Introduction In 2010, the UK National Health Service (NHS) published the March 2009 Francis report on the failures of the Mid-Staffordshire NHS Foundation Trust as stated by Francis (2010a). This report was released by an inquiry chaired by Robert Francis which focused on the standards of care at the Trust…
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These recommendations were fully accepted by the Trust Board and the Department of Health. There were shortcomings in different aspects in the Trust that are explained below. Failures in Operations management The hospitals lacked well established protocols and pathways for the management of patients admitted in A&E (Accident and emergency) as expressed by (Francis 2010a). This department was understaffed and lacked proper equipment such as defibrillators for resuscitation trolleys. This left very few nurses to conduct urgent assessment of patients and receptionists who had no medical training were forced to take up this job. Nurses in the A&E did not have enough training and the hospital had weak leadership. The number of consultants to provide daily on call cover was insufficient and there were only few middle level doctors. The middle level doctors and junior medical practitioners were not adequately supervised. They were frequently under pressure to make prompt decisions in order to meet the set target of attending all patients in four hours and go through the A&E. This had resulted to a situation whereby patients are taken to the EAU (Emergency Assessment Unit) without necessary diagnosis and assessment. The situation of the EAU was not any different from that of the A&E. The EAU was outsized and had a poor layout and this made it difficult for nurses to tend to patients. This was aggravated by poor communication between patients and the medical staff as well as inadequate staff (Francis 2010b). The situation in this department can be simply described as hectic and chaotic. There was poor compliance with the accepted standards of practice in infection control. There was poor handover from the A&E to the EAU. This notwithstanding the care for patients from heart related conditions was reported to be excellent. The management had failed to attend to serious issues and monitor performance in the hospital. This had led to poor treatment of patients in the emergency department. There is poor recording and documentation of the patients’ activity and outcomes and the hospital does not have any reliable historical account of their past patients. The medical team generally lacked proper training to handle different complications. Most of the doctors and nurses admitted that the staff in the EAU lacked the skills to take care of surgical patients (Francis 2010b). There were poor procedures in surgery and the surgeons did not work as a team. Measurements to be taken by the hospital and stake holders There have been improvements on various areas in the trust after the shocking revelation by the investigation (Care Quality Commission 2009). The hospital has hired a greater number of qualified staff to improve the quality of care in the hospital. Training programmes have been set up for different staff to ensure their competence in handling equipment such as monitors and equip them with skills to handle patients. The trust deserves recognition for the measures it has undertaken to improve the quality of care in the hospital. There has been increased funding to the trust to hire more staff, purchase equipment and the necessary medication. The regulatory bodies have increased the number of inspections in the hospital to ensure strict adherence to quality standards. Stakeholder groups The DHS (Department of Health Services) works in collaboration with a wide range of stakeholders including community sector, government, voluntary sector, regional
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Effectiveness in business management processes demand that performance management be given the first priority so that competitive advantage may find its way (Alonso, Dadam & Rosemann, 2007). This paper will investigate into the recommendations of the review report that addressed performance management issues at the NHS trust at Mid-Staffordshire, due to the poor performance at Stafford and Cannock hospitals.
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