The Mayfield Hospital is a privately run hospital in Guildford, Surrey operating within the Carlton Health Group which owns and operates some 60 private hospitals in the UK. The Group’s aim is to offer ‘quality’ healthcare services to all their patients and clients who pay into their Health Insurance Plan. It is desirable to satisfy hospitals’ staff, too.
The Mayfield is a purpose-built facility opened in 1989. It has 100 private patient rooms, all with en-suite bathroom facilities, operating rooms and consultation facilities. The hospital generally offers day care services including minor operations predominantly to people in the 45-60 age group. Few patients extending the stay overnight. The medical care is managed by the professional medical team, however the ‘hotel’ services which includes three in-house departments: catering, portering and cleaning services. The Operations and Supply Chain Manager of the hospital is Jerry Davis, who has been in the post for two years.
Over the last year the Mayfield Hospital has been experiencing some difficult operational problems and challenges. The hospital has been undergoing a planned renovation of all the hospital’s facilities on a rolling programme of building works which has meant that at any one time 10 of the rooms are closed for re-fitting. The high cost of the re-fit along with the loss of income due to rooms being out of action has resulted in Jerry Davis being put under pressure to reduce operating costs whilst at the same time improving the quality of the hospital’s ‘hotel’ services.
During this time, the Carlton Group has instituting some new quality improvement initiatives as part of the strategy to raise the overall standard of care for patients. This has meant that the Group has instituted benchmark standards for all their hospitals as part of their new Total Quality Management (TQM) initiative. The key benchmark criteria include: Patient Satisfaction; Respect; Quality of medical care; Quality of staff. Hospitals need to apply at least three TQM tools. Each hospital is graded every two months on various Key Performance Indicators (KPI’s) and the benchmark standards are now linked to pay bonuses for management and full-time staff.
Added to this, Jerry Davis has lost a number of key supervisory staff who have either retired or left the company to work abroad. This has resulted in crisis in terms of poor staff attendance, an increase in patient complaints especially in relation to the quality of the food, cleanliness of the rooms, and late response of nurses when patients call them. The quality of patient food has been of particular concern. Many patients said that were not given the choices they had made on their menu selections, the food was usually cold when delivered, and the taste and quality of food are not satisfactory. When Jerry Davis investigated this further, it appeared that the kitchen staff had been preparing the meals too early, and even though they had left the kitchen at the right temperature, they had been left unattended by the portering staff in the corridors prior to service. The kitchen staff are not happy with the quality of the raw material used to prepare food. The raw material is also delivered weekly which is a long time between orders especially for fruit and vegetables. It leads to not having fresh raw material that means low quality of food.
The cleaning staff are responsible for cleaning each of the 100 rooms on a daily basis. The rooms take around half an hour to be completely cleaned. There have been several examples of rooms being dirty increasing the risk of cross-infection, and there have been complaints by both medical staff and patients. The cleaning staff claim that they are not given enough time to clean each room before the next patient takes the room. There is a ‘blame culture’ which is evident throughout the hospital.
Patients have made some complaints due to late response from nurses when are called and needed. But nurses are not happy with the nurses’ station, because it is located far from patients’ rooms. On the other hand, they believe the number of nurses is not sufficient to response to patients at each working shift especially at night shifts.
The hospital is consistently graded in the bottom 10% for the group as a whole in terms of overall guest patient satisfaction. The level of part-time staff turnover has gone up to 50%, again increasing recruitment and training costs.
Jerry Davis is planning a strategy to turn-round the hospital’s performance in some key areas like “Staff incentive schemes”, “Implementation of TQM model”, and “Managing operational processes”. This could include any changes in Operations and Supply Chain Management decisions like layout, supplier selection, and inventory management in Mayfield hospital.
Choose at least one of the following areas in Managing Operations.
Analyse Mayfield hospital in the selected area. Based on your analysis, you are expected to investigate in the hospital critically and make recommendations about how Jerry can improve its performance. You should show how performance will be improved in terms of performance indicators which are applicable in your selected area. Consider triple bottom line - described as the incorporation of economic, environmental and social factors as the three dimensions of sustainability in business practice - in your analysis.
