Shift from Service-Oriented to Outcome Oriented Healthcare - Coursework Example

Shift from Service-Oriented to Outcome Oriented Healthcare College: Shift from Service-Oriented to Outcome Oriented Healthcare Literature Review The performance of a healthcare system is an important aspect not only to the organization but also to the beneficiaries of healthcare service provision. However, there is evidence that health organizations have a long way to go in injecting efficiency within their organizations as health problems continue to increase despite increase in healthcare resource allocation. While the US government continues to push and support healthcare providers to increase operation efficiency, there is evidence that healthcare services are deteriorating and the serious healthcare issues are knocking at the door. The managements within health facilities are entangled in a battle as they evaluate the best possible approach to improve the quality and quantity of healthcare within the organizations. However, it is clear that a wide range of organizations have focused primary on increasing their service delivery while ignoring the outcomes that such strategies achieve. In view of this problem, a number of scholars have pointed out that measuring services is an inefficient way of assessing healthcare achievements. Essentially, there is need to move towards outcome-oriented healthcare systems to ensure that organizations can be credit their performance on their achievements rather than the services they offer. Healthcare indices indicate high dissatisfaction in healthcare in the US service delivery. According to 2014 healthcare statistics, the public satisfaction with healthcare stood at 66%, indicating high level of dissatisfaction with healthcare provision in the US (Gillies, 2009). Another way to look at the performance of health organizations within a country is to evaluate the citizen satisfaction. The citizens in any given country are satisfied if they have access to modest health care, they can afford it and that they receive quality services in the hospitals. Research shows that 87% of the Canadian population are satisfied with the health services they receive. In UK, 70 per cent consider the NHS systems as superior and feel that it is remains their favourite policy. In US, over 30% of the citizen population testify that the medical insurance policies are below their expectations and majority of them do not prefer their services (Boyce & Browne, 2013). From this perspective, there is evidence that the US healthcare organizations are performing way below the public expectation. In addition, there is evidence that the health outcomes within majority of the US health facilities are dissatisfying. Despite increase in the health spending by hospitals, quality service has yet to be achieved and access to health is still an issue of concern. The increase in health issues such as lifestyle related diseases shows that the health care services demand a new approach to achieve expected efficiency. Vast research shows that the major reason for failure in healthcare systems is inherent from poor management approaches and poor measures of health institutions performance. According to management theories, healthcare organizations are bound by the principles of management that govern other business organizations (Ivanyukovich et al., 2015). However, it is evident that majority of healthcare organizations have used a different approach and have isolated themselves from other business organizations. On the other hand, it is clear that the performance of a health organization can be optimized if managers perceive health organizations like any other business organizations. A wide range of research has revolved about the efficiency of healthcare organizations and the way that way that they have satisfied the health needs in the US. Evidently, the US health facilities have broadly increased their health service coverage in the past year. Majority of the organizations have focussed on the best approaches to increase performance within their organization (Jee & Or, 2012: Donabedian, 2014). A wide range of managers have paid significant attention to the range of services that they offer to their customers. The efforts of leaders have been to purchase systems and to employ staff from different fields to ensure that they can provide as many services as possible. Notably, this approach has its own strengths as it increase access to health and ensures that one single health facility can provide treat a wide range of illnesses within the public. Secondly, a service-oriented approach is concerned with the number of patients that a medical facility can handle at a time (Ivanyukovich et al., 2015). The value associated with this approach is that the quantity of service within the US market is satisfactory. Therefore, the benefits of a service-oriented approach have considerably attracted the attention of many health organization managers. However, the deterioration of quality of services implies there is need for a paradigm shift within the healthcare organizations. While the issues of access and quantity are effectively handled, the issue of quality in service provision remains a significant matter. An effective healthcare system requires that all health facilities provide effective healthcare, which can be assessed through quality service provision (Dolan, 2012). There