Description

Create a 3-5 page report that will help the Director of Quality Management at Vila Health understand the current trend of patient satisfaction numbers and propose potential solutions to any problems.

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Introduction

Similar to other service industries, health care organizations are comprised of multiple processes. “Identifying and eliminating or alleviating bottlenecks in a system (theory of constraints) can quickly improve overall system performance” (McLaughlin, Olson, & Sharma, 2022, p. 254). Organizations that seek to remain competitive in the industry work toward minimizing inefficiencies in their processes, resulting in several notable effects including improved outcomes. Patient flow optimization affects performance in various ways. Scheduling and capacity management must be factored in as health care leaders look to improve processes and patient flow, ensuring effective operation systems and outcomes.

Common methods utilized to understand complex processes include process mapping and value stream mapping. Effective utilization of these evaluation methods allows organizations to analyze a visual representation of their value streams, leading to the identification of problems in need of attention.

In this assessment, you will learn some useful process measures, basic tools for process improvement, and theories related to enhancing processes and patient flow.

Reference

McLaughlin, D., Olson, J., & Sharma, L. (2022). Healthcare operations management (4th ed.). Health Administration Press.

Preparation

This assessment is based on the Vila Health: Patient Flow media simulation, which is linked in the Vila Health: Patient Flow section of Assessment 1. Go to that section to complete the scenario at this time. The scenario presented in this media piece will provide you with the baseline information and context to create a report that addresses utilizing process improvement techniques and strategies to improve upon patient flow within and out of Independence Medical Center.

In addition to the information presented on fishbone diagrams and quality improvement strategies within the simulation, you may also want to conduct more in-depth research before creating your report. You are encouraged to research topics on patient flow, DMAIC, patient satisfaction, and performance improvement teams.

Instructions

Based on the media simulation you completed, the Director of Quality Management has asked you, in your position in the quality assurance department, to create a report on the declining patient satisfaction at Independence Medical Center (IMC). In addition to your findings, you have been asked to present potential solutions and rationale for why these solutions are potentially relevant and valuable to pursue at IMC.

Include the following in your report:

Explain why patient satisfaction is an essential component of a health care business.
- Identify a competitive advantage of the organization depicted in Vila Health: Patient Flow.
- Explain the organization’s strategic initiatives.
- Explain why patient satisfaction is a strategy for this organization.
Describe why leaders should select declining patient satisfaction as a performance improvement initiative.
- Describe potential reasons for patient satisfaction decline.
- Define a performance improvement initiative.
Complete a fishbone diagram of the situation presented in the Vila Health: Patient Flow media piece.
- Discuss the process to identify the top categories of an issue.
- Describe how to organize the subtopics when producing a fishbone diagram.
Describe the purpose of a performance improvement team.
- Identify the positions or roles that are necessary to form a performance improvement team.
- Describe the stakeholders that should be represented in a performance improvement team.
Describe Lean Methodology.
- Define Lean Methodology.
- Determine what kinds of projects benefit from the use of Lean Methodology.
Explain the define, measure, analyze, improve, and control (DMAIC) model for a data-driven improvement cycle.
- Define the problem or scope that is depicted in Vila Health: Patient Flow.
- Discuss what data you have to collect respective to the identified problem.
- Define the root causes of the problem.
- Determine the possible recommendations the team would offer.
- Define possible recommendations and what would affect them.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Apply the principles of effective composition.
Determine the proper application of the rules of grammar and mechanics.

Write following APA style for in-text citations, quotes, and references.

Determine the proper application of APA formatting requirements and scholarly writing standards.
Assess the relevance and credibility of information sources.

Additional Requirements

Written Communication: Writing is clear, precise, scholarly, and free of errors that detract from the overall message. Concepts flow in a logical order.
References: A minimum of three references, in addition to the course textbook.
Length: 3–5-page paper, plus your fishbone diagram inserted as an appendix following the reference page.
APA: Correct use of APA style and formatting.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Describe when and how the senior leader would directly impact health care operations.
- Describe why leaders should select declining patient satisfaction as a performance improvement initiative.
Competency 2: Analyze the impact of the various success factors of a health care organization.
- Explain why patient satisfaction is an essential component of health care business.
Competency 3: Analyze the concept of competitive strength by considering efficiency and effectiveness of organizational processes.
- Complete a fishbone diagram of the situation presented in this assessment.
- Describe the purpose of a performance improvement team.
Competency 4: Apply management concepts to lead an efficient health care system.
- Describe Lean Methodology.
- Explain the DMAIC model for a data-driven improvement cycle.
Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
- Write following APA style for in-text citations, quotes, and references.
- Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

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Criterion 1

Explain why patient satisfaction is an essential component of health care business.

