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Transcript of INTRODUCTION
problems, solutions & strategies
Problems on which we have focused:
Some problems with the management of Patel Hospital which we have identified could reduce the satisfaction level of patients.
Upon surveying number of patients and employees, the following main department wise problem were identified:
To be an institute of international repute in the field of healthcare provision, teaching, training and research.
To serve ailing humanity irrespective of cast, creed, color, religion or economic status.
To provide quality healthcare to all at affordable cost and serve the non-affording masses through Patel Welfare Programme.
Patel Institute of Nursing & Allied Health Science is affiliated with Pakistan Nursing Council for General Nursing Diploma & Sindh Medical Faculty for Technician Certification Courses in different specialties
Focus on patient needs and information’ to ensure patient’s preferences are taken into account when decisions about treatment and management are being made.
Action check lists’ to ensure appropriate and comprehensive action at decision making points
Before the appointment day call consultant for conformation
Feedback from patient on consultation.
Installation of a patient telephone hotline for appointment arrangements for all patients
Develop procedures for handling as much administrative work as possible before the patient arrives.
Evidence of problems
Delays in clinic start
Appointment timings overlap
Add on/walk-in is entertained in between appointments
Single registration counter
Complex registration form
Lack of proper communication
Delay due to entry in to EMR
Uncomfortable waiting area
Facts & Figures
Waiting time : 2.5 -3hr
Orthopedic OPD: 20 Pt in 1.5hr
ENT OPD : 20 Pt in 2.5 hr
MEDICINE OPD : 25pt in 2hr & 5 walk-In
No of Staff : 2
No of Dr: 4-5
Modern medical & surgical facilities
Affording & non-affording patients.
Block-4 of Gulshan-e-Iqbal.
Complete inpatient & outpatient care.
Accredited with PMDC & CPSP
Policy formation/implementation problems
1 Promote punctuality
2 Appointment adjustment
3 Add-on cases should be checked at
the end of the OPD
4 Simplify Registration Form
5 Provide adequate training for
6 To start work up for New visit OPD
at 8.30 am & Senior doctor
consultation at 10.00am every
7 Provide proper training for EMR
When patients make appointments online or via the phone, prompt them for necessary information such as address, phone# & symptoms.
Don't overbook appointments.
Use exam rooms to keep patients rotating from the waiting room.
Minimize tasks from physicians to speed up the process.
Physicians & clinical staff should spend as much time on patient treatment as possible.
Use software & services to make medical records management more efficient.
Ways to reduce frustration with waiting include:
Complimentary food & beverages
When possible, offer the chance to see a different physician within the practice to reduce waiting times.
Apologizing for delays.
Lab reporting error: A laboratory error is defined as any defect that occurs during the entire testing process, from ordering tests to reporting results, that in any way influences the quality of laboratory services.
2: Diagnostic errors
The Total Testing Process can be subdivided into three stages:
test request, patient & specimen identification, specimen collection, transport, accessioning & processing
reporting test results, interpretation, follow up, storage, retesting if needed.
Patient safety & quality improvement are increasingly prioritized across all areas of healthcare. Organizational factors in hospitals particularly support services, work engagement & effective symptom management, are important influences on patient satisfaction.
Effective health- care policies & strategies can add “quality of patient care” to the list of benefits of having satisfied employees, & other key benefits of increased retention, lower overall costs, repeat visits & positive word-of-mouth recommendations by patients.
Increased healthcare costs
Decreased patient satisfaction.
Any error during the laboratory testing process can affect patient care,
Delay in reporting,
Sometimes, these errors may even be fatal
Preventing errors from occurring in the first place
There are four basic strategies that work to prevent errors:
• Mistake-proofing, and
Up to 70 percent of errors associated with lab results happen way before the tests are even analyzed.
Getting a delayed diagnosis or misdiagnosis, particularly for what could be life-threatening conditions, can create significant emotional distress for patients.
Here are five strategies hospitals should implement:
Implement bar code identification system.
Provide automatic transmission of reports by computer, pager or other electronic formats.
Learn from mistakes & near misses
Establish clear format for reporting results
Set up facility-wide protocols.
In Patel Hospital, we have noticed that the basic IPD problem was:
• Doctors/nurses bad attitude towards patients and
• Un-responsive staff etc.
3: IPD problems
Evidence of problems IPD
Nursing and doctors attitude:
• Decreased patient satisfaction
• Patient will not share necessary information
• Poor understanding of information,
• Improper treatment will be the result
• Decreased customers loyalty
Increased patient satisfaction
Patient will share information that will help in treatment
It will enhance the image of organization
Increased customers loyalty
Benefits of improving attitude
Listen to your staff to confirm that the problem is in fact the employee’s attitude
Conduct bi weekly meeting to discuss all the happenings
Fix unacceptable working condition
List down if there is any disrespectful communication, excessive complaints, poor collaboration & disruptive behavior.
Discuss the problem with the employee in an informal conversation.
Discuss your expectation for future.
Focus on communication training
Lack of policies:
Quality & patient safety policy
Employee discipline policy
Orientation & training policy
4: Administration problems
According to our benchmark hospital following should be the purpose of quality & safety policy:
The intent of this policy is to:
Provide measure for a healthy & safe working environment
Prevent health & safety injuries and accidents on the job
Provide training to Faculty , staff & trainees to ensure that they understand their role in keeping a health & safe work environment
Involves employees in the management of their own occupational health & safety related problems.
Quality & patient safety
Service Excellence Standards (CARR)
• Respect and caring
The economic gains associated with occupational health and safety policy improvements include:
Increased productivity and worker morale
Reduction of working time lost due to injury and disease
Reduced equipment down-time, reduced damage to materials and machinery, and savings in the costs of recruiting and training replacement employees
Reduction in transaction costs such as insurance costs and legal fees.
Ideal discipline policy which is lacking in Patel hospital should be
The management requires all employees to maintain the highest standards of work performance and conduct, and to abide by established rules and regulations in order to contribute towards accomplishment of organizational goals.
Employees will be liable to disciplinary action for violation of organizational policies or involvement in misconduct.
An employee will be entitled to receive a fair and just hearing, and to state his/her version of the issue during disciplinary proceedings.
Employee discipline policy
Misuse of leave policies.
Improper attire - i.e. not in conformity with the Organization's dress code.
Theft, Fraud or Dishonesty
Damage of Property
Breach of Confidentiality
Disciplinary action' will consist of one or more of the following measures depending on nature of offense:
Suspension from work
Withholding the employee's increment or promotion for a specified period not exceeding one year.
With-holding annual merit increment for a specified period (to be given later with or without retroactive effect from due date)
Passing over annual merit increment for that year.
Termination of employment (with full benefits)
Dismissal for misconduct (without benefits).
There is no orientation & training policy implemented in Patel hospital.
The purpose of this policy is to set out specific procedures and performance standards to ensure quality training and development of employees.
This policy applies to all of the organization’s programs and activities.
3: Orientation & training policy
Identification & documentation of specific employee training needs.
Documentation of financial resources available & utilized for employee training & development.
Investigation & approval of specific training programs.
Identification & documentation of work-related improvements achieved from training.
Most training takes place on the job due to the simplicity and lower cost of on the job training methods.
Two popular types of on‐the job training include the following:
• Job rotation
• Monitoring program
Introduction of new equipment or processes
A change in the employee's job responsibilities
A drop in an employee's productivity or in the quality of output
An increase in safety violations or accidents
An increased number of questions
Complaints by customers or coworkers
Increases workers’ productivity
Increases workers’ job satisfaction
Keep workers’ skills and knowledge up-to-date
Helps to motivate workers
The benefits of training: