Business Case of Curtin Hospital - Research Paper Example

?Business Case of Curtin Hospital Executive Summary: Curtin Hospital is one of the largest hospitals situated in the Western Australia. The hospital has been providing its best to the service of the nation since 1829.The objectives of the hospital has always focused on providing valuable service to the patients in all dimensions. It stresses on the proper identification of diseases, diagnoses, admission, treatment, and even follow ups cases providing a better preventive care. The hospital aims to be one of the best teaching hospitals in the years to come. To adapt to the substantial growth of the business, Curtin hospital needs to take technological help to reduce the workload of its employees. The business case study deals with the implementation of a clinical terminology system which will work in the background of the EDIS. The product will also feature ICD-10-AM mapping including the full details of the coding rules. The case study focuses on the feasibility of the above mentioned system. The procedures applied for the case study underwent the option evaluation and came out with results favoring the implementation against the hiring of new personnel to reduce the workload and increase the effectiveness of the operation. The advantages and the disadvantages both in respect of the patients and the hospital authority were considered. Though the cost factor was significant enough and proved to be a major concern for the hospital authority but the preferred option which evaluated from the comparative analysis was significantly in favor of the ICD-10- AM encoder. The favorability of the project led to the devising of the project management strategy. Various areas relating to the implementations of the project were considered and their planning was done accordingly. Areas like manpower requirement, Funding of the project, operational policies and other social implications were considered and results raised concern for the future funding to be required for careful maintenance of the project, while other areas had satisfactory management control. Based on the plans for implementation, the milestones and stages of implementation were chalked out and the project was scheduled to be in full fledged operation in three months from the date of installation. In the stages of implementation much focus was given on the review stage and the benefit realization plan to access the benefits arising out of the project. T was noted that the benefits and the time taken to achieve them were satisfactory. The case study also focused on the risks to be associated with the project and clearly identified them along with their mitigation strategy. Every aspect of successful implementation were carefully analyzed in the case study. Introduction Curtin hospital is a leading emergency and the elective specialty hospital known for providing the best service to the community of Western Australia. It covers a community of people living in rural and remote area. The recent projects undertaken by the hospital includes research and the teaching activities. The popularity of the health service provided has become immensely popular over the years and most of the people choose Curtin hospital as their favorable destination for treatment. Curtin hospital has to deal with a large number of patients each day and they were looking for the automation in the business. In the process of the automation building they are looking to install a clinical coding system which carries out its performance with the help of ICD-10-AM which are used to interpret the correct code and looks to minimize the errors and cutoff the overtimes. The hospital will also provide morbidity data in a timely manner and carry out its work with the objective of the Health Information Centre. Background: ICD-10-AM encoder is designed to provide the full coding rules and application relating to the clinical communication and retains all the data stored along with the concepts. The clinical data under the implementation of the system will consist of all the minute details of the patient. Besides it will also provide numerous options other than the custom built ones to record the data.1 The implementation of the system in the hospital of Curtin is expected to deliver few advantages to the working process. The expected result will try to minimize the time of operation regarding the data retrieval process which would lead to further efficiency. The backlog of the clinical coding department is expected to be eliminated by the use of the service. The objectives of the Curtin hospital can be attained by the proper utilization of the technology. The knowledge of using this latest technology can also provide them to show a path for the rest of the hospitals. Objectives of the Business case: The Business case focuses on the implementation of the ICD-10-AM to regulate the operation of the business and to provide flexibility in the patient case. The objective of the case deals with providing thorough knowledge regarding the software to be installed, its software and hardware aspect and the technological support it needs to function effectively. The benefits arising out of the software implementation is also being aimed to study. The adherence of the benefits with the organizational aims and objectives needs to be provided. In relation to the implementation of any technology the difficulties and the constraints should be identified and the case study also focuses on these aspects critically. The identification of the limitations should be followed up by the proper risk management strategies and the case study looks for possible ways to handle them Option Evaluation: Curtin hospital has been facing the problem of workload management and the erroneous data retrieval. In order to counter the problem the hospital has preferably 2 options to suit its need, either to implement the ICD-10-AM