Health Sector Service Management - Research Paper Example

?Health Sector Service Management Executive Summary Wait times of the patients is duly considered to be one of the critical issues which is faced by different healthcare organizations in recent times. This can be due to the reason of ineffective operational functioning of the healthcare workers, poor operational management procedure and shortage of coordination amid the physicians or doctors and the medical staffs like nurses. In order to acquire a better understanding about the reasons as well as the impact of long wait time of the patients especially in the emergency units of the hospitals, an UAE based hospital named Tawam Hospital will be taken into concern. Various aspects that include a brief overview of wait times of the patients relating with health sector, causes along with their consequences will also be discussed. It is worth mentioning that in order to gain an in-depth knowledge about the prevalence of wait times across the health segment, a cross-examination of two hospitals namely Tawam and Al Ain will be considered. One of the critical challenges faced by the healthcare organizations in recent times relating to wait times of the patients is patient satisfaction. Thus, certain challenges and solutions to mitigate these challenges will also be depicted in this research paper. Table of Contents Executive Summary 2 Introduction 4 A Brief Overview of Wait Time for Treatment in Hospital Emergency Departments 5 Discussion 8 Overall Approach 11 Analysis 12 Cause-and-Effect Diagram 14 A Brief Overview of the Challenges 15 Recommendations 16 Conclusion 17 References 18 Introduction In healthcare sector, waiting time is fundamentally regarded as the duration of time that passes particularly between receiving ‘Recommendation for Admission’ form by a hospital and the specific day of the admission of patient in the hospital. In general, waiting time associated with healthcare segment is viewed to be a time period between when a specific activity is mandated or requested and its happening. It has been apparently observed in this similar circumstance that if the aforementioned form is arrived at a certain delayed time at the hospital, the waiting time would generally appear quite shorter (NSW Government, n.d.). Besides, waiting time in healthcare sector is also described as the total time taken by a patient starting from the registration till the consultation with the doctor. There generally exist two sorts of waiting time in this similar circumstance. One type of waiting time is viewed to be the time taken by a patient for making consultation with the doctor and the time taken for obtaining any medicine. The other type is the time taken by a patient particularly in registration is also regarded as one of the components of waiting time of a patient (Abdullah, 2005). The significant concern of waiting time can be related with triaging of patients. In this similar concern, the term “triage” is fundamentally regarded as a procedure that was initially executed especially by the militaries for the purpose of sorting their soldiers effectually who were wounded in any battle. Generally, ‘triage’is viewed to be the sole method through which healthcare professionals act proficiently towards categorizing the urgency of the medical requirements of the patients resulting in the deliverance of proper, secure and quality medical care to the patients. By taking into concern this particular approach of triage, it has been viewed that the prime intention of this process is to make sure that every patient is appropriately as well as timely treated at the time of their any clinical urgency. However, different healthcare organizations have been witnessed to face critical issues concerning waiting time that needs to be mitigated largely in order to support the patients by offering secure and quality medical care to them (Rambaran, 2009). In this research paper, a detailed investigation about a current management of service quality issue or problem faced by an organization today will be taken into concern. In this regard, the healthcare organization i.e. Tawam Hospital is facing a problem in terms of waiting times which is faced by patients before being seen by the physicians in the Emergency Department and certain other issues will be discussed in this research paper. A Brief Overview of Wait Time for Treatment in Hospital Emergency Departments In order to analyze the issue regarding waiting times in healthcare sector, it has been apparently observed that a patient necessitating any sort of hospital treatment or pathological test usually faces the issue concerning lengthy wait. This crucial issue can ultimately make the visit of the patients to the hospital more traumatic as well as unlikable. It can be stated that the valuable time of the patients and others involved in patient’s treatment would be saved only if the patients are able to get rid of the compulsion of facing lengthy waits. While examining wait times for treatment in emergency departments of hospitals, it has been viewed that when a patient arrives especially in the Accident and Emergency (A&E) room in a hospital, he/she is primarily assessed by any medical staff for confirming whether the patient necessitates urgent treatment or not. If it is noted that the patient does not require urgent treatment then he or she would be asked to be seated and wait until a registered doctor or a physician is available. In this particular situation, the average waiting time has been observed to be three long hours. Once, the physical condition of a patient is identified and diagnosed, a further wait of the patients begin for availing better treatment (University of Twente, 