Improvement of performance in health care system is a goal of every health organization. The Health care system has been under from many stakeholders group to improve organizational performance and also improve the quality of service to patience. Pressure from the media is an ongoing scenario. The media regularly focuses of inefficiencies such us lack of resources, long waiting lists, error and incidents and physical and damages that happen to patients in health care systems. Errors and incidents in the health care systems consitute great problems in the health care systems. According to Blumenthal (2012), it is estimated that 5,000 cases of medical error happen in the United State annually. Moreover, incidence of wrong diagnosis and wrong medication leads to 44,000 deaths. The pressure also comes from the government, which constantly demands for health care organization to use their power to fix this problem. On the other hand, in some countries, governments cannot keep pumping money for the health system to work efficiently. Therefore, the challenge for health care system is to improve their performance to eliminate these problems.
However, case studies from high performing organization can be employed to minimize or eliminated these problems. This is by improving the performance of the employee, where in this case the health professionals. In addition, quality leadership is necessary to “push forward” the implementation of training and other activities involved in performance improvement. Forbes, Day, Rotem and Jochelson (2006) research indicates that three components are critical to link people management and improve performance. These critical components include training and development, performance appraisals and feedback and effective teamwork. Moreover, leaders and manager are requires special competencies in order to handle pressure and able to manage employees. This essay focuses on performance improvement strategy that can be implemented to improve performance improvement in health care. The performance improvement strategy addresses specifically performance improvement of health professionals to address inefficiencies in diagnosis and prevention of medical incidences. The essay details the steps needed to implement the process and best approach to reach organizational goal. Additionally, motivating strategies to engage stakeholder and the leader roles are also discussed.
Objectives of healthcare
Medication error in health is very common occurrence in health care. According to National Reporting and Learning Service (NRLS), more than 5,000 cases are received every month (Spath, 2011). These problems arise solely from safety incidence relating to medication. The incidences are very high such a way that NRLS indicate that they require a special attention. A review of medication related patient safety shows that incidences that cause serious harm to patients, or even death, result from a number of common mistakes in health care. These mistakes include unclear/wrong dose/frequency, wrong medicine, omitted or delayed medicine, contradicted medicine, adverse drug reactions (allergy) to medicine, wrong route and mismatching patients. For instance, health care organization in the U.S. got challenged in 1999 for report released indicating that 44,000 people die annually due to wrong medication. This figure is more that people who die from accidents and breasts cancer (Spath, 2011).
According to the U.S. institute of medicine, preventing medication errors in the health system requires communication between patients and the health care professionals. Patients should know their disease well, and corroborate with health care giver to provide high quality services. In regard, profesionals have a responsibility to educate patients about their disease. Spath (2011) provides a solution for approaching the problem. The author indicates that, health care professionals need to know how to assess quality in health care system. Healthcare management of quality does not solely focus on quality management only, but it also focuses on strategic leadership. Primary health care professionals require proper training for them to provide quality education to the patient. They also require motivation to ensure they keep up to the requirement of health care. Therefore, the goal of health care system is to improve the efficiency of care professional and eliminate these errors.
Pressure for improvement
The goal of reduce error in health care is geared toward providing overall quality service to patients. According to William (2009), health care system faces eight problems. These factors are categorized into two groups comprising strategic factors and operational factors (cited in Bornstein, 2001). Strategic factors include the role of leadership and the role of physician, customer focus and investments of resources. Operational factors include quality management, process management and employee relation. Bornstein (2001) noted that the management of quality in health care has a problem because it lacks expertise, knowledge and skills. He suggests that health care professionals require training based communication. Other main problems in health care are over expenditure, medical errors and expansion costs. The goal for the management is to improve the quality of services to reduce medical errors. Improvement of internal arisies from new staff joining the organization. These new staffs are not highly experience and thereby there is a need immediate performance improvement. The issue was targeted as performance improvement. Already, the nurse have the knowledge; however, they have inefficiencies during administration of drugs and development of care plans. Other efficiencies are also seen in diagnosis of diseases. As a result, the whole process of patients care results to errors which leads to bringing more problem than doing good (McLaughlin and Kaluzny, 2006).
As many strategic plans require planning, performance improvement requires a good planning before an organization engage on improvement. Performance improvement plan involves improvement of various system, which are geared towards organization goals. In this sense, reduced medical error is over the goals the organization is entitled to achieve. This requires improves of different sectors involved in administering to drugs to the patient. For instance, reduced medical call for an organization to undertake a strategic avenue geared toward on improving health professionals quality of service delivered.
According to Institute of Medicine (2004), any strategic initiative takes three continuous phases. These phases include assessment (phase 1) planning Training and implementation (phase II) whereas phase III comprises of sustainment of improvement. This is in accordance with Lewin’s force field analysis theory. The theory shows current performance as a state of equilibrium. The equilibrium is between the force that promote upward movement and those that discourage it. Therefore, to enhance change in an organization, it requires reducing the forces that discourage upward movement. This process of reducing restraining forces has there steps, which include unfreezing (reduction the forces), moving (developing more organizational value) and refreezing (stabilizing the change). This part shows how the model operates in improving efficiency in medical professionals to ensure reduced medical errors.
