Patient Satisfaction as an Essential Component of the Healthcare Business
Currently, patients have easier access to health information and are more enlightened about healthcare matters. Hence, individuals seeking medical care often have expectations from caregivers and the facility as a whole. One of the metrics that healthcare facilities can apply to determine whether patients’ expectations are met includes patient satisfaction. Although other approaches can be adopted to appraise healthcare performance, patient satisfaction is an essential component that can be used to evaluate healthcare business because the metric reflects the attitude of customers towards the quality of care offered.
Competitive Advantage of the Organization Depicted in Vila Health: Patient Flow
Despite the existence of underlying problems that jeopardize patient satisfaction, Independence Medical Center (IMC) remains highly competitive in the industry due to its value-based care exemplified in the Integrated Practice Units (IPU). Notably, health services in the facility are integrated and offered in a full cycle in an attempt to maximize patients’ outcomes and lower costs that may arise from frequent readmissions (Low et al., 2017). For instance, patients that exhibit minimum or no risk factors are subjected to more profound expertise to ensure that complex and interrelated health conditions are diagnosed and treated efficiently. Such a practice indicates the responsiveness of IMC to patients’ needs, making it a competitive advantage against facilities that lack IPU.
Organization’s Strategic Initiatives
IMC’s strategic initiative is to enhance patient satisfaction concerning the waiting time. The action qualifies as a strategy for the organization because it highlights the desired future state of patients’ wait time. A previous survey carried by the facility shows that 49 percent of patients are dissatisfied with the amount of time that elapses before they receive healthcare services from the medical staff. Therefore, the efforts and plans made by the organization are drawn from the desired end outcome of improving patient wait time for the current poor state of patient wait time.
Importance of Selecting Declining Patient Satisfaction as a Performance Improvement Initiative
Scholars describe performance improvement as a model that can be altered to reflect a specific outcome. For instance, Song and Tucker (2016) define the concept as “a structured approach that uses repeated cycles of hypothesis testing to discover the way the process can be modified so that it can produce output that meets the performance target” (p. 3). During performance improvement, different ideas are often gathered and tested independently to determine the one that maximizes the expected output. Under a healthcare context, performance improvement initiatives are established to explore the way healthcare processes can be modified to improve healthcare outcomes.
Although a variety of performance improvement initiatives exist, leaders should select declining patient satisfaction because its effects have a direct negative impact on critical areas of an organization, including reimbursement. For instance, declining patient satisfaction may lower consumers’ preference for IMC and drive them to seek care in other facilities. Thus, the aspect may reduce the number of patients that visit the facility and revenue generated relative to industrial competitors. Furthermore, amidst policies enforced by the Centers for Medicare & Medicaid Services (CMS), payments may be withheld against hospitals that record low scores on quality measures such as patient satisfaction (Banka et al., 2015). In severe scenarios, reduced reimbursement can drive a facility out of business due to a lack of revenue to facilitate its operations. Some of the causes of declining patient satisfaction that hospital managers should be vigilant about may include unmet needs, poor care outcomes, and biased treatment in comparison to that of other patients (Shan et al., 2016). Based on the above reasons, leaders should focus on declining patient satisfaction as a performance improvement initiative.
The Fishbone Diagram
The Process of identifying the Top Categories of an Issue
While using a fishbone diagram, identifying the top categories of an issue and organizing the sub-topics is essential because the approach creates ease in determining the root causes of a problem. Thus, to identify the top categories of an issue, the quality improvement team uses the six standard categories highlighted by Ishikawa, which include people, equipment, materials, environment, management and process, and then select those that apply in the case scenario (Bose, 2012). By asking the question “why,” the team evaluates the way the chosen categories contribute to the stated problem. In addition, sub-topics are included in the diagram by brainstorming the sub-causes of the main events that facilitate the identified issue. After completing the two processes and brainstorming the root causes, the team can appropriately implement decisive actions to resolve the problem.
Purpose of a Performance Improvement Team
The goal of a performance improvement team is to modify and test different healthcare approaches to identify the one that enhances a facility’s quality measures. Hence, to form the team, an organization needs to fill positions in the executive, middle, and junior level management. In a healthcare facility, for instance, individuals such as leaders and subordinates from different departments would be required to fill various positions in the team. However, for the performance improvement team to develop the best initiative, it should comprise representatives of different groups of individuals that may be affected by the outcomes of the new plans. In a healthcare context, some of the stakeholders that may take part in the team include representatives of nurses, doctors, and policymakers.
