Introduction
Healthcare organizations play a vital role in ensuring appropriate administering of services to its patients. Some of the critical requirements are safety of patients and quality care. Through the use of regulations set by the health organization, the administration monitors the daily practices of the medical practitioners along with healthcare workers and develops ways of improving workflow. The outcomes realized in provision of care such as adversities like death or prolonged illnesses are closely observed to ensure the practitioners have followed the recommended rules. These regulations of work objectives are essential for increasing effectiveness and efficacy of care provided. The following paper presents quality management tools, performance management measures, workflow concepts, and project management techniques that ensure efficient workflow and appropriate outcomes in the delivery of care.
Apply Quality Management Tools
Some of the quality management tools include the fishbone chart, Pareto analysis, and control charts.
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Fishbone Diagram
This quality management tool also known as the Ishikawa or cause-and-effect diagram was developed Kaoru Ishikawa in 1968. It draws its name fishbone as its shape resembles the skeleton of a fish. The diagram helps healthcare practitioners to identify potential factors that may lead to a defect in the design of the product and its quality. In this regard, it enables a near achievement of perfection (Paul, Melendez, Stack, Capraro, Monuteaux, & Neuman, 2014). The various causes that may create adverse effects are classified into six major categories that include: equipment, processes, personnel, environment, management and materials. The problem under investigation is placed at the end of the head of the horizontal line as various causes bring about effects to the main issue (Paul et al., 2014). This diagram opens up a forum for problem solving as shown below.
Pareto Analysis Chart
The above named chart was developed by Vilfredo Pareto as a quality control tool for analyzing ideas brought about by brainstorming. This diagram enables health workers to effectively identify the various causes of problems in the organization that could have great adversities (Paul et al., 2014). In a pictorial presentation shows the recorded data in the form of a bar graph and line graph too. The frequency of the issues identified is depicted in a descending order measured by the left vertical axis (Paul et al., 2014). As a result, the right vertical axis presents the cumulative percentage of the problems noted as shown in the figure below.
Control Chart
The chart mentioned was created by Walter A. Shewhart hence it is also known as the Shewhart or process-behavior charts. The toolkit may be used as a statistical measure of pointing out different changes to a particular process within a defined duration (Paul et al., 2014). The control chart usually incorporates three line figures, the upper control limit, average and lower control limit. These lines help determine whether the data recorded is in control or unpredictable due to numerous factors causing the variations noted (Paul et al., 2014). As a result, this chart can help practitioners the expected range of results and developing ways of stabilizing the problem.
The above quality management tools are all measures of monitoring problematic areas in the healthcare industry. These techniques may either measure an issue on its own or in comparison with others (Paul et al., 2014). Therefore, these data collection toolkits enable health workers to improve their practices such that they deliver quality outcomes for the patients. They are essential measures to undertake especially when government regulations are enforced. The quality management tools prompt health practitioners to incorporate the different organizational structures, policies and processes that will curb a public health concern (Paul et al., 2014).
Construct Performance Management Measures
Benchmarking is a performance management process that involves continuous understanding, identification and adaptation of practices both within and out of the workplace. The administration team points out the most appropriate practice with the help of health worker and it is implemented over a duration of time for reliable performance and outcomes. The performance report cards and dashboards are appropriate tools for measuring the quality of practices.
The report card measure is one approach of implementing benchmarking techniques in the health organization. The process may include comparisons of the institution’s performance in comparison with national or state averages. However, this practice should not be the limit as the organization may seek to make comparisons with the highest performing institution (Jeffs, Beswick, Lo, Lai, Chhun, & Campbell, 2014). In this regard, the provider aims to achieve world class standards of care provided. The report card measure may include the statistical representation of scores earned through various processes in a particular department. For instance, the pediatric units may combine forces to evaluate their practices and develop measures that will ensure quality outcomes for its patients (Jeffs et al., 2014). The table below shows a report card of Evergreen Hospital making comparisons with others in terms of effectiveness, safety and focus on patient.