2013). With regard to determining wait time for treatment in the emergency departments of the hospitals, it has been apparently observed that the quantity of visits particularly in hospital emergency departments had risen by 32% during the years 1999 to 2009. In this regard, it has been viewed that the figure of patients who visited emergency departments in the year 2009 in the United States reached up to 136.1 million which is quite higher as compared to the patients who visited hospital emergency units in the year 1999 which reached up to 102.8 million. In certain hospitals, increased level of visits particularly in the emergency departments has ultimately resulted in the crowding of emergency department, augmented wait times for minors and the generation of serious health problems like myocardial infarction by a considerable level. It is worth mentioning that mean wait time between the years 2003 and 2009 had been raised by a level of 25% i.e. 46.5 minutes to 58.1 minutes (Hing & Bhuiya, 2012). This could be better understood with the help of the following pictorial illustration: Source: (Hing & Bhuiya, 2012) Certain imperative factors have been duly observed that broadly influence the significant concern of wait time amid the patients. In this similar concern, the factors comprise the sort of treatment which would be offered to the patients, the recognition of the specialist doctor who will be in-charge towards treating the patients and the standard of the hospital in which the patients would be admitted for availing better treatment. Besides, the transforming health requirements of the community as well as the societal members also deeply influence the waiting time of the patients by a greater level. As the triage of patients is correlated with the issue of waiting time in emergency departments of the hospitals, it has been apparently observed that triaging patients presented to hospital emergency units has been categorized into five acuity levels on the basis of the system of Emergency Severity Index (ESI). In this regard, ESI is viewed to be one of the imperative triage instruments, which is broadly executed in the emergency departments of the hospitals at large with the intention of lessening wait times of the patients. Notably, the principal intention of ESI approach has been observed to be prioritizing the incoming patients and most significantly identifying those patients who are not able to wait for longer time period. The five acuity levels relating to the approach of ESI concerning lessening of wait times for the patients include resuscitation, urgent along with non-urgent, emergent and less-urgent cases. In this similar context, the resuscitation acuity level signifies necessitating instant triage for adopting any resuscitation measure. The acuity level of emergent case denotes requiring emergency management by a doctor within ten minutes of presentation. The less-urgent acuity level represents viewing as well as solving the less-urgent cases within 1 hour of presentation. The acuity level of urgent cases signifies observing and mitigating the cases in 30 minutes of presentation. Finally, the last acuity level i.e. non-urgent cases denote viewing these cases within 1 hour of presentation (AHRQ, 2012). Discussion In relation to determining the critical issue of waiting times of the patients, it has been apparently observed that the different primary healthcare centers along with the government hospitals in the United Arab Emirates (UAE) adopted and executed new triage systems for the patients suffering with varied health related problems. The Ministry of Health belonging to UAE has passed a resolution especially designed for the healthcare provider organizations depicting that the healthcare organizations of this region would need to recognize pre-defined triage areas of the patients on the basis of severity of condition prior to commencing any clinical assessment. According to the Ministry, the patients suffering from high-level of illnesses must be triaged through conducting a comprehensive clinical assessment. Moreover, the Ministry also confirmed that if the patients fall under the group of high-risk level then they would be arranged for immediate hospitalization, admission to Intensive Care Unit (ICU) or home isolation without considering waiting times (Khaleej Times, 2009). It has been viewed that the opportunities of interacting with different healthcare professionals regarding treatment processes along with medical diagnoses and pathological tests are the best facets about the different hospitals that prevail in the entire region of the UAE. However, on the other hand, it has also been noted that the worst facet about the hospitals prevailing in the region of the UAE is the issue concerning waiting times. In this regard, certain hospitals belonging to the UAE have been identified to be recorded with attaining maximum level of patient satisfaction amid both outpatients as well as inpatients in terms of interacting with the different healthcare professionals but needs greater enhancement especially in the area of lessening waiting times. According to certain portion of the residents belonging to the UAE, the biggest problem of the hospitals in the entire region is that the patients had to wait around two long hours in order to consult with a doctor despite having prior appointment or not (Zaman, 2011). Thus, on the basis of the above discussion, it can be observed that a growing trend of prioritizing the patients based on their severity of health condition regardless of their triage acuity is prevailing amid the different hospitals prevailing in the UAE. With this concern, Tawam Hospital has been viewed to be engaged in healthcare industry