is need to ensure that all members of public that receive service within the health facilities do so with satisfying outcomes. This ensures that that there are few cases of repeat diseases and that there is satisfying outcome for every case. An out-come oriented approach measures the performance of health organization by the outcomes and the satisfaction that can be attributed to service provision (Ivanyukovich et al., 2015). A number of researchers have suggested a service oriented approach is traditional as it ignores the outcome of service provision, while the end result is what counts in the long-term survival of an organization. The demand for quality service provider underpins the current shift in focus from services offered to the outcomes attained at the end of service delivery. Patients want hospitals that can cure them rather than those that can treat their diseases. On this ground, an outcome-oriented approach is would be essential in ensuring that organizations meet the threshold requirements of a health organization. There is adequate literature evidence and research that supports an outcome-oriented approach as the best model for ensuring optimal performance within health organizations. Pronovost, & Krumholz (2013) note that in the contemporary health care facilities, it has become crucial to improve the quality of service rather than the quantity of service. The two scholars base their argument on the evidence most health units consider their performance on the quantity of services that they offer, hence neglecting the quality of services they provide to the public. . In the U.S., the majority of the prominent applications have not met their performance improvement. One example is the test of the combined use of public reporting and pay-for-performance, called the Medicare Premier Hospital Quality Incentive Demonstration (Hayward, DeMarco & Lynch, 2013). This demonstration has little or no impact on the value of care received for important clinical condition; such as the reduction of the patient mortality or cost growth. However, the important issues of P4P are the health plans performance that relate to patients with acute health care problems. In addition, the P4P approach faces a great challenge when it comes to measuring the quality of service accurately especially for major manual patient services (Lee, 2014). The complexity of keeping accurate record poses a big challenge in the measurement of quality of service in healthcare units. If it is not possible to measure the quality of service, it becomes a big challenge to offer a proportional reward for services delivered to the customers. Cromwell et al. (2011), identifies a wide range of challenges that undermine the results of this service delivery approach. In health care units, the outcome-oriented approach involves the setting of achievable targets and working towards them. The development of these targets is an issue that has posed a challenge to many health practitioners. The question of whether the targets are too low of too high is a controversial issue. Consequently, it becomes hard to define the reward system and how to punish or reward a health facility. Cromwell et al (2011) identifies the challenge of implementing the pay algorithms that accompany the challenge of setting up standards for quality services. Therefore, it becomes a critical issue to define new approaches of health care quality measurement to be able to set clear objectives and possible reward schemes for services delivered. While there is great value for implementing an outcome-oriented approach in raising the health standards with the health care system, existence of challenges of measuring quality of service has undermined these methods (Glennerster & Lieberman, 2011). The major reason for the development of these challenges is that there exist no universal standards of care that can be applied within the health sector. Secondly, it is impossible to use the same targets for all organization and stimulate quality improvement. This is because different hospitals are capable of providing different healthcare qualities depending on their level of development. The main purpose of the service-oriented approach is to stimulate constant quality improvement by rewarding high performance and punishing low-quality provision (Sollecito & Johnson, 2013: Pilcher, Ginter & Sadowsky, 1997). Therefore, there is a need developing individual realistic targets for each hospital to ensure that organizations strive to achieve these targets during their operations. However, research shows that there exist solutions to the challenges of one possible solution to the challenges that continue to undermine the P4P approach is developing clear algorithms of measuring the quality of services within a health unit. To measure the quality of services, it is crucial to develop data collection strategies that can support in processing of the quality improvement. In the modern organization systems, the role of data has become critical in the evaluation of organizational performance at any time of the year (Gulzar, Moon, Attiq & Azam, 2014). In the big data era, the use of management information systems and computer technology is inevitable if organizations have to collect and analyse reliable information to measure their performance. Therefore, it would be crucial for organizations to adopt new technology in measuring the