Encoder, or to recruit more manpower to distribute the workload among them. The comparison of both the options available is done below in the table. The mode adopted in the comparison is mostly based on qualitative term whereas the criterion of quantitative measurement has been used in some of the attributes. In the below mentioned table, we will first deal with the advantages and hen e will look into the disadvantages of both the options. The advantages and disadvantages of the options are highlighted in perspective of the hospital, patients and the employees. The option 1as mentioned below refers to the use of ICD-10-AM encoder whereas the option 2 deals with the hiring of additional manpower. Criteria Option1 Option 2 Advantages Hospital The problems with coding of information will cease to exist and will help the hospital to meet up its target The pending issues will be dealt properly Patients Improved patient care due to quick retrieval of data The patient queue mat get shortened as more manpower will be involved in the coding Employees The employees will be motivated using the software as it will lead to reduction in the data backlog Increase in staff of the hospitals. Disadvantages Hospital The cost of implementing the software may be an added burden on the hospital The new employee needs training of the operations which may require additional time Patients The extra amount of money spent in installation may harm the other services dedicated towards patient The new employed staff may be unable to understand the sentiments of patients and may result in dissatisfaction Employees A training regarding the new system needs to be carried out to educate the employees The additional employee hired was cause reduce an increment n salary of the already existing staffs. The findings of the above discussion suggest that the addition of extra man in the organization may help the employees to reduce their work pressure and provide more effectiveness to the work assigned to them but the data redundancy and correction cannot be eliminated, whereas the installation of the new technological product will address to both the above mentioned problem. Preferred option: In coming to a conclusion regarding the choice of preference the cost factor associated regarding both the options needs to be considered as well. The estimated cost for the implementation of the IC-10-AM is roundabout 68,000 $ per year, deployment of additional workforce will result an additional expense of 45,000$ per year. The cost of support devices involved in the installation will arise in timely maintenance of the system, and the backup devise will also generate some additional cost. It is found that the cost involved is significantly high. But the striking advantage the system has over the other option is that it will enable the organization to link up with the Electronic health record and will automate whole clinical process which will cause less error and would help in gaining more reputation to the organization. The hospital would be able to provide far better operation with reduced error and the best service towards their patients. So it is quite preferable for the organization to stick themselves towards installation of the latest technologically built system. Project Management Strategy: The project management deals with providing guidelines which are necessary for carrying out a new project. The project management starts with the initiation of the project and continues till the closing phase. The project management team makes the plans and strategies relating to the planning, designing and execution of a project. The importance of any project management team lies in mitigating of risk to a large extent. It helps in the risk identification, and devises strategies to handle them. The project management team works across all the working groups involved within the organization and tries to chalk out plans for the effective implementation of the new system. The stakeholders in the project concerned regarding the implementation of the project are 1.The administrators 2. Hospital Executives 3. The patients or the public in general 4. External agencies Once the implementation of the software occurs successfully the effects of the software implementation should be known to all the stakeholders concerned. The desired level of output expected and the outcomes are compared and analyzed to find out how effective the system can prove to be. Project Plan and Implementation: If the organization opts to implement the project after comparing the other options, it will need to set up proper plans and actions for the implementations to be effective. Several areas need to be highlighted for the planning according to the aspects of each of them. Areas Measures Location The location layout of the server where software to be installed requires to be planned properly. It should be in such a place which is safe in all respect and will provide limited access to people. Capital requirement As the estimated capital required to implement the project is high proper funding should be arranged beforehand, so that the operation is not withheld due to capital constraint. Staffing Requirement The staffs need to undergo an extensive training session to cope up themselves in efficiently using the software Operational Policies The implemented software should not be made accessible to all the staffs, only those employees who require using the system will be permitted to use by the help of registered user id and password. Social Implications The implication of the system by the hospital should be in knowledge of the general public and patients to increase the curiosity among them. Stages and Milestones: The breakup of the projects into key events which is referred to as the milestones is a key part of the project management strategies. The schedule of the different stages are done to complete the buildup of a project on time and to estimate the time period required for the completion of the project.2 The stages of the above mentioned case can divided into 3 segments which are Implementation, training, and review. Stage 1 Installation of ICD -10-AM encoder. Date: 1 August, 2011- 8 August 2011 The software installation to the server computer is planned to be done within the range of dates mentioned. The company representative of the software company should come down to the hospital and equip themselves accordingly for the effective installation. The guidelines for using the software should be discussed with the information technology department of the hospital. Proper manual and a detailed demonstration need to be provided to them for a clear understanding. Stage 2: Training of the employees 9 August, 2011- 25 August 2011 After the successful implementation of the system, extensive training program of the employees, doctors, and the medical in charge need to be carried out so that they may have a clear view of the system. If the mode of operation varies among the different set of users, separate training needs to be provided to them. Chance of having a practical view of the software should be provided to the users individually. Other than the general guideline relating to the working of the software, the users should be taught about the troubleshooting modes also. As the training period is very crucial for the effective running of the system, a considerable amount of time has been stipulated in the stage. Stage 3 Go-live Date 1, September, 2011 From this date onward the project should be all set to launch itself. The manual operation will no longer exist. During the initial days of operation, a support back up is needed for proper usage of the system. Stage 4 Review Date – Post Go-Live As the system will start working, the review of the process needs to be traced and monitored. Feedback from the users, patient and administration needs to be taken during this time. If the feedback is on a positive note, then long term planning of the usage of the software should be considered. The variability of the desired level of outcome and the actual performance will decide the possible result of either accepting the move on a long term basis or to discard it. Implementation Approach: In order to attain the necessary stages and milestone proper implementation is required. Efforts should be given to complete the each of the stages on time. Proper resource should be allocated which includes both human and technical. The users of the system should have basic knowledge relating to operation of any kind of computer oriented software. The platform required to install the software should also be taken care of and implemented accordingly. The support staff should provide their knowledge in relation o the operation of the system. Benefit realization Plan: The implementation of the technology is aimed to provide certain benefits to the working of the hospital. The predictions of various benefits which the system may generate are as follows Benefits Expected to achieve Percentage of achievement Time Taken To Achieve Benefits Accuracy in Coding 90% 4 months Improvement in patient statistics 85% 4 months Increase in Workflow 65% 6 months Increase in employee morale 55% 6 months Post Implementation Review Strategy: Proper review regarding the working of the software needs to be maintained. The report gathered should be properly distributed among the stakeholders for their thorough analysis. The hospital executive will carry out the comparison between the previous mode of operation and the current efficiency of the software. There needs to be the mention of the effectiveness of the software in the annual report of the hospital and it needs to be distributed among the patients and the other external agencies. The Health Information will take into account the number of patients who are still waiting for the coding process to happen and thus can determine the success or failure of the implementation. Funding: Considering the enormous cost in the implementation of the software, the directorate of corporate services has decided to sponsor a part of the expenses. The organization is ready to cover up 45% of the total cost incurred. The organization needs to be careful in arranging for funds required to carry out the support functions which the software required and should have sufficient possible funds in hand for any up gradation or change required. The arrangement of recurring funds for the software maintenance should be given much priority. Risk management: The implementation of the software to meet its goal may result in generating a few risks for the organization which are mentioned below. The technology adapted may not be effectively used due to lack of proper knowledge which the employee may fail to grasp. The employees may be in sort of panic regarding the organizations policy to switch over to technology and may be in fear of losing their job and lead to de-motivation and lack of effort from their side. The funding which the organization is ought to receive if stopped will be a big threat for the company to sponsor such a big amount. The software becoming obsolete in the near future will force them switch to another technology which may incur additional cost for the company. Proper risk management methods need to be addressed by the company. The training method should be dealt with proper care and responsibility by both the trainers and the trainees. Job security is needed to be provided to the employees for better dedication towards their work and modes of funding need to be confirmed on behalf of the organization.3 Procurement: The important decisions relating to the procurement of the software should cover a legitimate and precise request for proposal. The needs and the actions required should be properly mentioned. The project scheduling and the specification of requirements of deliverables should be documented