serving considerable quantity of patients for numerous years. The mission of the hospital is to deliver quality healthcare with the motive of complying with the requirements of the total population belonging to the UAE and the adjoining Gulf Cooperation Council (GCC) nations. Along with the mission, the vision of the hospital is to treat every patient, employee and visitor with utmost dignity, equality and respect by following as well as maintaining legal guidelines of UAE laws. In this similar concern, the different guiding principles of the hospital include embracing the aspect of cultural diversity, performing different operational functions as a team and incessantly enhancing the quality of healthcare service. Moreover, the other guiding principles of the hospital are fostering professional development of the entire workforce, encouraging innovation and most significantly offering effective healthcare to the patients and the visitors (Tawam Hospital, 2013). According to Tawam’s Chief Executive Officer named Mr. Gregory F. Schaffer, the hospital has succeeded to mitigate several issues during the preceding years that it faced relating to the deliverance of secure and quality healthcare to the patients. The CEO of the hospital strongly believed that its motto concerning treating the patients alike their own family ultimately facilitated the hospital to cope up with various challenges (Tawam, 2013). However, it has been apparently observed that the hospital is currently facing certain crucial challenges. In this regard, one of the critical challenges has been noted to be the incorporation of its newly designed Hospital Information System (HIS) with the deficiency in technology supporting the professional doctors of Tawam. Another major problem of Tawam that has been viewed is raising disagreement with SEHA about the internal policies which restricts Tawam from adopting any independent decision relating to healthcare system. SEHA is regarded as the corporate name of Abu Dhabi Health Services Company that is mainly established for managing as well as developing various curative actions that are performed by different clinics and hospitals belonging to the region of Emirate of Abu Dhabi (SEHA, 2008). Apart from the aforementioned issues or challenges, Tawam has also been noted to face another problem concerning waiting times of the patients. In this similar context, it has been viewed that though Tawam possesses superior quality of healthcare professionals and medical staffs, late appointments or huge waiting times largely prevail in the hospital. It has been apparently observed that there exist certain particular reasons for which the hospital had to face the issue regarding extended waiting times of the patients. In this regard, one of the causes has been viewed to be low quantity of doctors present in Tawam. It is quite problematic for the hospital to find a replacement of a retired physician or a doctor as the new sought-after doctors do not desire to leave their original place of origin (Salem, 2012). It has been apparently observed that the different hospitals belonging to healthcare industry are incessantly preparing, designing and executing dynamic solutions in order to address the issue concerning wait times of the patients successfully. In this regard, several hospitals have been viewed to be addressing along with managing the significant concern of wait times by formulating better management as well as coordination programs with the aim to lessen waiting lists. Moreover, it has also been noted that the hospitals are emphasizing more upon utilizing the valuable resources in an effectual manner and establishing greater teamwork amid the doctors and the medical staffs like nurses (Canadian Health Coalition, 2013). Relating to this aspect, the hospitals strongly believe that they can successfully address as well as manage the critical issue of wait times by implementing the aforementioned approaches at large. Overall Approach The two hospitals named Tawam Hospital and Al Ain Hospital in the region of Abu Dhabi Emirate has been taken into concern while acquiring a better understanding of the wait times prevailing across the healthcare sector. In order to scrutinize the issue concerning wait times of the patients, the dimensions that embrace assurance, tangibles, responsiveness, reliability and empathy would be evaluated. According to Ryan (2002), reliability denotes the capability to perform promised operational functions or services precisely. The dimension of responsiveness signifies keenness towards aiding the customers with the deliverance of prompt service. The aspect of empathy represents individualized as well as caring attention that an organization offers to its customers. The aspect of assurance denotes the courteousness along with the knowledge of the personnel and their capability towards inspiring confidence as well as trust. Finally, the facet of tangibles signifies the appearance, utensils and physical competences of workforce. A quantitative approach in terms of conducting interviews has also been taken into concern for obtaining better knowledge regarding the significant concern of wait times prevailing in the healthcare sector. The interview has been mainly administered to senior managers of both Tawam and Al Ain Hospital from which it has been apparently observed that the results concerning waiting times are quite similar within these two hospitals. Analysis After conducting interviews, the following aspects have been observed based upon the dissimilar constituents of quality service that needs to be emphasized while providing quality healthcare services to the patients. The results can be better explained with the help of the following