On the other hand, performance dashboards are an alternative benchmarking measure where the health practitioners can recognize outcomes of significant departments. Numerous hospitals and clinical institutions have employed this approach as a measure of increasing transparency with its patients (Jeffs et al., 2014). Through the graphical presentation of data it is easier to understand and make possible changes. Additionally, the performance dashboards enable quick review of key performance indicators (KPI) used for decision-making processes. This information is evidently important in presenting to boards on seeking financial support for making improvements in the institution (Jeffs et al., 2014).
As evident in the above benchmarking techniques, the clinical institutions identify their current performance to other organizations. Furthermore, these indicators empower practitioners to improve average or below average scores to meet the standards set by the government (Jeffs et al., 2014). These regulations force the institution to monitor their practices such that they can achieve better health outcomes for the patients they serve.
Demonstrate Workflow Concepts
Swimlane diagrams are one of the numerous workflow concepts deployed in healthcare institutions for appropriate performance of tasks. It entails details of the various parties involved, the task, and the time. This approach is significantly different in that the decisions and processes are grouped in distinct lanes that are clearly labeled (Singh, Singh, Singh, & Singh, 2013). The swimlane diagram is an effective approach as it does not require training for its users to understand. Furthermore, it shows process of work from beginning to end helping identify areas where time can be saved or processes that can be combined to improve efficiency (Singh et al., 2013). One swimlane diagram will show how workflow presently takes place and the other on possible solutions.
The top down diagram is an alternative workflow structure and probably the most commonly used in clinical institutions. The visual presentation provides a breakdown of activities or processes to the lowest manageable standard. Through this workflow concept, the hospital assigns health workers with certain tasks depending on the level of qualification (Singh et al., 2013). This process also shows the time each process should be undertaken depending on the actual work in question. There are instances of delays, links to different pages, input or output of data and decisions made from questions. The step by step process help alleviate issues related with inconsistency.
In the transition to a new Electronic Health Record (EHR) system, the swimlane and top-down diagrams are important in ensuring the smooth adoption of the technology system without much resistance from the health workers. The workflow concepts will depict ways of evaluating the technology to ensure it is beneficial to the objective tasks of the practitioners (Singh et al., 2013). The various areas of concern include patient safety, improving quality and the ability to save time spent providing care. The costs incurred in the implementation of the technology are necessary for making decisions on the technology.
Apply Project Management Techniques to Ensure Efficient Workflow and Appropriate Outcomes
Grantt chart is an effective project management chart that is incorporated as a means of scheduling the tasks involved in the adoption of the EHR. The chart was created by Henry Grantt after whom it was named in 1910 (Schwalbe, 2015). It is also recognized as a type of bar chart where the information is laid horizontally to indicate the start and end of the project. The Grantt chart breaks down the various tasks in terms of terminal and summary elements. The modern uses of the chart may present relationships between activities and the status until its completion. It is an important project management technique as it enables the health institution to monitor the progress (Schwalbe, 2015). Each activity has a significant deadline failure to which it may cause higher costs in the implementation of the EHR.
Risk analysis is a project management method of easing the adoption process of EHR. Despite appropriate planning of the project, the transition from manual to EHR could encounter multiple problems. Therefore, the risk analysis method will forecast various concerns that could hinder the smooth implementation of the technology (Schwalbe, 2015). There are strategies that may be incorporated for effective elimination or alleviation of the problem. Each of the mitigation techniques enables the team members to undertake a role in avoiding the vulnerabilities of the project.
References
Jeffs, L., Beswick, S., Lo, J., Lai, Y., Chhun, A., & Campbell, H. (2014). Insights from staff nurses and managers on unit-specific nursing performance dashboards: a qualitative study. BMJ quality & safety , 23(12), 1001-1006.
Paul, R., Melendez, E., Stack, A., Capraro, A., Monuteaux, M., & Neuman, M. I. (2014). Improving adherence to PALS septic shock guidelines. Pediatrics , 133(5), e1358-e1366.
Schwalbe, K. (2015). Information Technology Project Management . New York: Cengage Learning.
Singh, R., Singh, A., Singh, D. R. & Singh, G. (2013) Improvement of workflow and processes to ease and enrich meaningful use of health information technology. Advances in Medical Education and Practice 4: 231–236. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826941/pdf/amep-4-231.pdf