Lean Methodology
The lean methodology mainly focuses on eliminating activities that add less value in a process to promote continuous improvements. Scholars define lean methodology as a “set of operating philosophies and methods that help create maximum value for patients by reducing waste and waits” (Kawal et al., 2014, p. 103). While lean methodology can be applied in different sectors, it is mainly beneficial to projects that comprise processes, human resources, and materials (Magalhaes & Olayebi, 2015). The standard features among such projects are that they constitute activities and mechanisms that can be altered to optimize value, thus qualify for management through the lean methodology.
The Define, Measure, Analyze, Improve, and Control (DMAIC) Model for a Data-driven Improvement Cycle
Apart from the lean methodology, the DMAIC model can also be used as a standalone performance improvement method. The model involves five major interconnected phases, which define, measure, analyze, improve, and control (Rahman et al., 2017). In the first stage, the problem, scope, metrics of importance, and stakeholders are defined. The quality team then proceeds to the measure phase to evaluate data that is available concerning the stated problem. The team also evaluates whether the data is accurate and the way it ought to be arranged. The next step involves the analysis of the top causes of the highlighted problem, evaluation of the validity of the root causes, and determination of the area of focus. Finally, the team improves the process performance by formulating action to address the root causes of the problem and to control the adopted processes to maintain and improve process performance. The DMAIC model is an integral part of the improvement cycle of data-driven approaches.
Problem/Scope Depicted in Vila Health: Patient Flow
The main issue depicted in Vila health entails reduced patient flow. Some of the data required concerning the identified problem include background of the organization’s policy, information from caregivers, and data gathered from shadowing activities within the organization.
Root Causes of the Problem
Based on the analysis of the data collected for the identified problem, it is evident that the root causes of the problem are inadequate organizational rules and policies, poor communication, and incompetence among some staff. Notably, the attendance rules of the organization appear to be lenient, thus making senior caregivers less accountable for their actions, such as failing to attend to patients when the need arises. Overall, a culture of poor communication within the facility is evident, whereby clinicians offer inaccurate information to their patients.
Possible Recommendations and Factors that Would Affect Them
To curb the problem of decreased patient flow, IMC should review its organizational policies, foster a culture of effective communication, and indulge in financing further training for its staff. The rationale of the recommended solutions is based on the premise that the root causes of the slow patient flow are entrenched in the policies, communication, and knowledge among the staff within the facility. Besides, tackling the problem from the above root causes will facilitate the improvement of processes within the organization, thus enhance its reimbursement rate and competitiveness in the industry. Nonetheless, the management should be ready to face some of the issues that may hinder the implementation of the initiatives, including resistance from employees against stringent policies and monetary constraints that may impede the financing of employees’ training sessions.
References
Banka, G., Edgington, S., Kyulo, N., Padilla, T., Mosley, V., … & Ong, M. (2015). Improving patient satisfaction through physician education, feedback, and incentives. Journal of Hospital Medicine, 10(8), 497-502.
Bose, T. (2012). Application of Fishbone analysis for evaluating supply chain and business process- A case study on the St. James Hospital. International Journal of Managing Value and Supply Chains, 3(2), 17-24.
Lawal, A., Rotter, T., Kinsman, L., Sari, N., Harrison, L., … & Flynn, R. (2014). Lean management in healthcare: Definition, concepts, methodology and effects reported (systematic review protocol). BMC, 3(103), 1-6.
Low, L., Tan, S., Ng, M., Tay, W., Ng, L., … & Lee, K. (2017). Applying the integrated practice unit concept to a modified virtual ward model of care for patients at highest risk of readmission: A randomized controlled trial. PLOS ONE. doi:10.1371/journal.pone.0168757
Magalhaes, V., & Olayebi, S. (2015, May 14). Lean Methodology: How to make our projects more efficient. Good Rebels. Retrieved from https://www.goodrebels.com/es/lean-methodology-making-projects-more-efficient/
Rahman, A., Shaju, S., Sarkar, S., Hashem, M., Hasan, K., … & Islam, U. (2017). A case study of six-sigma define-measure-analyze-improve-control (DMAIC) methodology in garment sector. Independent Journal of Management & Production, 8(4), 1309-1323.
Shan, L., Li, Y., Ding, D., Wu, Q., Liu, C., … & Ren, J. (2016). Patient satisfaction with hospital inpatient care: Effects of trust, medical insurance and perceived quality of care. PLOS ONE. doi:10.1371/journal.pone.0164366
Song, H., & Tucker, A. (2016). Performance improvement in health care organizations. Foundations and Trends in Technology, Information and Operations Management, 9(3-4), 153-309.
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