Microsystem Performance Improvement Plan
The concept of microsystem in the health care unit makes health care services providers work with several assumptions such as, bigger systems are composed of a smaller system and the smaller systems (microsystems) give the healthcare system an opportunity to produce quality, safety, and cost effective outcomes. For a successful assessment, the microsystem improvement plans at Charlie Norwood VA Medical Center (CNVAMC) will use the 5Ps. In this hospital, the 5Ps framework is a tested and useful technique for microsystem members since it allows members to view the system in a different perspective. Thus, this paper focuses on explaining the performance improvement plan by concentrate on describing the purpose of the study, review the literature concerning the subject, giving out a methodology of the plan, and the result of the survey. The paper will also review the improvement model or theory used to guide the improvement plan. Finally, the issue of financial considerations will be described in this study, whereby the primary focus will be on the cost of the plan and the way the hospital carrying out the plan will cover for the implementation cost.
Current Strategies Priorities
The healthcare system’s current strategic priorities involve providing the highest level of innovative and compassionate care for the patients. In the recent years, Charlie Norwood VA Medical Center has focused on providing tertiary care in different healthcare fields (Charlie Norwood VA Medical Center, 2016). Charlie Nor0wood VA Medical Center’s top priority is the care services in spinal cord treatment services, rehabilitation medicine, psychiatry, neurology, surgery, and medicine (Charlie Norwood VA Medical Center, 2016). For the hospital to offer the care services strategically, the hospital operates in two Division Medical Centers (The Downtown Division and Uptown Division). The Downtown division has 155 beds; 58 beds are for medicine patients, 37 for surgery, and 60 beds for spinal cord injury (Charlie Norwood VA Medical Center, 2016). On the other hand, the Uptown Division, which is located just three miles away from the other division, has 315 beds; whereby 68 beds are authorized for psychiatry services, 15 beds for patient taking blind rehabilitation treatments, 40 for medical rehabilitation, 132 for nursing home care, and 60 for domiciliary care services (Charlie Norwood VA Medical Center, 2016).
The Improvement Model or Theory (LEAN/Sigma 6)
The improvement theory that will be applied to the organization is LEAN/Sigma 6 model, which is one of the improvement approaches that is used by the healthcare organizations to apply improvement plans. According to Womack, et al. (2005), when using the LEAN model in hospitals, there is a possibility of the healthcare organization having positive impacts on productivity, cost, and timely delivery services. The theory is powerful, as it will give the hospital an opportunity to eliminate wastes, create more capacity in existing programs, and practices that have been planned by the hospital. The model will require all employees to attend training sessions to affirm that they participated in the rapid improvement plans. Womack, et al. (2005) point out that before the use of the model, it is essential for the hospital to consider vital concepts such as leadership, culture, and the improvement process, as these concepts will determine the way the theory will influence the performance improvement plan at the health care system. As Womack, et al. (2005) assert, the LEAN model will give the hospital an opportunity to create value, satisfy people to perform, managers to manage, and the clients served by the organization to experience the services.
Plan for Improvement
In this chapter, the key focus is to discuss the plan for improvement and the plan that will enhance Charlie Norwood VA Medical Center (CNVAMC) to influence employees’ performance.
Project Title
The consequence of sending letters that are confusing patients about the time that they will receive the treatment services.
Purpose of the Project
The aim of this project is to analyze the impact of sending letters with confusing surgery times for patients at the Charlie Norwood VA Medical Center.
Research Questions
- What is the percentage of patients who visit the hospital based on the time provided in the letter?
- What is the average delay time for patients visiting Charlie Norwood VA Medical Center on time as opposed to when the surgery is scheduled?
Literature Review and Background of the Microsystem Concept
In the hospitals, microsystems offer various functions such as allow the social system to cut across different disciplines within the systems. Barach and Johnson (2006) carried out a research on understanding the complexity of redesigning the health care system and suggested that due to its interdisciplinary focus, the concept of microsystems gives the hospitals a conceptual and substantial framework. Importantly, the hospitals can use these frameworks to simplify the complexity within the system of delivering care. Additionally, Barach and Johnson (2006) suggested that in the hospitals, the healthcare systems are usually cumbrous, unmanageable, unfriendly, and opaque to the users. In this point, the researchers found out that the health systems could be a problem to the nurses, patients, doctors, and staffs, as the primary users of the systems.
As microsystem plans for improvement in the healthcare systems comprises of different contexts among them being communication, Peate (2006) notes that if the healthcare professionals fail to communicate effectively with each other, chances are that they will not be effective when communicating with the patients. Peate (2006) outlines the concepts of nurses in 21 century and notes that nurses in the hospitals send the wrong information to patients because of the issues such as role confusion, variation in the philosophies of care, and variation in styles that they use to communicate.