Distinguished

Explains why patient satisfaction is an essential component of health care business and includes the consequences for not achieving it.

Proficient

Explains why patient satisfaction is an essential component of health care business.

Basic

Explains a few reasons why patient satisfaction is important for health care business, but overall the explanation lacks depth or specific details.

Non Performance

Does not explain why patient satisfaction is important for health care business.

Criterion 2

Describe why leaders should select declining patient satisfaction as a performance improvement initiative.

Distinguished

Describes why leaders should select declining patient satisfaction as a performance improvement initiative and substantiates the reasons with support from research.

Proficient

Describes why leaders should select declining patient satisfaction as a performance improvement initiative.

Basic

Describes some reasons why declining patient satisfaction should be a performance improvement initiative.

Non Performance

Does not describe why declining patient satisfaction should be a performance improvement initiative.

Criterion 3

Complete a fishbone diagram of the situation presented in this assessment.

Distinguished

Completes a fishbone diagram of the situation presented in this assessment and discusses the diagram’s utility.

Proficient

Completes a fishbone diagram of the situation presented in this assessment.

Basic

Completes a fishbone diagram of the situation presented in this assessment but does not include all necessary steps.

Non Performance

Does not complete a fishbone diagram of the situation presented in this assessment.

Criterion 4

Describe the purpose of a performance improvement team.

Distinguished

Describes the purpose of a performance improvement team and provides meaningful examples.

Proficient

Describes the purpose of a performance improvement team.

Basic

Describes a performance improvement team.

Non Performance

Does not describe a performance improvement team.

Criterion 5

Describe Lean Methodology.

Distinguished

Describes Lean Methodology and notes advantages of adopting it.

Proficient

Describes Lean Methodology.

Basic

Defines Lean Methodology.

Non Performance

Does not define Lean Methodology.

Criterion 6

Explain the DMAIC model for a data-driven improvement cycle.

Distinguished

Explains the DMAIC model for a data-driven improvement cycle and includes examples of each phase.

Proficient

Explains the DMAIC model for a data-driven improvement cycle.

Basic

Describes some aspects of the DMAIC model for a data-driven improvement cycle.

Non Performance

Does not describe aspects of the DMAIC model for a data-driven improvement cycle.

Criterion 7

Write following APA style for in-text citations, quotes, and references.

Distinguished

Writes following APA style for in-text citations, quotes, and references without errors and uses current resources.

Proficient

Writes following APA style for in-text citations, quotes, and references.

Basic

Writes mostly following APA style for in-text citations, quotes, and references, but there are lapses in style use.

Non Performance

Writes without following APA style.

Criterion 8

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Distinguished

Writes clearly and logically, using evidence to support a central idea, with correct use of spelling, grammar, punctuation, and mechanics; the report contains supporting examples for the main points.

Proficient

Writes clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Basic

Writes with few errors, making text difficult to follow at times; errors involve spelling, grammar, punctuation, and mechanics.

Non Performance

Writes with many errors, making text difficult to follow; errors involve spelling, grammar, punctuation, and mechanics.

Patient Flow

Vila Health ® Activity

Introduction

The physical delivery of health care is a complicated process, and one which can have implications for the organization’s finances and its patients’ health. For those reasons, organizations try to make their delivery as efficient as possible. For example, hospitals routinely analyze how patients flow from one department to another – such as from the ER to a room in one of the units, or from Surgery to Med-Surg to discharge. The goal is to make sure that patients get treatment in a timely fashion and then discharged or moved to a more appropriate floor as soon as possible.

In this activity, you will observe the flow of patients in an ER.

Email From Quality Assurance

Independence Medical Center is a critical access hospital in Independence, Iowa. You are a recently hired project manager in the hospital’s Quality Assurance department, and you’ve been given an assignment: Find out why patient satisfaction has been going down in recent months.

Email from Chad Williams, Director of Quality Assurance

Subject: Survey Numbers

Hey there! I’m in charge of Quality Assurance and I hear from Albert Lynton that you’re in charge of the project to figure out our problem with patient satisfaction. Albert (he’s our director of operations) asked me to send you the survey numbers so you know what we’re seeing.

So here’s the scoop: In the last 8 months, our patient sat has tanked. We’re talking 93 percent satisfaction at the beginning of that time to 79 percent now. Ouch!

We’re still at 90 percent satisfaction with treatment outcomes, so at least there’s that. And we’re at 85 percent with the quality of the environment – beds, food, that sort of thing.

But here’s where we’re hurting: communication and wait times. We’re at 65 percent for communication (by providers, that is, our docs and nurses), and 49 percent for wait times.

Now, here’s a breakdown of those who said they were dissatisfied with their wait time:

47 percent of those who completed the survey were treated in the ER.
38 percent were admitted from the ER to the floor (to Med-Surg, the ICU, and other departments).
15 percent of the patients who completed the survey were parents of pediatric patients.

Other facts you might want to keep in mind: 73 percent of the hospital’s admissions come through the Emergency Room, and nearly half (46 percent) of these admissions occur between 6 p.m. and 4 a.m.

Good luck, and let me know if you need anything!

––Chad

The Emergency Room

You decide to use a common technique for figuring out problems in patient flow: shadowing patients as they come through the ER.

Ruby Martindale, Linda Mueller, and Stephanie Foster

Ruby Martindale: We’re going to have to divert all ambulances to Buchanan County. We are at capacity, and by that I mean we are beyond capacity.

Linda Mueller: When can I see a doctor?

Ruby Martindale: Any time now! (to another nurse) Who’s attending today? Aren’t there any doctors we can pull in?

Stephanie Foster: No, they’re still doing rounds.

Ruby Martindale: What? It’s 3:00! How many patients do we have still here who could have been moved?

Stephanie Foster: I don’t know, but Med-Surg is under capacity. So probably several.

Message over the hospital PA system:

Dr. Fabiola, please call the ER. Dr. Fabiola, please call the ER.

Debra Green and Beverly Mitchell

Debra Green: That’s his third page. I wonder where he is?

Beverly Marshall: I don’t know, but Mr. Tensleep, the one with the confusing lab results, isn’t going anywhere until we can consult with him.

Winston Sutherland and Heather Taylor

Winston Sutherland: Let’s get an EKG on Ms. Mueller.

Heather Taylor: But she’s not showing any cardiac risk factors.

Winston Sutherland: Let’s get one anyway. She’s driving me nuts and I’m not giving her a single excuse to sue us. Besides, the last patient who didn’t have any risk factors went home on my okay, and he was back here three hours later.

Heather Taylor: Well, it will have to wait. There are quite a few elective surgeries today, and several of the patients needed a preoperative EKG.

Winston Sutherland: Oh, right. It’s Monday. I should have known we’d get backed up. Remind me again why they don’t spread those out?

Heather Taylor: Don’t get me started.

The Fishbone Diagram

Email from Chad Williams, Director of Quality Assurance

Subject: Template for You

How did your observations go? I hope you learned what you needed to. Meanwhile, here’s a template for you to use as you pull together your ideas for improving patient satisfaction. I think this is a useful tool, and I use it myself regularly.

Attachement: The Fishbone Diagram.docx

Now, please answer the following questions.

Question 1: Generated from customer feedback on their perceptions of hospital care, this important and regularly utilized indicator for measuring quality in health care produces data relative to patient experiences, allows for benchmarking, and encourages hospitals to work towards improving the quality of care they deliver.

CMS reimbursement: Incorrect

Correct Answer: Patient Satisfaction

Demonstrating the organizations ability to be respectful of, and responsive to the needs of their consumers which will in turn improve the quality and safety of the care being delivered, decrease costs and increase provider satisfaction as well. Organizations who seek to remain relevant in the industry, improve business operations, continue to capture market share and continue quality improvement efforts, should always be focused on establishing patient safety as an improvement priority. Patient safety should never fall off the improvement radar as organizations can quickly suffer from the implications of declined satisfaction if they are not monitoring the needs of their consumers.

Online Reviews: Incorrect

Correct Answer: Patient Satisfaction

Patient Satisfaction: Correct!

Communication Plans: Incorrect

Correct Answer: Patient Satisfaction

Question 2: Commonly referred to as a cause and effect diagram, this visual tool categorizes potential causes of a problem.

