Performance Improvement

Performance Improvement Project

Universally, the health care system has many problems associated with a break-down of communication. This is obvious within my organization, particularly between rival departments. The outcome of these communication breakdowns is decreased performance. Therefore, a requirement for change management with a performance improvement strategy is over due.

DESCRIBE, IN DETAIL, THE PERFORMANCE IMPROVEMENT PROJECT, WHY YOU HAVE CHOSEN IT, AND HOW IT ALIGNS WITH YOUR ORGANIZATION'S MISSION AND GOALS

The performance improvement project I chose relates to health care providers and the support staff at Naval Hospital Yokosuka, Japan and out-lying health centers. The primary focus will be in the avenue of patient tracking, and the improvement of effective communication among the many medical departments. As related to the submission of specialty care consults, which constitutes much of the frustration from both internal and external customers. I chose this project because it is a systems problem, with a systems solution. (1)

There has been an increasily high number of communication breakdowns and delays involving paitnet specialty care refferals. The perception from the staff of the many departments is, that providers and staff of the other departments are not properly completing the required specialty care paperwork. Therefore, re-work is required resulting with increased patient wait time for appointments. And increased man-hours lost in other departments completing the unfinished paperwork.

In any health care organization communication issues can become very complex,very rapidly. Therfore, the problems associated with communication should be addressed quickly and efficiently. Education and training becoming the key ingrediants for the performance improvement solution here at Yokosuka.

The utilization of a vigorous "First Line Health Care Communication" training program will provide employees at all levels. The tools and methods to better understand the shortfalls and complexity of poor communication habits.

The first step is the institution of this training process begins with workshops. The first workshop being for course facilitators and instructors, this will be a small diverse rank structured, group of personnel. This groups training will consist of one week, and include education on course facilitation, with a review of basic instruction techniques.

Following the instructor trainer course as stated above. The core staff will begin attending workshops, taught by said instructors/facilitators. The course curriculum will include such topics as effective communication, patient tracking techniques, leadership continuum, understanding internal/external customers, patient satisfaction, reportable disease matrix, systems thinking verse linear thinking approach. The last session will include a presentation by the executive officer, which will focus on a reiteration of the commands mission while pointing out its correlation with a systems approach.

I believe much of the solution can be found by creating ownership in the process, which in turn should create improvement and efficiency through accountability. Also, a systems apporach will provide enlightment to each employee. As they realizes the impact one over-sight can have on another department.

RATE YOUR ORGANIZATION'S PRESENT PERFORMANCE IN THIS AREA.

I cannot give an accurate rating of the entire organization as I only have the data from my directorate. Frankly, we are doing well, it is the interaction with other departments outside of our directorate that brings this problem to light. I would say in a word the hospital has failed to be efficient in this process and presently lacks the motivation to fix it, or roughly a seven out of ten. The staff, to include the majority of senior management is comfortable allowing a patient to wait two-three weeks for a routine specialty care appointment. When this process could be improved considerably with a few communication improvement processes and a centralized specialty referral tracking metrics.

I have reason to believe this issue may come to the forefront. As our hospital is preparing for a new commanding officer and ten days prior to his arrival an inspection team will be on-sight. The Navy Inspector General and the civilian Joint Committee on Accreditation of Healthcare Organizations (JCAHO) will arrive. With that said, the organization results of the inspection will probably be in the middle to low high area, with noted deficiencies in communication and patient standard practice measures.

EXPLAIN THE OBSTACLES TO IMPROVING PERFORMANCE IN THIS AREA THAT CURRENTLY EXIST THROUGHOUT YOUR ORGANIZATION.

Peter M. Senge provides a wonderful example of leadership and change management, "if the captain says to change course, but no rudder has been designed into the ship, then there can be no change. If an order is given to turn left, but the ship is designed to turn right only, then no amount of effort to change direction will matter". Therefore, regardless of the efforts of a few to implement change, nothing will occur, as this organization is designed to resist change.

The biggest obstacle facing this performance improvement process is "change and the resistance to change", particularly, senior management. As they seem to be comfortable with the current practices and procedures of the current facility.

The second obstacle with our organization's implementation of a plan for performance improvement is with leadership and planning. With the majority of our providers being senior officers, which are set in the military hierarchy of leadership and rank structure. They often exude an un-wiliness to listen to information provided by those of less rank or position.

This is especially important when it involves adding improvement activities into a systematic, organization wide approach. Leaders are supposed to ensure that necessary processes and structures are in place to carry out performance improvement activities. While all services and disciplines collaborate to implement the change.

Having all the departments begin to trust and communicate with each other will be a challenge, a challenge that could be overcome with the support of leadership. With the key to the success at this facility being a leadership re-design.

IDENTIFY THE BENEFITS TO YOUR ORGANIZATION THAT WOULD RESULT FROM THIS PERFORMANCE IMPROVEMENT PROJECT.

All efforts for improvement are based on the concept and goal of eliminating errors in a process. Typically, driven by cost and measured