In the healthcare, quality care and risk management are at forefront regarding ensuring financial stability and organizational longevity. Along with the healthcare that is expected for growing frequently within 2020, potential risks towards healthcare firms can also grow. Therefore, for being prepared, while facing such risks, it is crucial for companies to identify all possible issues, which comprise of organization and quality of service user care. Furthermore, potential issues of risk management can put impact on healthcare sector in variety of paths, though greatest influences are often upon finances of employers. On other hand, general liability problems can cause raise within insurance liability premiums. Besides, quality issues does fall under the umbrella of such risk management, as they pose greatest risks towards employers of healthcare.
Question 1 what are the wastes that can identified in the hospital as described in the above mentioned article? What is the financial impact of these wastes?
| Wastes | Descriptions |
| Downtime | Defects
It includes all the time spent by doing something inappropriately by inspecting and fixing errors. For example, defect waste act as time spent by looking for item that is missing from cart of surgical case (Chong et al. 2015). Overproduction It includes doing over what is required by service user and doing this sooner than required. For instance, performance of unessential diagnostic procedures. Transportation Essentially moving service users, materials and specimens throughout system as wasteful. Such kind of waste has been evident, when hospital has poor layout, like catheter laboratory situated at long distance varying from emergency department. Waiting Waiting for next event for its occurrence and next acting of work can eat resources with time. As stated by Chong et al. (2015), service users are waiting for appointment is sign of the waste, though as employees are waiting due to their unparalleled workloads. Inventory Hospitals create more waste, which they incur with excess costs of inventory along with movement costs, spoilage, waste and storage costs. For example, letting supplies to explore and disposing those, involving outdated medications. Motion It deals with movement of employees from one room to another, one floor to another and one building to other more essentially. This accounts for some kind of waste. For instance, laboratory employees can walk miles every day because of poor layout of hospital. Over processing It describes work that are performed, but not valued from service user’s end and caused by quality definitions, which are not aligned along with needs of service users. For example, extras stamps of data are put into forms, while those data are never used (Labelle & Rouleau, 2017). Human Potential Such waste has been caused, when the employees failed to get engaged, helped and heard. In addition to this, employees can feel like burnt out as well as ceased sharing concepts for enhancement. |
| Waiting time | Waiting includes delay of process of production flow. Such delay can occur by unplanned downtime that can happen by waiting on proper materials and malfunctioning of materials, which have poor quality to finish a task. It also deals with unbalanced workload, which can bottleneck such workflow. |
| Financial waste | Every year wastes of healthcare industry has estimation of $750 billion, while employers are overwhelming to perceive this as an issue with about 60%, which is not actively handling this matter (Healthcarefinancenews.com, 2018). |
| Overproduction | Overproduction occurs, when company manufactures more goods than market demands. It is one of largest kinds of waste, which contribute to raise cost of inventory holding along with facility cost and labor cost. |
| General Waste | It involves bulk of medical waste, such as office waste and typical household. |
| Hazardous Waste | It includes discarded equipment for surgery, chemical waste and sharps. |
| Infectious Waste | As opined by Chong et al. (2015), it caused infection within humans, such as human tissue, contaminated with the blood fluids and blood. |
| Radioactive Waste | It is generated as outcome of the radioactive treatments, such as medical equipment and cancer therapies, which uses the nuclear elements. |
Table 1: Wastes in Hospital
(Source: As influenced by Chong et al. 2015)
Question 2 what was the proposed improvement project? What were the objectives and what were the intervention/ solution proposed? How would the hospital know that their interventions eliminated or reduce the problem they were facing?
As result of concerns in this case scenario, this study proposed healthcare quality enhancement project to decrease the number of cultures of anaerobic blood unindicted pediatric. As suggested by Chong et al. (2015), purpose of the study is to decrease median use of cultures of anaerobic blood unindicted pediatric by about 50% in 6 months within pediatric wards. In case, if it becomes successful, the study can result within savings in context of resources with money, though still it maintains quality of the healthcare services served.
From start of the improvement project, most obvious cause for overuse of cultures of anaerobic blood has been fact that the physicians forgot true indications regarding cultures of anaerobic blood. Thus, educating staff regarding true indications along with costs of cultures of anaerobic blood supported to handle this. In addition, persuasive interventions within form of brochures, wall mounted reminders and education in conjunction along with some restrictive measures. As influenced by O’Rourke, Wrigley & Hammond (2018), these measures get reduced for amount of cultures of anaerobic blood unindicted pediatric as successfully. Therefore, this can be observed that general change in principle has been underlying such significant enhancement initiative that associates towards changing behavior of physicians by education as well as restriction of availability of cultures of anaerobic blood. This lead to reach out towards all the healthcare professionals, who are involved by daily teaching sessions within meetings, scope teaching sessions and orientation lectures of nurses and service providers.
Figure 1: Number of blood cultures performed before and after interventions
(Source: As influenced by Chong et al. 2015)
For instance, handover sessions deals with raising their awareness upon actual indications for performing cultures of anaerobic blood in pediatric population, such as bloodstream infections. Furthermore, as explained by Bunting Jr & Siegal (2017), having certain restrictive measures with different reminders is put within place inwards, weekly quality of cultures of anaerobic blood remained low. On other hand, as amount of cultures of anaerobic blood started to fall by 85%, positive reinforcement within time held from HODs and head of service for infectious diseases has supported to handle such ongoing enhancement.
Various interferences are put within place, which are piloted in one pediatric ward regarding 1 week. It involved limited amount of cultures of anaerobic blood replenished bottles that are available in every ward by putting up reminders for wall mounted with indication forms and replenished bottle tags. It also included brochures and educational lectures that are served for the staff members. Henceforth, as observed by Chong et al. (2015), after successful pilot operation, these interferences get rolled out towards rest of the general and pediatric wards.
References
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Bunting Jr, R. F., & Siegal, D. (2017). Developing risk management dashboards using risk and quality measures: A visual best practices approach. Journal of Healthcare Risk Management, 37(2), 8-28. Retrieved on 26th December 2019. Retrieved from: https://onlinelibrary.wiley.com/doi/abs/10.1002/jhrm.21287