Trends in the Healthcare Industry, Information Systems for Information Management at the Facility - Research Proposal Example

Managing Knowledge and information in an organization Name: Tutor: Course: Date: Table of Contents Table of Contents 2 List of Figures 4 List of Tables 5 PART A 6 1.0 Collection of information and identification of problem 6 1.1 Introduction 6 1.2 Identification and analysis of business issues and problems 6 1.3 Required information to solve the problem 7 1.4 Gathering and testing of reliable information 7 1.5 Formal and informal networks to access corporate knowledge 8 2.0 Analysis of information and knowledge 9 2.1 Objectives 9 2.2 Identifying Patterns and trends 9 2.3 Cause and effect analysis 10 Figure 1: Fish-bone diagram on physical and verbal abuse of nurses in the past year 10 2.4 Statistical analysis 11 Figure 2: Financial performance of Riley Hospital 11 Figure 3: Regression analysis for discharges rates and patient satisfaction 12 2.5 Situational analysis 12 Table 1: SWOT analysis of Riley Hospital 12 PART B 13 3.0 Business decision making 13 3.1 Introduction 13 3.2 Implementation process 13 Figure 4: Implementation of knowledge management process 14 3.3 Monitoring and evaluation process 14 3.4 Obstacles encountered 15 3.5 Championing the program 15 3.6 Information systems decisions 15 4.0 Recommendation and decisions 15 4.1 Risk management Plan 15 Table 2: Risk management Plan for Riley Hospital KM implementation 16 4.2 Appropriate quantitative methods 16 4.2 Consultation and collaboration 16 4.4 Decision taken 17 4.5 Recommendations 17 Reference list 18 Appendices 19 Appendix I: Personal interview schedule 19 Appendix II: Minutes 20 List of Figures Figure 1: Fish-bone diagram on physical and verbal abuse of nurses in the past year 10 Figure 2: Financial performance of Riley Hospital 11 Figure 3: Regression analysis for discharges rates and patient satisfaction 12 Figure 4: Implementation of knowledge management process 14 List of Tables Table 1: SWOT analysis of Riley Hospital 12 Table 2: Risk management Plan for Riley Hospital KM implementation 16 PART A 1.0 Collection of information and identification of problem 1.1 Introduction Riley Hospital is a 600-bed capacity healthcare facility established in 1992. It is a specialist referral, orthopedic and trauma centre serving a community of 350,000 people and treats about 130,000 patients annually. The hospital has 105 employees including doctors, nurses, administrators, social workers and security. It intends to be a leading national provider of efficient and effective healthcare especially on emergency, surgical and medical operations. To achieve this mission, the hospital is focusing on engaging the community, attracting and retaining quality staff, improving infrastructure and financial viability, enhancing community services and delivering coordinated, accessible and quality healthcare. However, the hospital lacks standardized procedures, experiences rampant wastage of human and financial resources, and siloed operations. 1.2 Identification and analysis of business issues and problems As mentioned above, Riley Hospital has recognized some problems which when handled will lead to efficiency, better working relationships, and increased satisfaction from patients, community and hospital staff. The problems identified in the hospital are; 1. High employee turnover due increased cases of workplace violence against nurses.25 nurses reported physical and verbal abuse by patients and their visitors in the previous year. 2. Delays in patient discharge and processing of medical insurance claims. 50 patients and their families had complained that they are taking unnecessary 2 or 3 more days when they should have been discharged. 3. Loss of income due to pilferage, manual recording, and its retrieval. Manual receipting of payments into MS Excel has led to some hospital staff cheating on the records. The hospital loses an average of $1.2 million annually on siloed operations and pilferage. 4. Delays in retrieval and updating of patient records. Patients take an extra 1 hour to be treated as the staff are looking for records and making updates. 5. Delays on salary processing and overtime claims. Hospital staff has to wait for 1 or 2 days from the salary payment date to get paid. 1.3 Required information to solve the problem The hospital requires information on number of nurses experiencing workplace violence and reasons why there was an increase in reported cases compared to the preceding year. It will also need to capture durations of patients in the hospital by taking admission dates and time as well as discharge dates and time. Payment tracking-Patient payments also have to be matched with money collected per day and reconciled against the day’s expenses. The hospital will need information on type of records, payment systems, and managerial responsibility. Lastly, the facility will need to capture or log-in complaints and queries on salary delays and missed overtime claims. 