Flow chart: Incorrect

Correct Answer: Fishbone

A flow chart is a diagram utilized to depict a workflow or process.

Fishbone: Correct!

The fishbone diagram (or cause and effect diagram) is a visual tool utilized to highlight potential causes of a problem in order to determine its root causes. The tool itself breaks down the problem into causes under each of the following categories: methods, people, materials, equipment, and environment.

Venn Diagram: Incorrect

Correct Answer: Fishbone

Venn diagrams are mathematical diagrams used to demonstrate the relationship between sets.

Pareto Chart: Incorrect

Correct Answer: Fishbone

Pareto charts are utilized in quality management to identify the most common causes of defects.

Question 3: The front-line staff member is a critical member to the performance improvement (PI) team, as they offer valuable insight into daily operational functions where variation and waste generally occur.

True: Correct!

The front-line staff member is generally closest to the process the PI team is seeking to improve. Including them will provide the team with valuable insight into the process and what areas need improvement. In addition, success of the implemented improvement will require buy-in from those who are going to be impacted most by the change. Including them in the improvement process will generate a sense of ownership and buy-in amongst those on the front line.

False: Incorrect

Correct Answer: True

The front-line staff member is a critical member of the PI team. Failing to include them in the process may result in unsuccessful improvement attempts, lack of staff engagement and buy-in.

Question 4: This systematic improvement methodology focuses on removing waste from the value stream without forfeiting productivity.

Total quality management: Incorrect

Correct Answer: Lean methodology

The lean methodology focuses on making rapid improvements towards the goal of delivering value, eliminating waste, establishing flow and pursuing perfection. Reducing unnecessary and wasteful steps is key towards creating a dramatic improvement in flow in the value stream resulting in improved efficiency and speed – the main goal of the methodology.

Just-in-time: Incorrect

Correct Answer: Lean methodology

Lean methodology: Correct!

Six Sigma Incorrect

Correct Answer: Lean methodology

Question 5: A plan created by the organization to move from their present operations to a more advantageous point in the future in the face of uncertainty, competition and constant change.

Strategic Plan: Correct!

The strategic plan is created by the organization to highlight the desired future state. The plan includes goals, objectives, and tactics necessary to achieve the desired state. This form of planning works from the desired end backwards to the current status.

Risk Management Plan: Incorrect

Correct Answer: Strategic Plan

The risk management plan is created with the intent to minimize the organizations exposure to risk. At a minimum, the plan should include information related to patient safety, federal regulations, medical errors, and health policy and legislation.

Marketing Plan: Incorrect

Correct Answer: Strategic Plan

The marketing plan is created to guide the organization in its efforts towards marketing their products and services. The end goal is to persuade customers to purchase products or seek services from the organization.

Emergency Operations Plan: Incorrect

Correct Answer: Strategic Plan

The emergency operations plan describes how the organization will respond and recuperate from hazards.

Question 6: Demonstrating outstanding scores in patient satisfaction distinguishes an organization from its competitors providing for a dash________________ advantage.

Reputation: Incorrect

Correct Answer: Competitive

Creating and maintaining a competitive edge in the health care industry is a topic of focus for many organizations as change is constant requiring organizations to be innovative and agile in their operations. Given that reimbursements are tied to patient satisfaction, quality, and outcomes any organization wishing to remain relevant in the industry would make patient satisfaction a priority within their strategy. Demonstrating the organizations ability to be respectful of, and responsive to the needs of their consumers which will in turn improve the quality and safety of the care being delivered, decrease costs and increase provider satisfaction as well. Organizations who seek to remain relevant in the industry, improve business operations, continue to capture market share and continue quality improvement efforts, should always be focused on establishing patient satisfaction as an improvement priority. Patient satisfaction should never fall off of the improvement radar as organizations can quickly suffer from the implications of declined satisfaction if they are not monitoring the needs of their consumers.

Quality: Incorrect

Correct Answer: Competitive

Reimbursement Incorrect

Correct Answer: Competitive

Competitive: Correct!

Question 7: According to the Institute for Healthcare Improvement (IHI), the six major bones included on the fishbone diagram include; measurements, materials, people, machine, methods and dash________________.

Variables: Incorrect

Correct Answer: Environment

The environment bone will highlight key elements that may contribute to an error including patient acuity at the time of the error, staffing ratios, conditions (time, temperature, culture of the unit etc.).

