Service Operations Management - Report Example

PROMOTING GOOD PHYSICAL HEALTH FOR PEOPLE WITH MENTAL HEALTH NEEDS. Student’s name: Instructor’s Name: Class Name and Code: University: Date of Submission: A good mental health is closely associated with a stable physical health, and there is the huge need of increasing knowledge of mental health within an acute hospital environment and at the primary care. In relationship to secondary healthcare, Ashwood Court Independent Hospital is an established hospital with a capacity of twenty beds and is a residential environment for individuals who are undergoing through mental health challenges such as schizophrenia, severe depression, and Bipolar disorders. People suffering from mental disorders have an increased chances facing physical illness in comparison to the mentally stable individuals in a general populace (Smith 2012, 4). Various assessment has indicated that such people of poor mental health have increased incidences of cardiovascular and respiratory diseases, obesity, type 2 diabetes, and cancers (Naylor 2012, 24). Individuals undergoing severe mental conditions often die earlier than the mentally stable persons by an average of between 10- 15 years. Further, the age-adjusted rate of deaths per year is between 2-4 times as higher as in the general populace. Additional reporting on Avoidable Deaths on persons with mental sickness indicated that close to fifty percent of patients under study had respiratory and cardiovascular diseases. Such high numbers have indeed led to raised awareness and concentration on the needs of physical health in such a group. The huge bracket of persons undergoing severe mental illness (SMI) receives health care and management by the general practitioners (GP) in the community. According to research, there is a great danger of depending on the doctors for mental health care at the primary level (Creek 2011, 45). The challenge exist because such patients having SMI have a huge problem in utilising services of primary health care. The DNAs (Do Not Attend) proportions are much elevated for persons who need mental care and those who face challenges of learning. Such a problem of engagement hugely affects the need of doing the needed treatments and screenings meant for improving the status of the physical health of such people and minimise the inequalities in health among such a group of clients. As a response to such a challenge, Making Space, in collaboration with GPwSI agreed on the need of making screening and interventions for treatment highly reachable to persons having mental problems. The main aim was to ensure that interventions of screening and treatment were brought much closer to where people resides which include homes, community and day centres. The collaboration between Dr. Alistair Partnership and Making Space was a brain child of a shared passion for improving the physical health condition of persons having mental health needs and minimise the inequalities of health through innovative approaches to deliver the needed treatment and care to the individuals who are hard to reach. The pilot initiative supported the deployment of support worker from Making Space to be residing at Ashwood Court Independent Hospital. The Hospital is a rehabilitation center for psychiatric cases and falls under the management of Making Space. Dr. Alistair as a GP in the partnership has a vast training on dietary support, spirometry, exercise therapy, cessation of smoking and assessment of IHD. Dr. Alistair also has experience in the awareness of illness through the use of the How R You assessment especially for the cancer of the lungs in which a local information indicates lung cancer presentation is much late. Finally, the doctor is knowledgeable in accessing and communicating with the local practices of the GP. Dr. Alistair incorporated her variedly acquired knowledge into clinical engagement at the Ashwood Court Independent Hospital which improved the capability of the institution to obtain the most excellent possible result for the patients. The physical health assessment entailed Liver Function Test (LFT), Full Blood Count (FBC), Chest X-ray, Cholesterol, Dental Check, Glucose Tolerance Test (GTT) and Blood Pressure. Other tests included Podiatry, Thyroid Function, Urinalysis, Weight, Body Mass Index, height and the Conference of the weight. The assessment also included checks of Diabetic Retinopathy and optical assessment. The visible improvement was noted which made a tremendous difference to persons such as patients who were diagnosed with diabetes received proper care and treatment. Consequently, such patients’ level of depression demonstrably improved. Patients who had high levels of cholesterol which could significantly lead to cardiovascular infections were noted and appropriate measures adopted to curb such risks. The successful adoption of such a pilot project regarding bettering the physical health and mentally challenged patients’ well-being emphasized the commitment and belief shared by Dr. Alistair and Making Space collaboration. The partnership stated that arming the unentitled support workers with appropriate competence and knowledge to provide the needed interventions of screening and treatment in different environments such as the setting of a community could create the substantial difference in ameliorating the outcomes of physical health and minimizing inequalities of health for patients who have needs of mental health. Operation Management Efficient service management of medical establishment is crucial for its effectiveness and longevity (Chesbrough 2010, 8). Every system of health care is faced with increased cost and unevenly distributed quality world over in spite of the hard work of properly informed clinicians. Policy makers and leaders of healthcare have made attempts of making various fixes including minimizing errors, enforcing guidelines of practices, attacking fraud and ensuring the patients feel better. Value agenda is necessary for the transformation of management in health