properly so that there is no misunderstanding between the customer and the vendor. The payment criteria and the type of contract which is initiated should be present.4 Request for proposal: The request for proposal for Health e-Words should cover the underlying points. A complete outline of the approach to the project, the technology which will be used in the development of the software, the methodology to be used and the timeframe required for the overall installation of the software Details regarding the total cost behind the installation and the implementation need to be proposed. The efficiency of the similar kind of software and their reviews from various organizations highlighting their outcome, advantages and disadvantages The deliverables should include electronic reference library and user documentation. The request for tender is an invitation for the supplier to respond to the varied needs by an organization. The suppliers should provide relevant information about their products in relevance to the needs required by the company. A detail analysis based on both technical and analytical process should be done. The cost breakup of the installation should be done in a proper way. Any added advantage which the product may carry should also be mentioned. Based on the tenders the organization should select the best possible options for the project. I.T. Strategy Various technological needs and up gradations which are required to be maintained by the hospital are given below. The overall platform of the computer systems should be upgraded to the latest versions available in the market and as specified for the optimum running of the software. The network installed should be capable for the proper running of the software in various departments. The temporary coders and the people working in support of the software should be capable of proper software handling and solving the issues. The central data depository should be large enough to accommodate all the data and store it properly. Change Management Strategy: When organizations adopt for the change in the work environment, effective back up plans relating to tackle with the changes should be made in advance. The level of impact which the change will create is needed to be identified first. The change should not be made suddenly in a large way. In the case of implementation of the new software, the implementation should be done gradually and the announcement of the implementation to happen should be addressed in the hospital much before than it comes into practice. Proper communication among the employees regarding the change which is to happen should take place and the aims and objectives for the change should be illustrated in a proper manner. Points of incongruence needs to be identified and plans for alignment should be made.5 The employees need to be provided with proper training so that they do not face any difficulty in the running of the system. Change Management Schedule: Changes to be implemented Effective time for each change Announcement regarding the implementation Semptember,1, 2011 Specialist technical person recruitment October, 1, 2011 Employee training October,15,2011 Complete change over to the new system December,15,2011 Communication plan: Communication plan involves the proper choice of communication which is necessary for project announcement, and creating awareness among the people in the adoption of latest technology. The popular modes of communication involve publication of the annual report, and distributing articles and updating of the information in the web portals. The hospital may also call for press meet and advertise about their technology in the newspapers. Effective communication will reduce harassment among the employees as well as in public relating to the measures taken by the hospital. Project evaluation: Based on the post implementation review, the project needs to be evaluated and future plans relating to the project needs to be considered. The difference the software creates in the general working of the hospital needs to be evaluated. The software was planned to attain organizational effectiveness and raise its standard. Progress in attainment of those objectives needs to be monitored as well. Conclusion: The business case study critically evaluates the scope of implementation of the ICD-10-AM decoder. The analysis reflects upon the advantages and the disadvantages of the implementation and various strategies relating to the successful completion of the project. From the post implementation reviews and the feasibility analysis, it is quite evident that the technological up gradation will really help the organization in the long run. It is noted from the thorough analysis of the case that the benefit expected from the software is meeting up with the benefit gained as it is reflected in the review. However the organization should switch to effective change management strategy and should arrange for proper funding for the implementation. The implementation of the software will reduce the errors in the system and the data fetching will be achieved at a quicker rate. The overall organizational objective of providing better facility to the patients can be reached within a short period of time Appendix: Element Description Risk Factor New client Risk Product, Schedule, Resources Analysis Chance of misunderstanding clients need-High Chance of survey options- low Chance of lack of technical knowledge of client-low References Gray, Project Management 4E. London: Tata McGraw-Hill Education, n.d “Health ewords”: Products, < http://www.healthewords.com.au/Prod_STC.php> (5 September 5, 2011) Portny, Stanley E. Project Management for Dummies. New York: Wiley Publishing, 2010 Schwalbe, Kathy. Introduction to Project Management .Kentucky: Cengage Learning, 2008 Wenderoth, Martin. Change Management Strategy for Implementing Shared Services. Muenchen: GRIN Verlag, 2009 Read More