & McDemott, 2009). The swimlane diagram serves the same purpose of defining the relationship among different actors. This diagram also identifies the actions performed by different parties at different stages of the implementation process. Given below are visual representations of the two diagrams:
Procure EHR system
Top-down diagram
Obtain funding fotraining
training
Set up system
Prepare departments
Begin training
Begin evaluation
Swimlane diagram
Procure system
Procurement
Obtain funding
Finance
Prepare departments
Begin training
Administration
Human Resource
Begin evaluation
Human Resource
Workflow process and changes in healthcare regulation
The workflow concepts discussed above are closely linked to the internal policies, processes and structure of an organization. The workflow process that an organization chooses will determine the policies and the processes that it adopts. The organizational structure will also be affected. For instance, suppose an organization has opted for the top-down approach. The organization may be forced to change its structure to ensure that it corresponds to the top-down approach. The change in structure could involve the adoption of a hierarchal structure. In an earlier discussion, it has been mentioned that changes in healthcare regulation forces organizations to change their processes, structures and policies accordingly. This means that workflow processes and healthcare regulation reform are related in that they have a similar impact on the operations of an organization.
Project management techniques for efficient workflow and appropriate outcomes
The adoption of the EHR system will require the application of a number of project management techniques. These techniques ensure that the entire project proceeds as scheduled and within budget. Risk analysis and Gantt charts are some of the techniques that are used for project management. Risk analysis is used to examine the perils that could make the effective implementation of a project impossible. On the other hand, the Gantt charts are used for evaluating the progress that is being made (. These charts are made up of lines which represent the section of a project that has been completed. Visual representations for risk analysis and the Gantt chart are given below:
Risk analysis
|
Inadequate funding Ineffective training |
System malfunction Power outages |
|
Poor leadership Lack of cooperation from staff |
Total failure to adopt system |
Each of the four quadrants above represents various risks. The first quadrant contains realities whose likelihood of occurring is rather substantial while the fourth quadrant contains those eventualities that are least likely to occur. This chart can be used by the organization to identify areas that require the most attention.
2
In the chart above, the progress made in the execution of different tasks is represented by the different horizontal lines. The leadership of the organization can use the chart above to determine which tasks are being performed as per the schedule and the ones that require more dedication of resources.
Project management techniques and changes in healthcare regulations
In earlier discussions, the impacts that changes in healthcare regulations have on the policies, processes and structure of an organization have been explored. These impacts are related to project management techniques in various ways. One, the impacts dictate the techniques that are selected. For instance, when the healthcare regulation changes affect the policies of an organization, the organization will be forced to alter its project management techniques. This alteration could involve the selection of new techniques for managing projects. Two, the impacts drive the general direction of an organization, thereby influencing the techniques that are selected for project management.
In conclusion, the project management process can be hectic. To allow for easy implementation and management of projects, various concepts and insights have been put forward. These concepts range from those that concern performance management to those that relate to quality management. Each of these concepts is accompanied by a range of tools that organizations can use. As they use these tools, organizations need to keep an eye on changes in the legal environment.
References
Al-Abri, R. (2007). Managing Change in Healthcare . Oman Medical Journal, 22 (3), 9-10.
Nohe, M. (2009). Implementation of Quality Control Measures in Project Management and its
Impact on Customer Satisfaction . Munich: GRIN Verlag.
Peris-Ortiz, M., & Alvarez-Garcia, J. (2014). Action-Based Quality Management: Strategy and
Tools for Continuous Improvement. New York: Springer.
Sharp, A., & McDermott, P. (2009). Workflow Modeling: Tools for Process Improvement and
Applications Development. Norwood, MA: Artech House.
Total Quality Management. (2011). Delhi: Pearson Education India.
Zairi, M. (2010). Benchmarking for Best Practices. Oxfordshire: Taylor & Francis.
1 Image courtesy of Veracode: http://www.veracode.com/sites/default/files/styles/media_responsive_widest/public/analytics.png?itok=vwMSkzm1
2 Image courtesy of Smartsheet: https://www.smartsheet.com/sites/default/files/Gantt_chart_excel_0.png