In this sense, the health organization should involve health care professionals in the establishment of strategic goals. For example, the health care professional can play a part in research and questionnaires to find out the cause of medical errors. Then, health professional should also be involved in creating goals which will be achieved by the organization (Institute of Medicine, 2004). The health care organization should also hold a regular meeting with employees. These meetings should be geared towards elaborating strategic goals. As a result, their achievement will not only be those concerning organization, but also concerning them. Managers in the health care organization should focus on sharing organizational goals with health care employees. In regard, it is very important for employees to be aware of organization goals so that they are in harmony with them. Otherwise, their striving will be pointless. This results to health employees perceiving their work as routine. Therefore, this results to demotivation to be more efficient. In this case, the health care managers are supposed to develop a good relationship with employees. In this this case is that, manager should continuously provide information to employees about the strategic goals. In respect to Lewin’s force field analysis theory, this process can be referred to as unfreezing.
As a focus of providing a good communication method to health care professionals, the management can develop a new communication technology and telecommunication strategy. As such, new communication technology can allow a good form of communication to prevail (McLaughlin and Kaluzny, 2006). In regard, health care manager do not need to face an employee in person. However, the manager can use the intranet to communicate to employees either within or outside the organization. Additionally, a good communication system can facilitate better delivery of service. In fact, good communication method can result to reduction of medical errors. Institute of Medicine (2004) suggests that good communication facilitates sharing of information, allow faster consultation and, therefore, contribute to overall improvement of quality services.
In actuality, a good telecommunication technology facilitates a good way of storing and retrieving patient information. In regard, telecommunication allows access to patients’ medical history. In this way, the health care professionals are able to understand patients’ current condition, as well as, historical health condition. In actuality, the health care professional can understand whether the patient under care has any history of allergy when using some drugs. However, with improved communication technology, confidential medical health record of patients can be easily revealed. Therefore, health care professional have their duty to protect patients medical history from third party, or from external extruders. With the help of contemporary technologies, the confidential records of patients can be easily accessed.
Therefore, health care professional should put protective measures to avoid intrusion. The benefits of health records cannot be underestimated. In fact, the efficiency achieved in retrieving and storing patients’ records does not only reduce error during treatment, but also result to improved quality. According to McLaughlin and Kaluzny (2006) faster retrieval and recording of patients are vital for patient survival. For example, a patient with a history of an allergic reaction towards a certain medication, the health care professional should have a detailed history record of the patient in order to avoid an allergic reaction.
Furthermore, the health care organization should develop training programs for health care professional in order to perfect their action. In regard, the health organization has a mandate to encourage the professional to gain more knowledge related to his or her field. In regard, health care professional is attending refresher training in order for them to keep up with the emerging discoveries. For instance, over the years, diseases have become resistance to some medication. Therefore, the health care organization to ensure they engage with the discovery. Training improves efficiency (NHS Institute for Innovation and Improvement, 2008).Therefore, reducing medical error requires health care professionals to have a thorough knowledge concerning the treatment that isused. Examples of training that can be offered in reduction include medical health record training, cultural training and (McLaughlin and Kaluzny, 2006). In regard to cultural training, health care professional should understand the culture of the patients. In actuality, a health care professional should understand the values of the patient in order to enhance communication. Communication between patients and health care professional is very important. Institute of Medicine (2004) suggests that communication between employees and health care professional should be facilitated. Prevalence of a good communication between health care professionals and patient provide a good avenue in which to avoid medication. In regard, good communication provides private information of patients which could have not been revealed if it were not for good communication. Clearly, training ensures continual development of health care professionals and managers. This ensures continual performance improvement within the organization. As a result, overall reduction of medical errors, as well as quality improvement delivery becomes a reality.
Finally, health care manager should stimulate establishment close cooperation between employees and team work. In this way, the health care can establish teams that assist each other on regular bases. In actuality, the health care organization should provide a training course to health professional on how to work in a team efficiently. The health care organization should encourage teamwork among health professionals and also among manager and also share the experience. In regard, the employment of modern method of telecommunication may not only helpful but may also facilitate sharing of information (Berwick and Finkelstein, 2010). In this respect, medical error and attainment of quality service delivery can be achieved. This results to sharing of skills abilities and strategies among professionals.
Approach best to improve organization performance
Health care organizations have varieties of approach they can use to improve performance. In regard, Six Sigma is a best method for reducing medical errors in health care system (Institute of Medicine, 2004). Six Sigma is a powerful optimization of methodology that aims at perfection of every single organization process. This is information driven methodology that reduces waste, improve customer satisfaction, and also improves processes within the organization. The objective off the methodology is to reduce the variance enhance control methods in order to conform to critical specifications.