Quality management is a part of operation management, which gives assurance that the service or the product of a business is consistent. In the context of the healthcare industry, the quality management is essential to maximize the service user experience (Mohammad Mosadeghrad 2014). The success of a business depends on the quality of the service or the product. In the healthcare sectors, the quality management is crucial, as by offering high-quality service at the affordable rate the care organizations are able to establish a sustainable business. However, the healthcare organization can achieve the quality of their service by educating the staffs, implementing the quality improvement program and proper monitoring process (Gilmartin and Sousa 2016). This study deals with the quality management process in the Mayfield hospital. However, this organization has been facing several issues in their organization regarding the quality of the service. Hence, the role of the performance indicator and possible solution to improve the quality in this organization will be addressed in this section.
Mayfield is a private hospital, established in Guildford. This organization is categorized under the Carlton Health Group. However, there 60 hospitals present in the Carlton health group in UK. The aim of this group is to provide quality care service to the patients as well as the clients those pay for their health insurance plan. Mayfield hospital includes 100 rooms for patients with proper bathroom facilities. This organization also offers minor operation facilities to the patients along with overnight staying facilities. This is a hospital cum hotel service with proper facilities for the patients who come for the treatment. However, it is important for the care organization to manage the quality of the service by enhancing their operation process (Mosadeghrad and Ferlie 2016). In the context of Mayfield Hospital the operation and supply chain manager Jerry Davis has noticed that there are some operational challenges in this organization which highlights that both patients and the staffs are dissatisfied with the service. This hospital has established a plan for renovation to enhance the hospital facilities, which includes the re-fitting of the rooms. Such re-fitting is costly and the Jerry Davis has faced pressure to reduce the operation cost besides increasing the quality of the service.
Carlton Group has initiated several quality improvement initiatives to enhance the care standards of the patients. TQM tools and benchmarking are applied in this quality improvement process. In Mayfield Hospital Jerry Davis has lost many numbers of supervisory staffs as many people retired and many left the organization to work abroad. In the recent years, the Mayfield Hospital has been suffering quality issues regarding the poor staff attendance. In the care organization, proper staff attendance is crucial, as it is associated with the quality of service (Fifolt et al. 2017). On the other hand, patients have complained due to the poor quality of food. The quality of food is the major quality concern of this organization. According to the patients, they do not get a scope to choose their menu and the food is extremely cold when it is delivered. This incident ensures that the patients of this organization are not satisfied with the service that affects the image of the organization. On the other hand, the staffs said that quality of raw materials is not good as it is delivered weekly. As a result, when customer orders for fruits and vegetable the staffs are failed to serve fresh food. As per the given scenario, the staffs do not provide concern to the food preparation, which creates quality issues in this organization.
Cleaning issue is very common in the care organization, which affects the quality of the service. However, it is important for the care organization to maintain the hygiene in their care provision (Wager et al. 2017). In the context of Mayfield Hospital, the staffs have to clean 100 rooms on regular basis. Due to the poor maintenance of the rooms, the cross-infection occurs, which is the main complaint of the patients as well as the staffs. According to the cleaning staffs, they do not get enough time to clean the room as next patient comes to the room after just leaving it to another patient. In this organization, a continuous mistake by the staffs has created a blame culture, which is the main reason for patients' dissatisfaction. However, the nurses are not able to respond to the patient's call as their station is far from the patient's residence. On the other hand, there are insufficient staffs in the night shift this is a big quality issue in this hospital. However, for a care organization, it is crucial to maximize the availability of the staffs to build a quality service (Raja Sreedharan et al. 2017). However, less number of staffs and poor accountability of the staffs affects the image of Mayfield Hospital and decreases the customer loyalty.
According to the given scenario, Mayfield Hospital has been suffering from the quality issues in terms of food, cleaning, and availability of the staffs. However, in a care organization quality of the service is the prime area as it is associated with the health of the patients (Garayoa). It has been received that the patients are not satisfied with the service in this hospital and the staffs have shown their issues that resist them to fulfill their responsibility. One of the major issues is the food issue in this organization. Jerry Davis has to reduce the operation cost besides maintaining the quality. Conduction of the survey will be helpful for Jerry Davis to identify the patients variable that is the main reason for the dissatisfaction. On the other hand, implementation of the cost-effective changes in the food service section will be beneficial for this organization to reduce the operation cost and to improve the food quality. However, it has been found that the patients claimed about not to get food menu of their choice. As argued by Aung and Chang (2014), improving the care service of the patients should be the highest priority of healthcare otherwise it is difficult to meet the organizational objectives. Hence, the establishment of the customer-oriented food service will be effective for Jerry Davis to meet food service expectation of the patients. Patient satisfaction can be achieved through their stomach. For this reason, maximum hospital gives their concern in improving the food service (Dailymail.co.uk 2017). Hence, improvement in that area will allow Mayfield to get a significant outcome in patient’s satisfaction score and marketing.
