Patient Flow Continuous Improvement Methodology- PDCA
Introduction- Organizational Problem
The hospital management overseeing the healthcare facility that I work in is under pressure to improve patient flow. The organization has invested vast resources and borne high costs to improve facility service delivery and attract many customers. Poor results in any sector are a result of inadequate systems put in place. The employees always complain about their safety due to the fast handling of patients due to management pressure. The manager wants us to reduce the waiting time of patients to convince patients that the hospital service delivery is immediate and quality.
Nevertheless, this will happen at the expense of healthcare workers’ safety. In a hospital set-up, there are many risks. The employees need to be fully equipped and prepared before they attend to a patient.
The employees have turned a deaf ear to the call by the management team to offer their services to the patients expeditiously. They feel that their safety will be compromised, and the employer is not interested in their health despite providing health services. They have together resolved to mind their health and safety fast before administering any treatment to the healthcare seekers. The clinicians and nurses have relaxed even more and taking their time to see the patients. They believe quality can only be improved by diagnosing one patient correctly and offering the right medication. This is contrary to the management. The facility is private-owned, and the primary objective is to make high profits. Thus, there is a stand-off between the two; employer and employees.
This paper will apply the Plan-Do-Check-Act (PDCA) continuous improvement methodology to address the differences and contrast between the key stakeholders in the healthcare facility. PDCA model is an iterative four-stage cycle used for problem-solving in organizations. It encompasses both carrying out a change and improving the existing process service or product. It entails systematic testing of possible solutions, results assessment, and implementation of the ones that have proven viable. The scientific method was popularized by Dr. Edward, the father of modern quality control (Thomas & Caldwell, 2019). The PDCA model will provide a practical and straightforward approach for solving the quality-safety problem of the organization by developing hypotheses of the change or improvement required, testing those hypotheses in a continuous cycle of feedback, and lastly, gaining helpful knowledge and learning. The four components of the PDCA model are briefly explained below:
i. Plan – the element entails problem identification, relevant data collection, understanding the root cause of the problem, hypothesis development of the probable issue, and decision-making of the one to test.
ii. Do – the element constitutes solution development and implementation, determining the effectiveness measurement, potential solution testing, and result measurement.
iii. Check – the results are thoroughly assessed by comparing it before, and after data, effectiveness is measured, and deciding if the hypothesis is supported.
iv. Act – the results are documented, others are informed about the improvement or change, and recommend for the subsequent PDCA cycle.
The above process is repeated until a viable solution is found. Therefore, the PDCA model is the most appropriate tool in resolving the stand-off in the healthcare facility that this paper illuminates (Graban & Swartz, 2018).
Application of the PDCA to the healthcare organization under the study
The following fundamental questions will be significant in determining whether the solution is optimal;
1. What is the target we intend to accomplish?
2. What changes are equivalent to the improvement preferred?
3. How do we know that the change is the desired improvement?
Stage 1: Plan
Recruitment of a team
The team constitutes a committee part of the management team and the employees’ representatives in the facility, in which I am a member. The committee will be charged with the mandate to bridge the gap between the employer and the management. In so doing, a middle position will be identified where none of the stakeholders will lose. The committee will embark on a study to authenticate the current problem and determine the root cause of the problem. It should carry out its responsibility as a neutral party though it is affected by the solutions they decide on.
Description of the current problem and the context
The reason for solving the problem internally will give the employees confidence with their employer and know that he or she has no ill motive towards them. Employees are a human resource that is never replaceable with any other, and on occasion, it is replaced, another kind will come but still human characteristic. Therefore, it is prudent to deal with employees carefully since they can sabotage the employer’s objective and render his vision useless. Including their representatives in the dispute resolution committee will give them a sense of honor and worth from the employer’s perspective. They thus, begin becoming less obstinate and stubborn to the decisions of the management and air their views and opinions to the employer without arriving at misinformed self conclusions.
Also, the committee must put the interest of the employer at heart in the decisions they make. The purpose of the commencement of the organization is vital for keeping the organization operating. The employer desires to improve patient flow in the facility to increase its profitability. On the other hand, employees’ safety concerns should be factored in to make them feel part of the organization and boost their productivity.
Develop alternative cause of action
Alternative mitigating strategies of a problem are identified by completing this statement (Destino et al. 2019),
“If we do………………., then ……………… will happen.”
For this case, alternatives include:
1. Going the way of management, increasing the speed at which we serve our clients.
2. Are we are going the way of employees; cautiously offering satisfactory diagnosis and treatment service to the client without minding the time factor.
3. Blending the management and employee options, offering quality services to the patient but still expeditiously.
Each of the three alternatives should be run through the PDCA feedback loop to identify the most appropriate cause of action for our case scenario.
Stage 2: Do
In this stage, the action plan is implemented. The collection of data is critical because it used to help gauge the effectiveness of the alternative in step 3: check. Flowchart or check sheets can be used in capturing occurrences or data over time or as they happen. In this case, the committee will also record general observations and unexpected effects. For instance, the benefits of the first alternative are documents as well as its cons. Its effectiveness is also gauged, depending on the results. The same process is repeated for the second and third alternatives if the desired improvement has not resulted. It is possible to settle to a particular cause of action without knowing that there is still another better option with more significant improvement and results. That is is why the PDCA model is called a continuous improvement cycle. If the team latter identifies, another option will still be tested for its viability and applicability to the organization (Idigo et al, 2019).
Stage 3: Check
At this stage of the cycle, the first and the second stages are evaluated. The questions formulated earlier as the determiners of the optimal solution are asked. The committee will ask itself if the option planned and implemented was worth their time, and if it resulted in an improvement. The effectiveness degree or level is always emphasized to ensure we get the best cause of action. The unintended side effects are also assessed against the benefits. Various tools are used to evaluate the results and effectiveness; they include control charts, Pareto charts, and run charts.
Stage 4: Act
This is the last stage for every alternative run through the cycle.
Reflection of the Plan and Outcomes
The committee’s identified alternative must have been successful in improving the process and service delivery at the health facility. The improvement is thus standardized, and its regular use starts. After a short while, the committee will return to the planning stage to re-examine the process and results of their previous cause of action to identify areas for further improvement. Also, the committee is allowed to identify a different approach altogether and run it through the PDCA model. This is a continuous improvement methodology that the organization will adopt to address its problems and become more efficient.
After every task done, the feedback should form the basis for a new challenge or celebration. The cause of action shall be communicated to the management and the employees. The lessons learned to help the organization sustain its accomplishments and make long term plans for continuous improvements. The subsequent iterative PDCA cycles will always result in improved results since more viable alternatives to improve patients flow are being examined.
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