Analysis of Performance Improvement - Research Paper Example

Performance Improvement Introduction Today nations give great emphasis to their healthcare sector knowing that a healthy population is the basic criterion and an engine for economic growth. For this reason, economically developed countries such as US and UK make huge budgetary provisions toward meeting their health care costs. According to a Forbes report by Munro (2014), the annual US healthcare spending hit $3.8 trillion in 2014. In spite of mounting healthcare costs over the years, the US health sector is still struggling to ensure enhanced patient experience and great patient satisfaction. Evidently, there is a weak link between healthcare spending and patient experience. In this context, it is advisable for health organizations to review their health delivery policies and think how their health budget could effectively enhance patient experience. Evidences suggest that efficiency of workflow is the key to improve patient experience, and in turn a number of factors such as time, process designs, and procedural efficacy may influence workflow efficiency. This performance improvement paper will discuss how improving workflow can contribute to enhanced patient experience by reducing wait-times. The paper will also address the outcomes of a one on one meeting with the finance team, patient experience team, and patients. Improving Workflow and Patient Experience The term workflow refers to the sequence of administrative and other processes through which a particular healthcare work passes from initiation to completion. As mentioned already, time is a crucial component of workflow such that a long wait time would contribute badly to patient experience. According to a Press Ganey article (2010), US patients have been experiencing the longest wait times in emergency departments since 2002. The report says that in 2009 a US patient spent an average of four hours and seven minutes in the emergency department from the moment he entered the room until the time he was discharged. This average time spent was 31 minutes more than the national average in 2002 and indicated an increase of four minutes compared to 2008 (Press Ganey, 2010). Previous researches have established a clear negative relationship between long wait time and patient satisfaction. According to one finding, “patient wait time for medical care has a direct impact on patient satisfaction, medical compliance, return show rate and patient attitudes toward clinicians, staff and clinics in general” (Cuevas & Joseph, n.d). To illustrate, researchers including Anderson, Camacho, and Balkrishnan (2007) conducted a study to evaluate the influence of patient wait time on satisfaction with primary care. They found that longer wait times resulted in lower patient satisfaction. The researchers also identified that a combination of longer wait time and shorter doctor visit time is associated with very poor overall patient satisfaction (Anderson et al). As long wait time leads to poor patient experience, there may be a worse relationship between the patient and the health provider, a pathetic situation resulting in poor patient outcomes. When a patient is dissatisfied in the way he is treated initially, he would get angry with the whole health care staff. With such a mental state, he may find it difficult to disclose all his health problems to the physician and to cooperate with the medical treatment. In addition, he may downgrade the overall health services offered by the organization and this situation in turn would adversely affect the reputation of that health organization. Therefore, reducing wait times is extremely vital for hospital facilities to improve the workflow and add value to patient satisfaction. Whereas the wait time in a healthcare environment contributes to poor patient experience, the time spent with the physicians is the most powerful element determining the overall patient satisfaction. Affleck, Parks, Drummond, Rowe and Ovens (2013) state that the lower physician staffing combined with high patient loads is creating potential operational constraints on hospital facilities because this situation leads to longer wait times and shorter physician visit times. Promoting a sensible combination of these two time-based measures is very crucial to improve the workflow in the healthcare environment and to accomplish a higher level patient experience. Modern people lead a very busy life due to tough work schedules and social changes, and therefore time is of paramount importance in their life. Although there have been many strategies put forward by previous researchers to reduce wait time and to improve the workflow in a health care organization, it is vital to ensure that those strategies would not compromise care quality and patient safety. A one on one meeting with the finance team and patient experience team and three meetings with patients were conducted to increase the credibility and authenticity of the final research outcomes. From the meeting with the finance team, it is identified that the changes implemented to reduce wait times and to achieve improvement in the workflow led to an increase in patient volume and drove revenues up. Referring to the higher patient volume in January 2015 compared to the volume in December 2014 with the old process, the finance team claims that the workflow improvement directly led to an increase in patient volume. The interactions with the patient experience team reflected that some process improvement changes are also essential to promote the overall workflow. It suggested not to call patients name out in the lobby and allow patients to wait in the lobby for long times. This change would provide convenient care to patients and protect the confidentiality of patient information with utmost importance. The one on one meeting with the patient experience team led to a number of suggestions for process improvement changes so as to enhance the overall workflow. The major advice was to provide service to patients within 15 minutes so that they would not get dissatisfied with the longer wait times. Although it appears to be a potential suggestion to provide an enhanced patient experience, it is not really a practical option because there may not be always enough physicians to implement this strategy. When patient service in 15 minutes is made mandatory, hospital may reduce the physician visit time, and such an approach will certainly affect the quality of care and patient safety. Hence, it should not be a compulsory service but the patient must be kept informed of any possible delay. Such a facility may assist patients to avoid infinitely long waits and to adjust their schedules according to the actual appointment time. In addition, patients must be treated with great respect and care because they may have been broken down due to chronic illnesses or bad health conditions. When patients are treated in such a way, they would be loyal to their health providers and even they may accept a fair amount of wait-time without any dissatisfaction. According to the patient experience team, escorting patients to the procedure area is a potential way of greeting them with warm care. Those simple acts can significantly influence patient behavior and add value to patient