1.4 Gathering and testing of reliable information Telephone surveys and personal interviews will be the most reliable methods to obtain information. On telephone surveys, specific respondents from finance, ward, emergency, and outpatient departments can be contacted. This will enable up to 80 respondents to be contacted. It will follow a prepared script similar to the written questionnaire that has been tested for reliability and validity. This method also provides an opportunity for opinion probing (Dewhurst, 2006). It lasts less than 10 minutes, cheaper and can be completed in less than four weeks. Telephone surveys will attempt to get information on complaints, satisfaction and queries from nurses. Personal interviews will be used to obtain comprehensive and in-depth information (Dewhurst, 2006). One person interviews one person for detailed or personal information. The questions are also asked from written questionnaire and answers recorded verbatim. This also means the instrument has been tested for validity and reliability. Industry experts like finance officer, human resource officer, nurse-in-charge, and public relations will provide information that they could not divulge through other methods. Data like patient payments, record systems, admission and discharge processes, hospital revenue and expenditures, and management information. To test the two instruments for reliability, split-half technique will be used (Dewhurst, 2006). Two sets of printed questionnaires (5 each) will be sampled and administered to a pilot group of 10 people. If all the responses show more than 80 percent consistency, then they are reliable. Special experts in research will be contacted to peruse both scripts to ascertain validity. 1.5 Formal and informal networks to access corporate knowledge Information for management decision making comes from two sources; internal and external sources (Dewhurst, 2006). For internal sources, it comes from the staff and information systems used such as MS Excel. Personal sources could be the experience of doctors or nurses while interpersonal sources could be the expertise of the finance of finance officer. Basic internal data is available in the control systems and accounting records. This data is reliable, relevant and accessible continuously (Anderson et al. 2012). Data inputs to the management systems includes schedules and budgets and can be obtained from billing records and equipment shipment information. Internal sources will help answer questions like; is it wise to expand bed-capacity in the hospital? Are revenues declining? Could high turnover of staff be minimized? However, management and accounting information systems are too rigid hence inappropriate to reach decisions as it is highly aggregated and lacking specific applications. It may also not be accurate but it remains an excellent information source for management decision making. For external sources, it comes from outside the industry, suppliers and government (Dewhurst, 2006). The main data sources are primary research, published data sources and government. Published data sources are the most popular since data is sufficient and readily available. For example, finding the suitability of certain business process map or prevalence of workplace violence against nurses, it may be possible to consult various statistics and find the answer. Major published sources are industry associations, medical journals, periodicals and government publications (Anderson et al. 2012). Primary research is also part of external sources. A research project is conducted on behalf of the organization to gather data. However, it is costly but pinpoints the exact piece of data needed. It is also expensive and time consuming. It provides tailor made information useful for specific tasks. For example, to understand the high turnover among nurses, it will be important to undertake a survey which addresses issues of complaints, job satisfaction and suggestions for improvement. To answer questions relating to work productivity, queries, complaints on discharge rate, salary claims and patient records, it is better to consult internal sources. However, to obtain data on industry minimum wage or prevalence of workplace violence, then external sources like industry magazines is appropriate. 2.0 Analysis of information and knowledge 2.1 Objectives 1. To find out the challenges facing utility and sourcing of data for use in the facility in the past year 2. To identify specific trends and patterns in the healthcare industry in the past four years 3. To identify cause and effects of challenges facing Riley hospital in the past year 4. To recommend appropriate information systems for knowledge and information management at the facility 2.2 Identifying Patterns and trends The hospital collects, summarizes and analyzes data to identify patterns and trends. The data collected will be associated with the functional processes of the organization. For example, by taking an industry analysis of workplace violence against nurses, the trend could show increasing cases of physical assault as compared to verbal abuse. Similarly, internal sources could be showing decreasing revenues compared to the previous years. Staff turnover compared to the industry average could also be high. By looking on patterns and trends it is easier to pinpoint the cause of the problem. If for instance, the revenue of the hospital is decreasing while industry average revenues are increasing, then it makes it easier to investigate internal organizational failures. However, certain patterns and trends such as use of online patient appointments, adoption of integrated management information systems, online treatment and prescription are gathering ground in the health care industry. 