Environment: Correct!

Outcomes: Incorrect

Correct Answer: Environment

Policy Incorrect

Correct Answer: Environment

Question 8: The Value Stream Map is a tool utilized in the lean methodology and analyzes the current state for a series of events that takes a product or service from its beginning through to the end.

True: Correct!

Value stream mapping is an effective tool utilized in lean six sigma projects to help visualize a patients path to treatment in an effort to improve the service an minimize delays. Delays in care are considered wasted time in health care as time spent with the patient equates to dollars reimbursed. A key component to the value stream map is identifying the ideal state.

False: Incorrect

Correct Answer: True

Question 9: This five-step model is a core tool utilized in Six-Sigma improvement projects:

Lean: Incorrect

Correct Answer: DMAIC

DMAIC: Correct!

The DMAIC (define, measure, analyze, improve, and control) is a five-step process utilized in the Six Sigma method which is focused on eliminating defects and waste resulting in improved quality and efficiency. The data driven strategy requires use of all five steps in order to ensure the best possible results.

SWOT: Incorrect

Correct Answer: DMAIC

A strategic planning tool, the SWOT analysis includes a review of the strengths, weaknesses, opportunities and threats related to business planning.

ISO 9000 Incorrect

Correct Answer: DMAIC

ISO 9000 is a compilation of quality management systems utilized by organizations to meet the needs of various stakeholders while simultaneously meeting regulatory requirements.

Question 10: By improving dash__________________ organizations can realize monetary savings on staffing, decreased wait times, and increase provider and patient satisfaction as patients are efficiently transferred between.

Cultural Competence: Incorrect

Correct Answer: Patient Flow

Barriers to seamless patient flow may include staffing, limited inpatient bed availability and delays in radiology and laboratory study processing. Failing to address barriers to patient flow result in increased organizational costs, diminished patient & provider satisfaction and delays in rendering care. Barriers to patient flow exist between facilities as well due to lack of collaboration, communication, and established process. Facility to facility transfers in care will continue to rise given the increase of baby boomers entering into retirement and seeking services from the industry. Organizations who are proactive in addressing potential inefficiencies and barriers to patient flow between facilities will reap the benefits of seamless patient throughput.

Electronic Health Records: Incorrect

Correct Answer: Patient Flow

Patient Flow: Correct!

Patient Safety: Incorrect

Correct Answer: Patient Flow

Conclusion

Conclusion: Activity complete!

What did you learn about Independence Medical Center’s patient flow? What would you do to improve the situation?

Description

Introduction

Reference

Preparation

Instructions

Additional Requirements

Competencies Measured

Scoring Guide

Criterion 1

Criterion 2

Criterion 3

Criterion 4

Criterion 5

Criterion 6

Criterion 7

Criterion 8

Patient Flow

Introduction

Email From Quality Assurance

Email from Chad Williams, Director of Quality Assurance

The Emergency Room

Ruby Martindale, Linda Mueller, and Stephanie Foster

Message over the hospital PA system:

Debra Green and Beverly Mitchell

Winston Sutherland and Heather Taylor

The Fishbone Diagram

Email from Chad Williams, Director of Quality Assurance

Now, please answer the following questions.

CMS reimbursement: Incorrect

Online Reviews: Incorrect

Patient Satisfaction: Correct!

Communication Plans: Incorrect

Flow chart: Incorrect

Fishbone: Correct!

Venn Diagram: Incorrect

Pareto Chart: Incorrect

True: Correct!

False: Incorrect

Total quality management: Incorrect

Just-in-time: Incorrect

Lean methodology: Correct!

Six Sigma Incorrect

Strategic Plan: Correct!

Risk Management Plan: Incorrect

Marketing Plan: Incorrect

Emergency Operations Plan: Incorrect

Reputation: Incorrect

Quality: Incorrect

Reimbursement Incorrect

Competitive: Correct!

Variables: Incorrect

Environment: Correct!

Outcomes: Incorrect

Policy Incorrect

True: Correct!

False: Incorrect

Lean: Incorrect

DMAIC: Correct!

SWOT: Incorrect

ISO 9000 Incorrect

Cultural Competence: Incorrect

Electronic Health Records: Incorrect

Patient Flow: Correct!

Patient Safety: Incorrect

Conclusion

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