Cleaning is another big concern of Mayfield Hospital as there is a fear of cross-infection. As criticized by Hopman et al. (2016), traditional and manual cleaning are often suboptimal in the hospital sector. As stated by Han et al. (2015), implementation of the modern technology is an effective approach to improve the cleaning process on the care organization. As for example, use of “no-touch” technology will be helpful to reduce the bacterial contamination in the healthcare sector. This includes mobile devices and vaporized hydrogen peroxide, which act as disinfectants (Ncbi.nlm.nih.gov 2017). Such “non-touch” technology will be effective for Jerry Davis to improve the cleaning quality within the hospital. On the other hand, it has been received from the given scenario, the staffs get limited time to clean the rooms. Hence, use of modern technology will be time effective than the manual cleaning process.
Staff availability is the big concern of Mayfield Hospital. However, less availability of the nurses during the night shift hampers the care quality in this organization. One of the major reasons for this challenge is the less number of staffs. On the other hand, the nurses stay far from the patient's center. In order to minimize such issue, mobile intensive care will be helpful as it enables the staffs to provide quick response during the emergency of the patients. This also allows the staffs to assess the critical situation of the patients and provide necessary treatment to stabilize their condition. As for example, in the Arnold Palmer Hospital, the staffs use mobile intensive care to tackle the emergency. This process allows the staffs to provide 24/7 hours’ service (Jobsatorlandohealth.com 2017). Hence, application of mobile intensive care will be helpful for Mayfield to improve the staff availability. This advanced technology will reduce the problem of the nurse, which is taken place due to the distance between the nurse and patient center.
KPI or key performance indicator is an effective tool that is used to measure the performance. Cost reduction, process cycle time improvement, revenue improvement and increased customer satisfaction are the basic types of KPI (Parmenter 2015). In the context of Mayfield Hospital KPI will be used to measure the customer satisfaction in this organization, as the quality issue is the major concern in this sector. KPI allows the healthcare organization to centralize their business dashboard. However, split of data in a different system often creates difficulties. Hence, business dashboard helps the care organization to monitor the KPI matrix, track the revenue and performance data. Such dashboard provides necessary information to the medical staffs to enhance the quality care. Patient satisfaction is one of the vital metrics of KPI (Morse et al. 2017). Hence, by following the key performance indicator the rate of patient’s stay, quality of meal and service data can be achieved in the context of Mayfield Hospital. However, if the data show low patient satisfaction then it has been identified that changes are required in this section. Such KPI metric will be helpful for this organization to make a comprehensive business dashboard.
Benchmarking is another indicator that makes a comparison between the qualities of the services within two or many organizations. This highlights the competition among the several organizations and development of the best practices (Bourque 2013). Application of benchmarking will be helpful for Mayfield Hospital to carry out a comparative analysis of the services that are provided by other care organizations. As for example, Arnold Hospitals provide special care to the child. They have child surgery facility. They provide continuous effort to the childcare and quality improvement process. On the other hand, Mayfield only offers minor surgery to the 45 to 60 age group of people. Hence, there is no specialty in childcare. On the other hand, the staffs of Arnold Hospital are able to provide 24 hours service via mobile intensive care. Hence, by using the benchmarking indicator Mayfield Hospital can improve their performance as well as the service quality by analyzing the service of Arnold Hospital.
Triple bottom line or TBL refers to an accounting framework includes social, economic and financial factors (Savitz 2013). In a healthcare, sector TBL aims to provide better patient care, reduce the cost and improve the population health. These three areas are crucial to follow in order to develop sustainable business in the healthcare industry. In the context of Mayfield Hospital improvement of the service quality is the current need as the patients are not satisfied with the service. On the other hand, such hospital needs to enhance the health of the entire population in the community. Therefore, reduction of the operation cost is necessary for this organization, as their operating cost is too high.