experience at hospitals. The patient experience team also makes it clear that they approach patients directly and ask their name and other important information such as previous visit dates to ensure that patients sense a feeling of care and protection. Referring to health care professionals, this kind of a health care approach is better to foster patient motivation and involvement, and to achieve a greater level client satisfaction. The three meetings with patients were also helpful to identify what a patient expects from his/her health provider and the key factors contributing to enhanced patient experience. Patients demand health providers to regularly collect patient feedbacks to obtain a clear picture of the actual patient experience and thereby take measures that seem necessary to improve patient satisfaction. Evidently, collecting patient feedbacks is vital to increase the competitiveness of health organizations. As discussed already, a patient may be a victim of mild/severe health problems, and therefore his/her mental health would also be affected badly. In this situation, health providers’ interactions with the patient or the way the patient treated can have a great influence on his/her mental health. Hornik-Lurie, Lerner, Zilber, Feinson and Cwikel (2014) opine that health providers including physicians and nurses can influence a patient psychologically, and a mentally motivated patient would actively follow medical advices. From the meeting with patients, it is recognized that quick and compassionate care is a better strategy to deliver great patient experience and to motivate patients mentally. Many patients suggest the health providers to treat them as a human being rather than a number. Patients also want to be quickly alerted of any possible delay in service delivery in order to avoid infinite and longer wait times. Another key information obtained from this meeting is that patients do not want to last any procedure more than 15 minutes. It is essential to employ adequate number of caregivers and other supporting staff to meet this need efficiently without confusions and errors. It is recommendable for hospital facilities to consider these patient responses and execute them sensibly in order to meet improved patient experience. Although there are several strategies to improve workflow in a healthcare environment, reducing the wait time is most crucial and productive approach since it has a direct impact on patient experience and satisfaction. According to a Press Ganey case study (n.d.), seeking patient feedbacks is the key approach to improve wait times and to meet the resource investment interests of the patient in an efficient manner. By properly evaluating patient feedbacks that are collected on a regular basis, the healthcare providers can identify the design and process inefficiencies impacting the workflow and thereby take immediate actions to address the scenario. As Solomon (2013) points out, since patients are the ultimate beneficiaries of a health organization and they interact with the health facility frequently, they can more effectively point out the issues leading to longer wait times and even recommend feasible solutions to improve the workflow by reducing wait times. When patient suggestions are considered this way, they may sense a feeling of belongingness, and therefore they would be more responsive to the physician and other care staff. In addition, when patients’ opinions are valued, they may derive greater degree of satisfaction and would be loyal to the organization in the long term. Similarly, health care staff can avoid disputes with patients to a great extent when they are able to attend a patient within 15 minutes. If a patient is greeted with warm care at the moment he enters the health care facility, he would rate it as a great experience and show a positive attitude and tolerance in his subsequent dealings. In short, reduced wait time is a powerful determinant of enhanced patient experience, and a mentally motivated client in turn can greatly assist a health organization to improve its workflow. Conclusion From the above discussion, it is clear that long wait time leads to poor patient experience and patient dissatisfaction. When patients wait long time in the lobby but get a short physician visit time, they would rate the health service poor. In contrast, reduced wait times would eliminate process inefficiencies in the workflow, and the situation in turn would contribute to improved patient experience. The one on one meeting with the finance team indicates that reduced wait time and an improved workflow led to a significance increase in patient volume and total revenues. The relationship between wait time, patient volume, and revenues was proved statistically. The patient experience team strongly suggested to stop calling patients name out in the lobby and allowing patients to wait in the lobby for long times in order to provide the clients with a great service experience. In addition, they recommended to attend a patient within 15 minutes and to keep the patient informed of any possible delay in the service delivery so as to avoid infinitely long waits. Finally, collecting patient feedbacks is a potential approach to identify what ruins the quality of patient experience. To sum up, reducing wait time is a crucial strategy to improve the workflow and enhance the overall patient experience. References Affleck, A., Parks, P., Drummond, A., Rowe, B. H & Ovens, H. J. (2013). Emergency department overcrowding and access block. CJEM, 15(6):359-370. Anderson, R. T., Camacho, F. T & Balkrishnan, R. (2007). Willing to wait?: The influence of patient wait time on satisfaction with primary care. BMC Health Service Research, 7: 31. Cuevas, E & Joseph, A. (n.d.). Improving Process Turnaround Time in an Outpatient Clinic. Six Sigma. Retrieved from http://www.isixsigma.com/industries/healthcare/improving-process-turnaround-time-outpatient-clinic/ Hornik-Lurie, T., Lerner, Y., Zilber, N., Feinson, M. C & Cwikel, J. G. (2014). Physicians’ Influence on Primary Care Patients’ Reluctance to Use Mental Health Treatment. Psychiatric Services, 65 (4), 541-545. Munro, D. (February 2, 2014). Annual U.S. Healthcare Spending Hits $3.8 Trillion. Forbes. Retrieved from http://www.forbes.com/sites/danmunro/2014/02/02/annual-u-s-healthcare-spending-hits-3-8-trillion/ Press Ganey Article. (Jul 22, 2010). Patients Spent Average of Four Hours, Seven Minutes in U.S. Emergency Departments in 2009, According to New Report from Press Ganey. Retrieved from http://www.pressganey.com/newsLanding/10-07-22/Patients_Spent_Average_of_Four_Hours_Seven_Minutes_in_U_S_Emergency_Departments_in_2009_According_to_New_Report_from_Press_Ganey.aspx Press Ganey: Case Study. Toward the Efficient Medical Practice: Physicians Gaining Greater Patient Satisfaction Through Process Changes. Retrieved from http://www.pressganey.com/Documents/Toward_the_Efficient_Medical_Practice.pdf Solomon, M. (February 11, 2013). 7 Ways To Improve Patient Satisfaction, Experience, And Customer Service, From Consulting In Hospitals And Healthcare. Forbes. Retrieved from http://www.forbes.com/sites/micahsolomon/2013/11/02/quick-truths-for-improved-patient-satisfaction-and-customer-service-from-consulting-in-hospitals-and-healthcare/ Read More