7055SOH – Leading in Complex Health Systems Assignment Sample

Project Plan for reducing Patient Waiting time

Introduction

Patient waiting and turnaround management can help in improvement of performance of healthcare organizations as well as professionals. In this assessment the learner has developed a project plan for reduction of waiting time.  A framework of six sigma principles is provided in the paper to ensure that organizations remain competitive in an increasingly competitive healthcare delivery industry, which is discussed in detail in the paper. As one of the most major components of this thought, the ability to provide timely care while also minimizing potentially harmful delays, which is one of its most critical components, is one the most significant components of this notion. Patients should not be required to wait for appointments or consultations for an extended amount of time, according to internationally recognized standards for healthcare service administration. (Sun,2017)

Project Background

In the past, patients have expressed dissatisfaction with extended waiting periods, and as a result, long waiting times have been identified as a consistent and significant source of prospective patient dissatisfaction in the healthcare environment. According to various studies, the amount of time spent waiting is inversely related to patient satisfaction in a statistically meaningful inverse manner. In a healthcare environment that is becoming more personalized and consumer-driven, the capacity to maintain perfect patient satisfaction is becoming increasingly important to survival.

Project Overview

In Chinese health-care systems, there is a persistent problem with waiting times, which may be separated into two categories: first, there are worries about the quality of care; and second, there are concerns about the cost of care. Those who are waiting in long queues at the registration and admission offices are classified as the first of these groups. Most Chinese hospitals did not require patients to register in advance, instead requiring them to register when they arrived at the hospital’s service window, resulting in an unexpected flood of patients that congested hospital hallways and caused traffic jams. Patient convenience is the first step toward ensuring that they have timely access to healthcare services. Making the appointment scheduling procedure as simple and straightforward as possible is the first step toward ensuring that they have timely access to healthcare services.

Project Aim and objective

 Appointment scheduling software has been developed to replace the antiquated practice of having clients arrange appointments in person at medical institutions, which is becoming increasingly obsolete. Paying using a credit card through the internet, by phone, via a mobile device, or through an automated teller machine (“ATM”) is simply one example of the many different sorts of payment options accessible at hospital.

Literature Study

A further contributing aspect to the problem is the significant amount of time that elapses between the time of a patient’s appointment and the time that they are seen by a physician. A 2015 China National Patient Survey , which included responses from 136 public tertiary institutions, discovered that outpatient customers of ambulatory services were the most dissatisfied, citing long waiting times for consultations as the main source of their dissatisfaction with the services. This is mostly since patient demand is increasing at an alarming rate, and this is surpassing the expansion in readily available health-care resources at an alarming rate, which is the fundamental cause of the current predicament.

Outpatient visits to public tertiary hospitals in China have nearly quadrupled in the preceding ten years (from 946 in 2005 to 1972 in 2015), despite the fact that the total number of public tertiary hospitals in China has more than doubled  . This is even though the total number of public tertiary hospitals in China has more than doubled. In two studies , it was found that increasing patient turnover had a detrimental impact on the overall quality of care provided to patients. For example, rising tensions between professionals and patients are becoming more prevalent.

Proposed innovation

To mitigate the negative impact of long patient waiting times on patients’ health, health-care providers must rely on improved flow control and better capacity allocation. However, doing so is becoming increasingly difficult in the face of constantly increasing demand and limited healthcare resources. Successful implementation of organizational and structural reforms, in conjunction with strategic planning and demand-oriented scheduling of outpatient therapy, is essential in order to achieve success in this endeavor.

There had only been a few interventions that were well documented, and the impact of therapies had only been studied in a reliable manner on a few occasions, according to the findings (Improta,2017).

Six sigma

DMAIC Activity list Duration
Define the problem and the project goals 1 week
Measure in detail the various aspects of the current process 1 Week
Analyse data to, among other things, find the root defects in a process 1 week
Improve the process 1 week
Control how the process is done in the future 1 Week
Define the problem and the project goals 1 week

Define the problem and the project goals

The taskforce measured the amount of time prescribed outpatients spent waiting for their prescriptions to be filled between February 22nd and February 26th, 2016, between the hours of 7:30 a.m. and 6:30 p.m. The data was collected between February 22nd and February 26th, 2016.