care. The system entails restructuring how the delivery of a health care is measured, organized and reimbursed. The transformation of health care that is based on value must be explicitly set. Organizations must establish pilot levels and initiatives in individual areas of practice (Hall and Johnson, 2009, 60: Hill 2012, 232). Management may involve some big institutions adopt changes of large scale which may entail various segments of the value agenda. The outcome may significantly enhance the efficiency and outcome and the growth in operations. The strategic agenda aimed at moving to a system of delivery of high value is made of six section. The components are mutually reinforcing and interdependent. Development is quite achievable and rapid if such components are pursued together (Hammer 2007, 111). The current health care delivery structure has been kept for years, but it has been founded on elements that are mutually reinforced. At the centre of the transformation of value is to change the manner in which clinicians deliver care. The fundamental principle in organization structuring is in the organization around the patient and need (Johnston and Clark 2008, 13). In the delivery of health care, that need a change to focus on the medical condition of a patient. Such is referred to as an integrated practice unit (IPU). In IPU, a passionate team consisting of non-clinical and clinical officers gives the entire cycle of care for the condition of the patient. IPU treat the disease and the associated conditions, circumstances, and complications that frequently comes with the condition, such as kidney disorder in diabetes. IPU provides both treatment and takes responsibility for involving the patients’ together with their families in the care. In the IPU, the personnel’s regularly work together as a team towards the achievement of a similar goal and maximizing the overall outcome of the patient as efficient as possible. In the primary level of care, IPUs are often multidisciplinary groups structured for the service of patients with conventional primary and the preventive needs of care. Measuring the care cost is another important aspect of management. For the areas in which a huge cost is a real problem, lack of precise cost information in the care of health is impressive. Few health professionals own a knowledge of the expense of each component of care. Most health care organizations lack precise information of what the care cycle cost for any patient who is suffering from a particular medical problem. The most systems of accounting in healthcare instead have based in the department and not on the patient. The systems in existence are excellent for the overall budgeting of a department, but they only give misleading and crude estimations of real service costs for a particular patient and their conditions. In determining value, the providers need to measure the costs at the level of medical condition, keeping track of the associated cost of treatment over the full care cycle. Such calls for one to understand the used resource in care, such as equipment, personnel, and the facilities. The most appropriate method to understand such costs is the Time-driven activity-based costing (TDABC). In the situation where TDABC is applicable, the approach enables the providers to obtain many ways to minimize the expenses without negatively affecting the outcome significantly. Mental Health Individuals with long-lived conditions of physical health often demonstrate problems of mental health including anxiety, depression or anxiety. Due to such comorbid issues, the prognosis of long-term conditions of such people and their life quality can have a remarkable deterioration (Thomas et al. 2016, 5). Additionally, the cost required to provide care to such individuals are elevated due to the ineffective care of self and other complicated issues which relate to the poor health of the mind. Health and services of social care are rarely organised in a manner supporting a response integrated to dual physical and mental health care needs of the individual patients. The professional and institutional separation of physical and psychological care of health results to a fragmented advance whereby opportunities of improving efficiency and quality are always missed (Knapp 2011, 25). The link between professionals of mental health and the primary care have been under-looked in various areas. There is the importance of exploring modalities in which patients with both physical and psychological health challenges can be addressed in an integrated approach. Evidence of research has often shown that patients with long-term health conditions have increased chances of experiencing problems of mental health compared to the general population (Hert 2011, 139). Disorders which include anxiety and depression are quite common in cognitive decline, dementia, and some other conditions. Substantial evidence has suggested close linkage with diabetes, musculoskeletal disorder, and cardiovascular disease (Fenton et al. 2006, 426). Many elevated problems of mental health are also indicated in the presence of conditions such as arthritis, HIV/AIDs, and cancer. To reduce the number of mental disorders in the society, the GPs can work with other partners such as leadership of Public Health. Such collaborations can engage in mapping local services such as in education, youth, and health. Care services and pathways can be mapped for physical health conditions such as cardiovascular diseases, mental health conditions as depression and the social situation such as the breakdown of relationship and debts (Cepoiu et al., 2008, 28; Mitchell, Lord and Malone 2012, 436). In targeting the promotion of health, data risk factors, morbidity, and mortality and breakdown of marriages can be amalgamated. A holistically structured approach is crucial whenever good results are required. Primary care must utilize biopsychosocial approach which is proactive in a consultative way in assessing and managing both physical and mental disorders. Consultation