Hence, for a healthcare organization, it is important to worry about the TBL in order to maintain sustainability in the business (Henriques and Richardson 2013). For the Mayfield Hospital, they need to improve the patient care by making sure that the staffs are responsible and the chemicals and equipment are completely safe. This will fulfill the social need in the context of this organization. On the other hand, to improve the health of the population such organization needs to minimize their impact on the environment as sick environment makes the individual sick. Apart from this to deliver a quality care such organization needs to reduce the cost by taking the short and long-term goal. This will help them to save the operation cost besides developing quality care.
The entire piece of work highlights the quality issues in the context of Mayfield Hospital. However, poor quality of food, the cleaning process and less availability of the staffs are the major issues of such organization. It has been found that, use of modern technology such mobile intensive care will be helpful for such organization to enhance the quality service. On the other hand, application of KPI and benchmarking will be helpful for this organization to measure their quality standards.
Aung, M.M. and Chang, Y.S., 2014. Traceability in a food supply chain: Safety and quality perspectives. Food control, 39, pp.172-184.
Bourque, C., 2013. Implementing an Integrated Performance Management System: The Early Experience of The Ottawa Hospital. University of Ottawa (Canada).
Dailymail.co.uk. 2017. New rules to improve hospital food. [online] Available at: https://www.dailymail.co.uk/wires/pa/article-2737405/New-rules-improve-hospital-food.html [Accessed 14 Dec. 2017].
Fifolt, M., Preskitt, J., Rucks, A., Corvey, K. and Benton, E.C., 2017. Promoting Continuous Quality Improvement in the Alabama Child Health Improvement Alliance Through Q-Sort Methodology and Learning Collaboratives. Quality Management in Healthcare, 26(1), pp.33-39.
Garayoa, R., Abundancia, C., Díez-Leturia, M. and Vitas, A.I., 2017. Essential tools for food safety surveillance in catering services: On-site inspections and control of high risk cross-contamination surfaces. Food Control, 75, pp.48-54.
Gilmartin, H.M. and Sousa, K.H., 2016. Testing the Quality Health Outcomes Model Applied to Infection Prevention in Hospitals. Quality Management in Healthcare, 25(3), pp.149-161.
Han, J.H., Sullivan, N., Leas, B.F., Pegues, D.A., Kaczmarek, J.L. and Umscheid, C.A., 2015. Cleaning Hospital Room Surfaces to Prevent Health Care–Associated InfectionsA Technical BriefEnvironmental Cleaning and HAIs. Annals of internal medicine, 163(8), pp.598-607.
Henriques, A. and Richardson, J. eds., 2013. The triple bottom line: Does it all add up. Routledge.
Hopman, J., Hakizimana, B., Meintjes, W.A.J., Nillessen, M., de Both, E., Voss, A. and Mehtar, S., 2016. Manual cleaning of hospital mattresses: an observational study comparing high-and low-resource settings. Journal of Hospital Infection, 92(1), pp.14-18.
Jobsatorlandohealth.com. 2017. RN STAFF (24/7) OF MOBILE INTENSIVE CARE AT ARNOLD PALMER HOSPITAL. [online] Available at: https://www.jobsatorlandohealth.com/job/orlando/rn-staff-24-7-of-mobile-intensive-care-at-arnold-palmer-hospital/861/6226972 [Accessed 14 Dec. 2017].
Mohammad Mosadeghrad, A., 2014. Essentials of total quality management: a meta-analysis. International journal of health care quality assurance, 27(6), pp.544-558.
Morse, L., Trompet, M., Barron, A. and Graham, D.J., 2017. Development of a Key Performance Indicator System to Benchmark Relative Paratransit Performance. Transportation Research Record: Journal of the Transportation Research Board, (2650), pp.1-8.
Mosadeghrad, A.M. and Ferlie, E., 2016. Total quality management in healthcare. Management innovations for healthcare organizations: adopt, abandon or adapt, pp.378-96.
Ncbi.nlm.nih.gov. 2017. Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827199/ [Accessed 14 Dec. 2017].
Parmenter, D., 2015. Key performance indicators: developing, implementing, and using winning KPIs. John Wiley & Sons.
Raja Sreedharan, V., Raju, R. and Srivatsa Srinivas, S., 2017. A review of the quality evolution in various organisations. Total Quality Management & Business Excellence, 28(3-4), pp.351-365.
Savitz, A., 2013. The triple bottom line: how today's best-run companies are achieving economic, social and environmental success-and how you can too. John Wiley & Sons.
Wager, K.A., Lee, F.W. and Glaser, J.P., 2017. Health care information systems: a practical approach for health care management. John Wiley & Sons.