Measure in detail the various aspects of the current process

To keep the baseline inquiry as small as possible, it was decided to limit it to the 10,868 ambulatory patients who came in for consultation specifically for the sake of the investigation. It took an average of 57 30 minutes for them to get through security, with the morning waiting period being significantly longer than the afternoon waiting period.

Analyse data to, among other things, find the root defects in a process

According to the data, a growing number of departments are being recognized as having much longer wait times than the general population. In each individual appointment, the average length of time spent in consultation was roughly five minutes apiece. As a result of discovering that the total number of targeted prescribed patients was 17,235, it was observed that their daily average waiting time for filling prescriptions was 34 19 minutes, with the longest waiting times (over 40 minutes) occurring between the hours of 10:30 and 14:00.

Improve the process

The researchers discovered that the longest waiting times (more than 40 minutes) were observed between the hours of 10:30 and 14:00. (Trakulsunti,2018)

Control how the process is done in the future

It was agreed to use the results of the patient satisfaction survey to evaluate the work of on-call doctors and pharmacists, and financial penalties were placed on those who did not perform up to the defined levels of excellence. All of these considerations were taken into consideration as part of the usual management procedure (Basta,2018).

An investigation into the core factors

Patient segregation efficiency in the hospital context is greatly impacted by physicians’ early arrivals and early departures, which are among the most significant factors affecting patient segregation efficiency. Some other factors to consider are the number of visitors who arrive in the morning versus those who arrive in the afternoon; the number of patients and follow-up patients; the number of doctors working in specific departments; a shorter time interval between consultations (four minutes) than the length of consultation times for some physicians; poor scheduling of receiving patients as well as late-arriving and early- departing physicians; and the number of visitors who arrive in the morning versus those who arrive in the afternoon According to the survey, it was determined that there was a severe scarcity of on-call personnel in the pharmaceutical industry during particular hours. This was especially true between the hours of 12:00 and 14:30 and after 17:30. (Sun,2017)

Interventional techniques should be approached in a systematic manner.

Changing the way appointments are scheduled, just a few of the supply-side modifications being implemented include rescheduling appointments, monitoring the attendance of on-duty doctors, and implementing financial penalties for late arrivals and early departures. Some of the other supply-side measures include sending text notifications to mobile phones the night before on-duty days and when on-duty doctors are late for more than 10 minutes; having weekly routine meetings to identify and humiliate bad performers; and deploying electronic medical records. Demand-side changes are being made through the use of electronic medical records, which are becoming more common. It is planned to use an application (APP) installed on patients’ smart phones to inform and remind them of the time of consultations. (Migita,2018) It will also be used to improve appointment scheduling through a variety of approaches; patients who are late for more than 15 minutes will be required to schedule a new appointment with the clinic. (Oueida,,2018)

Through the use of an LED screen outside the pharmacy during peak hours, the taskforce informed patients that they should be prepared to fill prescriptions; by increasing the number of on-duty staff and window openings during peak hours; and through the use of an LED screen outside the pharmacy during peak hours, the taskforce informed patients that they should be prepared to fill prescriptions When the taskforce received word after 17:30, it told patients that they should be prepared to fill prescriptions. Patients were made aware of the number of persons on a waiting list by displaying their electronic card numbers on a light-emitting diode, which was installed in the waiting room.( Laurenza,2018)

leadership and management concepts, theories,

We were able to get all of the necessary information from a variety of different information systems, which proved to be really beneficial (including process management, personal, and clinical information). Upon presenting oneself or herself for treatment at the registration desk, each outpatient is issued an electronic patient card, which has a unique identification code that can be used to identify the individual who has presented themselves. Any service provided by the hospital can be accessed through the use of an electronic patient card. These services include access to appointment schedulers, registration systems, doctors’ and nurses’ workstation’s, labs and pharmacies, and the payment system, to name a few examples. An electronic patient card, which contains all of the information regarding a patient’s health-care procedure, including diagnosis and treatment, is kept in one convenient location. (Horwitz,,2019). On the day of registration and payment of the prescription bill for each visiting outpatient, a printed receipt is also supplied to the outpatient who is visiting.