2.3 Cause and effect analysis To conduct cause-and-effect analysis, fish-bone diagrams will be used. This technique helps to identify causes and brainstorms major categories such as methods, equipment, manpower, materials, measurement and environment (Lighter & Fair, 2000). For example, the figure below represents the inquiry into the causes and effects of workplace violence against nurses. The hospital team looks into the causes and uses four generic heading to prompt the ideas (Lighter & Fair, 2000). Under the healing ‘people’ the idea of training could encompass college training and on-the-job training on how to handle co-workers, patients, and visitors. The diagram is as shown below. Figure 1: Fish-bone diagram on physical and verbal abuse of nurses in the past year From the graph above, it will be important to note that some of the reasons patients or visitors complaint about during admissions could be delays and discrimination which angers them. As a consequence, they resort to verbal abuse or even physical violence. 2.4 Statistical analysis Statistical analysis can be descriptive or correlational. Data existing in values are mainly descriptive while data that seeks to understand the influence of one aspect on the other is mainly correlational. In this case, the declining revenues in the hospital can be attributed to leakage of income or patients/community discontinuing services with the hospital. Bar graphs can be used as tools of analysis to capture revenues. For example, in the graph below, it can be seen that revenue has been decreasing in the past two years while expenditure has increased steadily. This is an indication or a warning that the hospital is not financially healthy. Figure 2: Financial performance of Riley Hospital The other set of statistical analysis is correlation which attempts to bring out the relationship or cause and effect of the various variables. For example, it determining discharge rates and patient satisfaction, the hospital provides ratings based on the Likert scale. The measurement scale for patient satisfaction ranges from; very satisfied to very dissatisfied, while discharge rates is the number of patients discharge per day. The results of the correlation are as shown in the graph below. Figure 3: Regression analysis for discharges rates and patient satisfaction From the regression analysis in figure 3 above, the R value is 0.913 indicating a strong and positive correlation between the two variables. As well, the slope of the graph is 0.349 which is a positive value. It indicates that both variables have positively correlated and that increase in one increases the occurences of the other. For instance, increase in patient discharge rates in the hospital will lead to a correspoding increase in their levels of satisfaction. 2.5 Situational analysis Situational analysis interprets the internal and external factors that affect an organization (Thierauf, 2001). In this case, SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis will be undertaken to understand the external and internal forces affecting the hospital. Table 1: SWOT analysis of Riley Hospital Strengths: Highly qualified and competent staff State-of-the-art facilities and equipment Excellent brand name Favorable location and access Proximity to a medical school and accessible to interns Weaknesses: Declining revenues Poor relationship between patients and staff Management rigidity and overbearing attitude Pilferage and leakage of revenue Manual operations with high downtimes Does not recognize workers unions Opportunities: Technological changes; presence of online consultations, examinations and prescriptions. Reduction in taxes and levies on medical equipment imports. New developments in generic medicines and control of hospital acquired infections. Collaborations and communications with various hospitals through modern tools such as Skype, WhattsApp and LinkedIn for best methods and access to skilled workforce globally. Threats: Planned strikes by nurses over salary increase will stall operations at the hospital Increased cases of new endemic diseases like Ebola likely to exert huge pressure on the facility New threat from an upcoming referral facility in the city From the table 1 above, SWOT analysis extols the organization’s physical, human and financial capabilities. State-of-the-art equipment and facilities as well as competence and skills of staff are core strategic capabilities that are needed for sustained competitive advantage. However, integrity and accountability as well as management rigidity need to be reversed as these would have been the distinctive strategic capabilities that will take the hospital out of competitive parity to sustained competitive advantage. PART B 3.0 Business decision making 3.1 Introduction As stated earlier, Riley Hospital has core strategic capabilities but it is getting it wrong on the aspect management and leadership. Its operations are full of red tape and seen to cause high staff turnover, increased customer complaints on various issues. The hospital will need to implement various information systems such as management information, decision support systems, human resource information systems and customer relationship management. 