sequence, care plans of the whole team and the self-care of the patient must be used in addressing various issues concurrently. Healthcare staffs must be informed of common ways expressed by patients of anxiety or depression (Katon 2011, 154). Practitioners of primary care must be made aware of social factors that determine ill health such as drug misuse and marital challenges. Upon identification, such issues can be handled through direct measures where practicable. Recognizing teachable and moments of learning in working with patients in the promotion of mental health and illness prevention must be done by all clinicians (Naylor 2012, 24). Mental health promotion opportunities are indicated when the clinicians care for families and people at transitions of life during chronic conditions of health, pre and postnatal health care. Managers and clinicians need to ascertain that the environment of practice enhances proper mental health care. Screening, assessing and prompt treatment and provision of support for persons at risk of acquiring mental health challenges are significant. Such practices need to be adopting proactive approaches throughout the course of life. It’s also crucial to get informed of the resilience and risk factors at each life stage for the registered populace. The practice must equip staffs with possible factors associated with increased mental disorder rates among children, such as bullying, child abuse, and violence witnessed by a child. Improvement, control, and conclusion The Feed Forward control and the Deming improvement cycle will be adopted. The Feed Forward control is done at the input production level and starts before the commencement of output or activity of service. The rationale of the approach is in foreseeing potential challenges and preventing their occurrences (Slack, Chambers and Johnston 2009, 7). The principle aim of Feed-forward control is problem prevention at the level of input before undergoing the process of transformation. The Deming Cycle also employed involves systemic steps series to gain critical learning and information for the continued enhancement of care process in Ashwood Hospital. The Deming Cycle commence with planning which entails identification of goal, theory formulation definition of success metrics and adopting a plan of action (Figure 1). The Do step then follows, and in such a step, the results are checked so as to test the plan validity for the indication of progress or to identify areas which need improvement. Finally, the Act step marks the end of the cycle, and it integrates the learning produced by the whole process which is utilizable in adjusting the goal. Figure 1. Deming Cycle Figure 2: Operation process Management Among the solutions to be done further, the GP, the healthcare workers, and the commissioners will be convinced of the current need of embracing new working ways and to delivering such interventions farther from the surgeries of GP to make them readily available by to people. The management of the hospital will also engage in training of support workers in delivering such interventions efficiently to the community by the provision of accredited programs of training meant for developing the needed skill, competence and knowledge. The management will further ensure the arrangement of the partnership between Making Space, the third sector institution, the GP and various other stakeholders and laying down the need for developing the processes and procedures aimed at safely exchanging information. In line with the recommendations stated for improvement, the leadership of Ashwood Court Independent Hospital resolved on setting an initiative with the Patient Care Technician (PCT) at the local level. The initiative aimed to use the workers of community support in line with the pilot model of the GP surgery in the provision of screening and interventions for treatment to the persons who have mental problems and are hard to reach. In the approach, the workers were seen as a being part of the program of ‘Find and Treat’ which was designed at minimizing Deaths from Cardiovascular Diseases, minimizing morbidity, health inequalities in Borough (Prince et al. 2007, 860). The program was further aimed at reversing the broadening gap in the expectancy of life for the persons who live in the borough and to better the registered prevalence of the primary care for diabetes, hypertension, and CHD. The leadership of the hospital further supported six support staffs from Making Space to be trained at Bolton University to increase their competence in screening and treatment. A Find and Treat a group of support was established within Ashwood Court Independent Hospital to give the support staffs any necessary clinical supervision and support. The assessment done by the support workers were passed to the GPs who utilize the program of ‘Contact plus’ in generating the clinical results and interventions given to the individuals by support officers in collaboration with GPs. Conclusion The New Health checks of patients commence within 48 hours following admission and come to an end after seven days. The test covers various tests such as full blood count random glucose and urinalysis. A multifaceted team discussion is held within ten days of the initial assessment and reference of the patient to the Specialists Care Pathways follows. Such pathways of care include cessation of smoking, substance use, and CVD. A plan of healthcare is made within six days through partnerships with carers and patients. A document of goals setting is also made in collaboration with the patient, then reviewed after 28 days. Since the pathway introduction, type 2 diabetes disease has been diagnosed and treatment done in the previously undiagnosed cases. Patients who were severely withdrawn who presented with the social and mental disorder were discovered to have born undiagnosed Cataracts. All the patients who received admissions with prolonged conditions were given referrals to a specialist care pathway. 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