It was determined that this report would be produced based on the results of the patient satisfaction survey. (Trakulsunti,2018)

Activities

Following clearance from the Hospital Ethics Committee, the taskforce began conducting a daily patient satisfaction survey on the first of January 2016, which was approved by the hospital administration. Starting on the first of January 2016, the taskforce encouraged outpatients to complete around 50 questionnaires every day, starting on the first of January 2016. A organized Likert scale quiz with five response alternatives was pre-installed on the iPad, and it could be completed whenever you chose. When the taskforce employees approached the patients, they went over a written Informed Consent statement with them before asking them to participate in the survey. By the taskforce’s standards, only those patients who had indicated no reservations were asked to participate in the survey. Specifically, one specific indication pertains to pharmacy services (“Are you satisfied with pharmacy services?”) and another pertains to the consulting doctor (“Are you satisfied with the consulting doctor?”) in the questionnaire utilized by the research hospital. Each signal was assessed by the patients, and the total score was added together in order to determine their overall level of satisfaction with the treatment plan. (Antony,2017)

  7055SOH – Leading in Complex Health Systems Assignment Sample

(Source: Created by learner)

  7055SOH – Leading in Complex Health Systems Assignment Sample

(Source: Created by learner)

  7055SOH – Leading in Complex Health Systems Assignment Sample

(Source: Created by learner)

Budget

Activity list Duration Units Cost ( all in GBP)
Define the problem and the project goals 1 week 1 10000
Measure in detail the various aspects of the current process 1 Week 1 12000
Analyse data to, among other things, find the root defects in a process 1 week 1 3000
Improve the process 1 week 1 4000
Control how the process is done in the future 1 Week 1 2000
Define the problem and the project goals 1 week 1 4000

How successful implementation of the innovation will be measured

The outpatient respondents were identified from the waiting area outside the outpatient pharmacy during working hours on a daily basis, using a convenient sampling procedure, during working hours on a daily basis. The inpatient respondents were identified from the waiting area outside the outpatient pharmacy during working hours on a daily basis, using a convenient sampling procedure (Antony,,2017). Inpatient respondents were recruited from the waiting area outside the outpatient pharmacy on a daily basis during working hours, utilising a simple sample approach that was convenient for the participants (Brown,2020). A simple sample technique was used to gather inpatient respondents from the waiting area outside the outpatient pharmacy on a daily basis during working hours, resulting in a convenient sample for the participants (Improta,,2018). After non-experienced patients were eliminated from the sample, a total of about 1000 responding outpatients (approximately ten percent of the total sample size) were included in the calculations of the monthly average outpatient satisfaction score for the relevant healthcare service.

Waiting times and patient satisfaction were measured using the following metrics for the aim of evaluating the system:

Many studies have shown that process is crucial in healthcare, and that using a process improvement team technique to analyze and change the patient care system can be effective in reducing waiting times and boosting patient satisfaction Following our research, we discovered that an extremely large number of investigations carried out at Chinese tertiary hospitals came to the same result, which was in agreement with our own findings. About the problem of long wait times in outpatient care, the investigated facility, which has risen to the top of the list among Chinese tertiary public hospitals, serves as an excellent example of how to implement continuous quality of healthcare improvements in outpatient care by optimizing the process management with the support of relevant evidence. (Gilbert,2019)

Recommendations

Quality improvement requires the existence of a multidisciplinary taskforce that has been authorized by the hospital’s top administrator and has final authority to devise interventions, evaluate the performance of targeted actors, and relate the outcomes of evaluations to financial penalties.

  • The implementation of a process-improvement approach that is backed by strong and continuous support from top-level hospital executives is also critical to improving patient outcomes. (Alotaibi,2017)
  • Second, they recognized and explicitly defined the problem of extended waiting times as the focus of their inquiry as a second phase in their investigation. Interventions with well-defined aims and target audiences were able to achieve success as a result of this finding.
  • Third, and most important, step was to re-establish confidence in the initiative after identifying a potential source of the problem, gathering and analyzing relevant data, developing solutions that addressed fundamental causes of the problem, and seeking support from the hospital’s chief executive officer.