In fact, Six Sigma focuses on improving the various processes in the organization in such a way they conform to critical specification. This implies that processes that dealing with patient treatment conforms to a specification provided. This will provide the high quality services to patients, as well as, as providing satisfaction to patients. Therefore, quality services within the health organization will improve consistently. Additionally, the health care should also employ data sharing among the health care professionals. In regard, this approach is important because it allow quick sharing of information within the organization. Professionals within the organization can share information as they undertake their daily work or during their training course. This comes as responsibility for health organization to prepare for its employees, as well as, their managers (Mainz, 2003b).
Furthermore, customer-approach I a unique tool organization can employ. In this approach, the patient becomes the major concern of the health care organization as well as its professionals. As a result, the approach will reduce medical errors, improve the quality of other services, and hence achieve customer satisfaction. The employment of teamwork does not only enhance relationship, but it also increases the effectiveness of employees’ performance (Berwick and Finkelstein, 2010). Team work ensures close cooperation and also ensures mutual support and knowledge sharing.
Type of the performance indicator selected
In response to the introduction of the aforementioned recommendation introduced to improve performance, it is more beneficial to for the organization to assess the changes that result from the introduction of those recommendations. In this regard, the assessment of cases of medication error is very important. The reduction of the medical errors can be analyzed to analyzing through previous data and the current data. Additionally, employees’ effectiveness is also a good indicator of the achieved performance improvement. In regard, Mainz (2003b) suggests that health organization should assess employees basing on the quality of services they offer to patient. Therefore, detailed analysis of employee’s effectiveness through analyzing outcomes of patients can be effective. Patients’ details analyses include patients’ treatment, wrong diagnosis, and patients returning for the same problem patient had in the previous occasion. Quality of health care delivery, which a health professional delivers, may also be addressed through questionnaires. The patients need to respond to the questionnaire to give their opinion on the services they receive from the health organization (Mainz, 2003b).
Strategies for motivating and engaging stakeholders
Healthcare professional are not only supposed to use material motivation, but they are also supposed to use non-material motivation to employees. Bonuses to employees cannot solely motivate employees to work better. However, health organization should employ non-material benefits as a mean of motivating employees. These methodologies of non-material methods include involving employees in development, elaboration and implementation of changes in the organization. They should also be involved in the elaboration of loyalty programs and other tools concerning them. At this time, the health care organization should also involve the patients tell them about the ongoing program and also suggestion of the most widely recognized problem. This involves providing an avenue in which patients and the health care professionals can freely communicate. In such a scenario, the health care profession can prevent medical errors that are creating a problem in health care system. In regard to this, provision to the public with the information will not help them be aware of the problem, but also help the healthcare professional to understand their problem. Therefore, overall performance will be achieved (Blumenthal, 2012).
Role of leaders in performance improvement
In regard to achievement of above set goals, performance improvement requires leaders who can provide motivation, as well as, provide a sense of responsibility within the health care. Health care service delivery is not done by single doctor. However, service delivery is done by teams (Berwick and Finkelstein, 2010). No team work can be perfect without a leader; this is very essential, especially in nursing, where leadership is vital for directing the team , as well as providing motivation to for the team members. According to Caress, (2005) “all good result of good nursing……may be spoiled or utterly negative by one defect, Viz. in petty management” (cited in Berwick and Finkelstein, 2010). Transformational leadership is essential in performance improvement in an organization. This type of leadership allows employees to gain faith, and treat employees as solver of the problem through innovation. This type of leadership allows transmission of ethical values and provision of challenging goal while at the same time communicates strategic goals. Transformational leaders are the perfect leaders for the ever-changing health care environment, which require fast adaptation. Berwick and Finkelstein (2010) claim that transformational leaders in leadership, correlates positively with employees’ satisfaction and better performance. In this respect, performance improvement to accomplish reduced medical error requires a transformational leader.
Transformational leader will offer a chance to motivate employees and to instill a sense responsibility. In regard, health care professional will be motivated to accomplish strategic goals as revealed by the leader. Performance improvement involves gaining efficiency to accomplish organization goals (McLaughlin and Kaluzny, 2006). These goals need to be communicated to employees to ensure they strive meet them. Therefore, reduced medical errors will be achieved through enactment of transformational leadership. Additionally, shared leadership is another leadership that emerging. Shared leadership empowers all staff for decision making. This leadership also empowers nurses to develop multidimensional care. It is a decentralized form of governance which gives responsibility to member of a team. Therefore, in performance improvement, those two leadership styles play a vital role (NHS Institute for Innovation and Improvement, 2008)
Thus, looking at the above mention it is clear that health care organization cannot provide quality services without effective organization performance. In this respect, health care cannot reduce medical errors unless there is effective organization performance. Therefore, to reduce medical errors, health care organization should improve the performance of the health care professional. This through establishing better communication, providing training programs and create an environment where patient and health professional can freely speak. The health organization also need to establish teams, encourage data sharing and improve telecommunication systems. This improves the performance of health professional which in turn leads to overall performance improvement.