3.2 Implementation process Implementing the Knowledge Management (KM) process requires finances, human resources and physical equipment (Thierauf, 2001). Management support is very important at this level. For effective implementation, various milestones are compared with baseline projections. The implementation process is as shown in the graph below. Figure 4: Implementation of knowledge management process From the graph above, it can be deduced that employees lack the time to commitment to the knowledge management process. The senior management seems to have a great support for the process which is desirable. However, there is also need to promote a culture of sharing and communication to help employees of the hospital to understand the need for KM and its benefits in the organization. 3.3 Monitoring and evaluation process Monitoring process requires comparison of progress with the initial inputs. It shows that employee skills on KM, benefits notification, and funding for KM needs to be increased. The baseline duration was 7 months involving 10 employees at a cost of $1.5 million and at the moment, the program has covered 5 months with $1.3 million with employee records captured in the Human Resource Information Systems. However, patient records are yet to be launched into the Health Care Administration Systems. So far, 40% of the benefits have been achieved. 3.4 Obstacles encountered Lack of business purpose is the greatest problem which has not won the attention of the employees, organization culture and benefits. There is also a challenge of poor planning and inadequate resources. The attention went to the KM pilot project and ignored the roll-out. Lack of accountability is also another problem in the implementation since it is not fixed on persons. Lastly, the program was not tailored to meet the need for individual users such as administration, HR, finance and emergency department. 3.5 Championing the program The organization is looking beyond implementation by defining ways of handling problems on how to use knowledge management. The facility is also planning on planning the pilot plan and roll-out simultaneously to keep focused on the mail roll-out. The implementation team is drawing on the support of the entire management and employees dedicated for the purpose. Lastly, the program is being tailored to fit into the needs of individual users and organizational culture. 3.6 Information systems decisions The organization decided to adopt management information systems, decision support systems, human resource information systems and customer relationship management. On customer relationship management, the systems were also tailored to not capture queries from patients and visitors but also from suppliers and regulators. These systems were chosen to address the various issues as stated in the objectives above. 4.0 Recommendation and decisions 4.1 Risk management Plan The risk plan was chosen to address the various risks and provide action plans as shown in the table below. Table 2: Risk management Plan for Riley Hospital KM implementation Risk Impact Occurrence Responsibility Action plan Delay in procurement of information systems and hardware High Low Suzanne Early listing of customer requirements and partnering with suppliers for the best systems and prices Poor uptake from staff and misunderstanding on its benefits Medium Medium Bob Incorporate all the employees in the design brief, communicate progress regularly, emphasize on costs to benefits Organization’s processes not compatible with KM High Low Sue Conduct feasibility studies; relate costs to benefits The tables 2 above identify the various risks and assign them a score on impact and occurrence. Each risk is then assigned responsibility and appropriate actions taken. 4.2 Appropriate quantitative methods Descriptive surveys: Data on financial performance of the hospital, staff turnover rates, discharge rates, and number of complaints from patient and visitors will be captured in graphs and regression charts as shown in the figure 2 and 3 above. This method provides an accurate and reliable measure of the position of the organization regarding its financial and human resource capabilities (Anderson et al. 2012). It will inform on the suitable information systems to be used such as Health Care Administrations Systems, Human Resource Information Systems, Management Information Systems and Decision Support Systems. 4.2 Consultation and collaboration The organization will consult widely with various relevant government departments on the need to install and implement knowledge management systems. The hospital will also collaborate with the leading healthcare providers in the region to learn best practices and integrate knowledge management in into the culture and mission of the organization. 