table. Dimensions Tawam Hospital Al Ain Hospital Interview Feedback Reliability Accurate patient triage Accurate patient triage Dissatisfaction relating to the aspect of waiting times in the acuity level of non-urgent cases Precise acuity level of 4 & 5 (waiting time) Skewed acuity level of 4 & 5 (waiting time) Responsiveness Responds slow when there lies extensive wait times Responds slow when wait times are uncontrollable Quite significant that the hospital staffs keenly assist the patients by delivering timely treatment Assurance Smaller proportion of ideal communication strategies has been identified Diminished communication owing to the reason of ownership problem Quite important to establish communication in a timely way Empathy Clinical staffs are busy at triage desk Accommodation of front desk Patients highly expect empathy especially from the healthcare professionals Important to the hospital Important to the hospital Tangible Lengthy wait times Stretched wait times Patients observed to be much anxious when they arrive to the emergency departments and desire to see a doctor Well-organized triage times Triage times are set by SEHA Important to the hospital Important to the hospital From the above table, it can be explicitly identified that both the hospitals need to enhance the decisive approach of wait times of the patients by a considerable level with the motive of attaining their predetermined business targets i.e. delivering effective healthcare to the patients and attaining superior level of patient satisfaction. It can be stated that the patients mainly suffer from the issue concerning wait times due to certain important factors. These factors embrace inadequately organized services like shortage of coordination amid the parties involved in delivering healthcare services to the patients, deficiency in the quantity of healthcare personnel and ineffective teamwork of the physicians or the doctors. Moreover, the other factors comprise cuts in different hospital related services and inefficient functioning of the different healthcare workers among others (Posti, 2009). Thus, the improvement in the aforementioned aspects would certainly assist the hospitals like Tawam to attain as well as to raise the level of customer satisfaction by a greater level. Cause-and-Effect Diagram The causes of waiting time have been identified to be many especially in healthcare sector. They can be segregated as different aspects that comprise environment, methods, people and equipment. In relation to environment, the causes of waiting time might include inadequate rooms of medical treatment and minute inner-city premises. With regard to methods, the reasons may comprise poor scheduling, ineffectual procedure of automation and consumption of much amount of time for operational processing. Relating to equipment, the causes may encompass unavailability of medical instruments and poor maintenance. In relation to people, the causes of waiting time generally embrace inaccurate referrals, missing of original appointments and overlapping of patients queue. One of the crucial effects of wait times concerning the aforementioned causes is that it broadly affects the hospitals in terms of attaining along with raising greater level of customer satisfaction (NHS, 2008). A cause-and-effect figure concerning wait times has been provided hereunder for a better comprehension. Source: (NHS, 2008) A Brief Overview of the Challenges In order to determine the challenges of different healthcare organizations associated with wait times of the patients, it has been apparently observed that deliverance of quality healthcare services to the patients matters a lot for them. This is owing to the reason that if the quality of healthcare services is not met in accordance with the preferences or the requirements of the patients then the various healthcare organizations are entitled towards facing certain critical issues that encompass patients’ safety, retention, value and most vitally business reputation. Similarly, relating to the issue of wait times of the patients, the healthcare organizations can also be entitled to face critical challenges in terms of acquiring greater level of customer satisfaction, retaining the customers i.e. patients and enhancing along with raising business reputation. In this similar concern, it can broadly be affirmed that one of the critical challenges which can be faced by the healthcare organizations relating to the significant concern of wait times is patient satisfaction. This particular challenge concerning patient satisfaction has rapidly emerged as a vital parameter particularly in the evaluation of healthcare quality. Relating to this aspect, the facet of waiting time can be regarded as a crucial determinant of patient satisfaction by a greater level. It can be stated in this similar circumstance that if the different healthcare organizations are able to enhance the perception of the patients regarding their time spend on waiting then it is predicted that the patients would become less aggravated and might experience comparatively greater satisfaction with the services that are offered by the healthcare organizations to them at large (Yeddula, 2012). Thus, on the basis of the above discussion, it is evident that the aspect of patient satisfaction is one of the vital challenges faced by the healthcare organizations linked with the issue of wait times of the patients. Recommendations Waiting times for a patient to be seen by a physician particularly in the emergency departments can prove to be disadvantageous for various hospitals like Tawam as the issue can make them to face certain crucial problems or challenges by a greater level. In this respect, the problems