outcomes of service provision if they have to attain the expected qualities of service provision. Economic management theories emphasize on the need to develop patient-centric healthcare systems that aim at optimizing efficiency. One suggestion is that health organizations should perceive their operations just like how other product oriented companies do. Recently, manufacturing companies have adopted an outcome-oriented approach to measure their business performance (Berenson, Pronovost & Krunholz, 2013). Managers are holding the customer tastes at the heart of business as one way of ensuring that they survive the harsh economic times. Whenever they develop a product, they are interest to ensure that such a product satisfies the target customer in terms of the services they receive. While a service oriented approached is short-term focussed, an outcome-oriented approach is long-term and perceives customer satisfaction as the driver of business (Bettencourt & Brown, 2013: Bohmer & Lee, 2009). In exchange, such organizations have benefited from high customer loyalty while and high inflow of new customers. Evidently, customers prefer organizations that provide them with high end results that ones that temporarily solve their problems. As such, business organizations have opted to focus on ensuring that they provide goods and services which attract customers rather than serve a large group whose loyalty cannot be won in the long-term. Evidently, health organization, just like other business entities, should focus on this approach to improve service delivery and to survive in the long-term. While a wide range of literature has focussed on how to improve the quality of service within the health organizations, many researches have ignored the management aspect of organizations and the precise measurement approaches that can ensure quality (Marek, 2011). Majority of scholar suggest that acquiring high end technology devices, integrating technology and recruiting the right members of staff is a guarantee for quality enhancement. While these ingredients are essential, there is evidence that they are not assurance for optimal service outcomes within a health organization (Beenen, 2014). There exists a literature gap in identifying the possible approaches that organizations can improve service outcomes within a health organization. While researchers have suggested an outcome-oriented approach for other businesses, they have isolated healthcare systems by not perceiving them like other business organizations (Pichler, 2012). This research, if granted, seeks to identify how health organizations can streamline their performance by shifting from service-oriented to out-come oriented model of service delivery. Also, it will provide recommendation on how health organization managers can develop strategies to implement and assess their outcomes within this service model. Closing the literature gap that exists in this domain will be a milestone in optimizing health performance within health institutions. Problem Statement Bentancourt (2014) expresses that the quality of healthcare in the US is an urgent issue that requires a prompt action. According to the World Health Organization (2014) performance measurement, the US healthcare system spends the greatest portion of GDP on healthcare but ranks 37 behind countries such as Japan, Spain and Oman. While the US has a large number of hospitals, it is clear that the health outcomes are dissatisfying and there is need for shift in the organizational strategies. Research indicates that the US health providers have for long focused on services while ignoring the outcome of the healthcare systems. Generally, the deterioration of healthcare systems and the quality of services is an alarm to the efficiency of healthcare institutions (Lizarondo, Grimmer & Kumar, 2014). On this ground, the US healthcare is faced by weak management programs that focus on services rather than the end results. The purpose of the research is to analyse the impact of shifting from a service-oriented approach to an outcome-oriented approach and how this can improve quality of service within the US. Therefore, the research is a response to a real problem that is threatening the long-term performance of the US healthcare system. Research Questions This research will respond to two questions that related to the efficiency of health care service provision in the US. First, the research will answer the question on what are the impacts on shifting from service oriented to outcome-oriented approach, and secondly, on what are the best strategies that will facilitate this shift in healthcare service management. References Betancourt, J. R. (2014). In pursuit of high-value healthcare: the case for improving quality and achieving equity in a time of healthcare transformation. Frontiers Of Health Services Management, 30(3), 16-31. Beenen, G. (2014). The Effects of Goal Orientations and Supervisor Concerns on MBA Intern Learning and Performance. Academy Of Management Learning & Education, 13(1), 82-101. doi:10.5465/amle.2012.0006 Berenson, R. A., Pronovost, P. J., & Krunholz, H.M. (May 2013.) Achieving the Potential of HealthCare Performance Measure: Timely Analysis of Immediate Health Policy Issues. Robert Wood Johnson Foundation. Retrieved on November 11, 2014 from, Bettencourt, L. A., & Brown, S. W. (2013). 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