On a different study by Pun, et al. (2015), the researchers highlighted that when the nurses send information to the patients and fail to adhere to what they have written or communicated, this creates a complex situation that may have negative impacts on both the patient and the hospital. Pun, et al. (2015) interviewed 28 doctors and nurses in the Emergency Department and the researchers found out that by sticking to the treatment programs set according to the information communicated to the patients, the healthcare organization promotes and improve patients’ safety. As most of the hospitals use the information in the records to facilitate the care services, it is important for doctors in the healthcare hospitals to use the record as guidelines when sending the treatment information to the patients.
According to Thomas (2009), the information, which is in the record document concerning the treatment of the patients, is crucial because the doctors use it as guidelines for patient management. Therefore, it is the responsibility of the doctors and nurses to oversee the issue of information that the hospitals send to the patients, as this will highly influence the treatment programs established within the healthcare center.
Methodology
The research method for this project will involve the use of primary data collected from Charlie Norwood VA Medical Center. The researcher will seek the help of the nurse manager, patients relations manager, assistant nurse manages, and receptionists, who will provide data on patient appointments and arrival. The analysis of the data will give the researcher an opportunity to come up with precise conclusions concerning the hospital’s performance improvement plans and the concept of confusion brought by the time set for the execution of that treatment services in the hospital. The researcher will collect data on patient arrival time for one month and determine the percentage of patients visiting the facility at or close to the appointment time. The researcher will determine the percentage of patients visiting CNVMC “on time” out of over the total number of patients visiting the facility. The data collected will guide on deciding whether there is a need to change appointment letters or introduce a new system that will help ensure that patients get the exact time of their appointments and when the surgery will take place. Thus, using the LEAN/Sigma 6 model, which has been shown to ensure proper management in many organizations including those in the healthcare sector (Womack, et al., 2005), the Charlie Norwood VA Medical Center will improve its communication systems.
Outcome Measures
The findings from the data analysis will be used to determine whether the improvement plans will influence the performance of the staff, clinicians, and trainees at Charlie Norwood VA Medical Center (CNVAMC). The review of the current performance of the two medical division at Charlie Norwood VA Medical Center (CNVAMC) will be compared with the overall performance of the hospital’s departments after and before the implementation of improvement plans. The project outcome will be measured according to the services that are provided by the hospitals two divisions’ medical center. Here, the findings will be grouped according to the list of services arranged from A to Z by of the hospitals and the way they will be influenced by the improvement plans. Improved performance in terms of communication on appointment or surgery times and a reduction in percentage of patients who get wrong appointment schedules will mark an improvement in performance.
Financial Consideration
The cost of human and materials cost will be a crucial consideration for this project. However, most costs will be channeled into computerizing appointments and will depend on the system the management will settle on. The plan will require the hospital to cover for all the cost that the implementation of the plan will use, especially the cost of redesigning the departments that are grouped according to their location. Since the departments that are located in different regions carry out various services at the healthcare center, any cost that incurred in connecting the department and comparing them from a distant location will be covered by the hospital as the project aiming at benefiting the hospital.
Conclusion
From the study, it is evident that the benefits of Microsystems plans are influential to the performance of the healthcare systems. For hospitals that want to offer quality services, and ensure that there is the achievement of the healthcare goals, microsystems are viewed as a rational locus that acts as the agent for change within the healthcare systems. Reducing cases of miscommunication that has seen many patients confuse the times thy visit the facility will be the focus of this study. A high percentage of patients vising th hospital on time as indicated in the letters as opposed to when their surgeries take place will show irregularities in the hospital’s systems. Thus, the focus will be on improving communication systems at the Charlie Norwood VA Medical Center to ensure patients are not disadvantaged by miscommunication.
References
Barach, P., & Johnson, J. K. (2006). Understanding the complexity of redesigning care around the clinical microsystem. Quality and Safety in Health Care, 15(l), 10-16.
Charlie Norwood VA Medical Center. (2016). About the Charlie Norwood VA Medical Center. Retrieved from http://www.augusta.va.gov/about/index.asp
Kosnik, L. K., & Espinosa, J. A. (2003). Microsystems in Health Care: Part 7. The Microsystem as a Platform for Merging Strategic Planning and Operations. The Joint Commission Journal on Quality and Patient Safety, 29(9), 452-459.
Peate, I., & Offredy, M. (2006). Becoming a nurse in the 21st century. Chichester, England: John Wiley & Sons.
Pun, J. K., Matthiessen, C. M., Murray, K. A., & Slade, D. (2015). Factors Affecting Communication in Emergency Departments: Doctors and Nurses’ Perceptions of Communication in a Trilingual ED in Hong Kong. International journal of emergency medicine, 8(1), 1-12
Thomas, J. (2009). Medical Records and Issues in Negligence. Indian Journal Of Urology, 25(3), 384-388 http://dx.doi.org/10.4103/0970-1591.56208
Womack, J. P., Byrne, A. P., Fiume, O. J., Kaplan, G. S., & Toussaint, J. (2005). Going Lean in Health Care. Cambridge, MA: Institute for Healthcare Improvement.