4.4 Decision taken The organization has made a managerial decision to implement the following knowledge management and information systems; Health Care Administrations Systems, customer relationship management, Human Resource Information Systems, Management Information Systems and Decision Support Systems. These systems will help in curbing high staff turnover, huge pilferage and revenue leakages, increased complaints from nurses and patients as well as address delays in discharge and overtime/ insurance claims. 4.5 Recommendations 1. Tailor the program to meet the individual needs all users 2. A core team should be selected for the purpose of implementing the knowledge management program 3. Plan pilot and roll-out to progress simultaneously 4. Define pressing problems and solve them using knowledge management 5. Involve everyone in the company and create regular forums to address emerging issues and challenges Reference list Anderson, D Sweeney, D Williams, T Camm, J Cochran, J 2012, Quantitative Methods for Business, Cengage Learning. Bagshaw, M 2000, Why Knowledge management is here to stay, Industrial and commercial training, volume 32- Number 5 Dewhurst, F 2006, Quantitative Methods for Business and Management, McGraw-Hill Education Lighter, D E & Fair, D C 2000, Principles and Methods of Quality Management in Healthcare, Jones and Bartlett Learning. Prusak, L 2007, Principles of knowledge management, Journal of knowledge management, Volume 1 Number 1 September 2007. Thierauf, R J 2001, Effective Business Intelligence Systems, Greenwood Publishing Group. Appendices Appendix I: Personal interview schedule 1. How has been the financial performance of the hospital in the last four years? 2. What challenges is the hospital facing in stabilizing revenue and expenditure? 3. What patterns and trends do you see in the healthcare industry? 4. Why have there been cases of increased cases of workplace violence against nurses in the organization? 5. What are the major patient concerns and how is the hospital addressing them? 6. How satisfied are patients with regard to treatment and discharge? 7. What information systems do you think should be implemented in the organization? Explain. 8. What benefits will the hospital gain in implementing knowledge management programs? 9. What challenges is the implementation team facing while trying to implement knowledge management systems? 10. How is the management prepared to ensure complete implementation of the knowledge management and information systems? Appendix II: Minutes Minutes of Knowledge Management debriefing Minutes of management of management debriefing held on 2nd April 2015, 10:00am at East-wing Board Room. Members present Sue Hathaway-Chairperson Rashid Ali Bob Duncan - Secretary Suzanne Bowen Lyn Johnson Isaac Members absent Duke Owens Agenda: Introduction Knowledge management system briefing Challenges on implementation Support /Way forward Any other business Adjournment Min 1: Introduction Sue welcomed all the members to the meeting and introduced the agenda of the meeting. She thanked all the members for being steadfast in ensuring the program gathers pace as planned in the original project brief. Min 2: Knowledge management system briefing Bob informed the members that the baseline duration was 7 months involving 10 employees at a cost of $1.5 million and at the moment, the program has covered 5 months with $1.3 million with employee records captured in the Human Resource Information Systems. However, he said that patient records are yet to be launched into the Health Care Administration Systems. So far, 40% of the benefits have been achieved. The members suggested more allocation of funds and additional 2 months to complete the exercise. Min 3: Challenges on Implementation Rashid Ali said that lack of business purpose is the greatest problem which has not won the attention of the employees, organization culture and benefits. Lyn commented on poor planning and inadequate resources. The attention went to the KM pilot project and ignored the roll-out. She also mentioned lack of accountability is also another problem in the implementation since it is not fixed on persons. Lastly, Lyn Johnson said that the program was not tailored to meet the need for individual users such as administration, HR, finance and emergency department. Min 4: Support/Way forward The team recommended the program to be tailored to meet the individual needs all users. They also suggested a core team to be selected for the purpose of implementing the knowledge management program. The team advised on planning pilot and roll-out to progress simultaneously. Isaac suggested definition of pressing problems and solving them using knowledge management. Sue said that she will involve everyone in the company and create regular forums to address emerging issues and challenges. She also suggested an extra allocation of $250,000 to complete the project in the next five months. Min 5: Any Other Business (AOB) The team did not have any other issue to address Min 6: Adjournment The meeting was adjourned at 11:20 am, the next meeting will be held on 18th June 2015 Sign: Sue Hathaway (Chairperson)­­­­____________________________________ Sign: Bob Duncan (secretary)______________________________________ Read More