or the challenges might embrace decreased level of patients’ safety, value as well as retention and most significantly diminishing business in terms of attaining lesser customer satisfaction level. In order to address and mitigate this critical issue concerning wait times of the patients, Tawam needs to adopt and implement effective measures. In this regard, the hospital should develop a standardized triage model in order to lessen the wait times of the patients by a greater level. Moreover, the hospital needs to standardize its various operational functions through employing pioneering technological advancements that would eventually support to minimize the overlapping of patients’ queue. Most importantly, Tawam should encourage its entire healthcare workers to perform their respective operational functions with different departments prevailing in the hospital in order to manage wait times of the patients at large (New Foundland Labrador, 2012). Thus, it can be projected that the aforementioned practices would certainly assist the hospital towards diminishing wait times of the patients by a significant level. Conclusion The deliverance of quality healthcare services to the patients has been viewed to be one of the prime intentions of the healthcare organizations. It has been apparently observed that the various healthcare organizations face certain crucial issues while delivering their respective services to the customers i.e. the patients. In this similar context, an UAE based hospital named Tawam has been noted to face one of the critical issues of longer wait times of the patients. This is due to the reason that the hospital possesses low quantity of doctors as it is not able to promptly find a replacement for a retired physician or a doctor. The critical issue of wait times linked with the patients imposes unfavorable impact upon different hospitals in terms of patients’ retention, value and most vitally satisfaction. It has been viewed in this similar background that most of the healthcare organization endeavor to manage this issue by designing effective better management as well as coordination programs and building along with developing a better teamwork amid the healthcare professionals such as doctors and medical staffs like nurses. In order to address and also mitigate the issue concerning wait times of the patients, Tawam needs to develop a standardized triage model which would eventually support the hospital towards lessening wait times of the patients at large. References AHRQ, 2012. Emergency Severity Index (ESI): A Triage Tool for Emergency Department Care. Systems. [Online] Available at: http://www.ahrq.gov/professionals/systems/hospital/esi/esihandbk.pdf [Accessed April 01, 2013]. Abdullah, M. H., 2005. Literature Research. Portal. [Online] Available at: http://www.statistics.gov.my/portal/download_journals/files/2005/Volume1/Contents_Article_Hanaffi.pdf [Accessed April 01, 2013]. Canadian Health Coalition, 2013. Wait Times. Issues. [Online] Available at: http://healthcoalition.ca/main/issues/wait-times/ [Accessed April 02, 2013]. Hing, E. & Bhuiya, F., 2012. Key Findings. Wait Time for Treatment in Hospital Emergency Departments: 2009. [Online] Available at: http://www.cdc.gov/nchs/data/databriefs/db102.pdf [Accessed April 01, 2013]. Khaleej Times, 2009. Government Hospitals Introduce Triage System. Nation. [Online] Available at: http://www.khaleejtimes.com/darticlen.asp?xfile=data/theuae/2009/September/theuae_September449.xml§ion=theuae [Accessed April 01, 2013]. NSW Government, No Date. What is Waiting Time? Hospitals. [Online] Available at: http://www0.health.nsw.gov.au/hospitals/waitingtimes/why.asp [Accessed April 01, 2013]. NHS, 2008. Cause and Effect (Fishbone). Quality and Service Improvement Tools. [Online] Available at: http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/cause_and_effect.html [Accessed April 02, 2013]. New Foundland Labrador, 2012. Introduction. Health. [Online] Available at: http://www.health.gov.nl.ca/health/wait_times/emergency_department_strategy.pdf [Accessed April 02, 2013]. Posti, B., 2009. Wait Times: Causes and Cures. Fact Sheets. [Online] Available at: http://medicare.ca/main/the-facts/wait-times-causes-and-cures [Accessed April 02, 2013]. Rambaran, 2009. Triage System to Become More Efficient At GPHC. News. [Online] Available at: http://www.kaieteurnewsonline.com/2009/11/09/triage-system-to-become-more-efficient-at-gphc/ [Accessed April 01, 2013]. Ryan, C., 2002. The Tourist Experience. Cengage Learning EMEA. SEHA, 2008. SEHA Formation. Pages. [Online] Available at: http://www.seha.ae/seha/en/Pages/SehaFormation.aspx [Accessed April 01, 2013]. Salem, O., 2012. Hospitals 'Must Cut Patient Waiting Times'. Health. [Online] Available at: http://www.thenational.ae/news/uae-news/health/hospitals-must-cut-patient-waiting-times [Accessed April 02, 2013]. Tawam Hospital, 2013. About Us. Home. [Online] Available at: http://www.tawamhospital.ae/english/Menu/Index.aspx [Accessed April 02, 2013]. University of Twente, 2013. Hospital Waiting Times Can Be Reduced. Health. [Online] Available at: http://www.utwente.nl/onderzoek/themas/health/en/proces-en-logistiek/proces_en_logistiek/wachttijden-korter.docx/ [Accessed April 01, 2013]. Yeddula, V. R., 2012. Healthcare Quality: Waiting Room Issues. Industrial and Management Systems Engineering. [Online] Available at: http://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1032&context=imsediss [Accessed April 02, 2013]. Zaman, S., 2011. Health Body Seeks To Reduce Waiting Time At Hospitals. News. [Online] Available at: http://gulfnews.com/news/gulf/uae/health/health-body-seeks-to-reduce-waiting-time-at-hospitals-1.823318 [Accessed April 01, 2013]. Read More