 A small sample of patients who were waiting for consultations was examined before the trial was expanded to include patients who were waiting for prescriptions to be filled, ensuring that the treatments progressed in the expected manner over time. In the following phase, students were required to evaluate and analyze the information they had gathered about their solutions, which enabled them to make evidence-based revisions to their answers in the sixth step. The integrated information system was shown to be crucial in ensuring that the problem-solving technique outlined above was carried out in a timely and efficient manner, which was the final demonstration (Cao,2020).

This poll was conducted after the initiatives to reduce consultation waiting times were introduced and only one month before the interventions to reduce prescription filling waiting times were implemented, which is a disappointment. (Alotaibi,2017).

Conclusion

However, it is possible that increased patient satisfaction is not the result of shorter waiting times, but rather of longer consulting times because of process improvement that results in longer consulting times. At the hospital under review, outpatient satisfaction surveys are conducted daily to obtain feedback from patients. An outpatient satisfaction survey asks just about how satisfied they are with the doctors who treat them, rather than how long they must wait for consultations as part of their routine care. Similar trends can be observed among outpatients, who report extremely positive experiences with pharmacy services.  Although the poll did not specifically inquire about patients’ satisfaction with the time it takes to fill prescriptions, this is the case. Though waiting time is a significant component of outpatient satisfaction with consulting physicians, there are several other important factors that influence outpatient happiness with consulting physicians, including: Patients’ satisfaction has been shown in previous studies to be highly dependent on interpersonal relationships, and this has been confirmed in this study. Because of this, patients who have been delayed in receiving medical treatment, but who afterwards have a good relationship with their doctor, are still likely to be happy. Because there is no data on outpatient satisfaction prior to 2016 and no data on outpatient satisfaction following interventions, we can only infer a general rising trend in outpatient satisfaction following interventions (the hospital outpatient satisfaction survey first began in January 2016).

References

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Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173.

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173.

Antony, J., Rodgers, B., & Cudney, E. A. (2017). Lean Six Sigma for public sector organizations: is it a myth or reality?. International Journal of Quality & Reliability Management.

Antony, J., Rodgers, B., & Cudney, E. A. (2017). Lean Six Sigma for public sector organizations: is it a myth or reality?. International Journal of Quality & Reliability Management.

Arcidiacono, G., & Pieroni, A. (2018). The revolution lean six sigma 4.0. Int. J. Adv. Sci. Eng. Inf. Technol, 8(1), 141-149.

Basta, Y. L., Tytgat, K. M. A. J., Greuter, H. H., Klinkenbijl, J. H. G., Fockens, P., & Strikwerda, J. (2017). Organizing and implementing a multidisciplinary fast track oncology clinic. International Journal for Quality in Health Care, 1-6.

Brown, T., 2020. Reducing Frustration with Wait Times Utilizing Technology and Education: A Patient Satisfaction Improvement Model.

Cao, M., Zhang, D., Wang, Y., Lu, Y., Zhu, X., Li, Y., … & Lu, H. (2020). Clinical features of patients infected with the 2019 novel coronavirus (COVID-19) in Shanghai, China. MedRxiv.

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Improta, G., Cesarelli, M., Montuori, P., Santillo, L. C., & Triassi, M. (2018). Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy). Journal of evaluation in clinical practice, 24(2), 338-346.

Improta, G., Cesarelli, M., Montuori, P., Santillo, L. C., & Triassi, M. (2018). Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy). Journal of evaluation in clinical practice, 24(2), 338-346.

Improta, G., Romano, M., Di Cicco, M. V., Ferraro, A., Borrelli, A., Verdoliva, C., … & Cesarelli, M. (2018). Lean thinking to improve emergency department throughput at AORN Cardarelli hospital. BMC health services research, 18(1), 1-9.

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Sun, J., Lin, Q., Zhao, P., Zhang, Q., Xu, K., Chen, H., … & Liu, Y. (2017). Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study. BMC Public Health, 17(1), 1-11.

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Trakulsunti, Y., & Antony, J. (2018). Can Lean Six Sigma be used to reduce medication errors in the health-care sector?. Leadership in Health Services.

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