Managing performance and workflow

Improved patient safety, higher-quality care, and greater employee involvement in healthcare
Research Problems
• What are the key actions and initiatives for enhancing patient safety in a hospital setting?
• What techniques are employed to gauge and track the patient's safety?
• What criteria are there for good medical care?
• What procedures are in place to ensure employee accountability?
• What strategies can be used to inspire employees to work toward the organization's objectives?
In order to define safety challenges and create remedies, the research will talk about patient safety enhancements. Organizations that provide healthcare services should be given the specific practical measures they need to establish organizational approach that improves safety of the patient.
Good quality treatment will be discussed exemplified by professionalism, equality, patient safety and competence (Tamburini et al. 2). Employee engagement aims to discuss ways of motivating the employees to fully achieve objectives of each department in the organization.
Employee Engagement
Patient and family engagement focuses on ways of developing approaches to improve patient safety through engagements of families and patients. Patient and family engagement is a concept that has been described to be evolving and suggests that it can improve the quality and safety of care delivery.
Research has shown that if patients are fully involved in healthcare, it can lead to improvements in quality and safety (Mitchell 3). It is therefore important to develop a guide to help patients, health professionals, and families. These people in primary care settings can work in partnerships in promoting improvements in healthcare. Nurses are the people in a key position to improve the quality of healthcare through patient safety strategies and interventions. There has been a close link to patient safety and the quality of healthcare. This conceptual definition, therefore, depicts the fact that quality does not exist in the discrete entity but as an abstraction.
Initially, the quality of healthcare was defined by IOM as the extent to which health services populations and individuals increases the potential of desired health outcomes (Mitchell 6). This, in turn, has led to the definition of quality healthcare to contain listings of indicators of healthcare quality. The standards are not necessarily in terms of conceptual cluster or possibilities.
Positive indicators of quality healthcare have been made sensitive to nursing input. The inputs include the perception of the patient being cared well for, demonstrating health promotion, health-related quality of life and criterion of symptom management. Morbidity, mortality and adverse events should be considered negative outcomes of interest that are represented in the integration of multiple provider inputs.
21st-century healthcare services focus on conceptual components of quality care than the indicators measured. The conceptual components of quality care are discussed below.
Patient Centered in Approach
This is the practice of caring for the patients and even their families in a valuable and meaningful ways to the individual patient. It includes informing, listening and involving patients in the care destined for them. It can also be defined as the responsive, respectful to patient needs & values, preferences and making sure that clinical decisions are guided by patient values. Some of the principles that are covered by the patient-centered approach include Coordination and integration of care, respect for patients needs and preferences, information education, physical comfort, involvement of family and friends, emotional support and continuity and transition.
Timely
The patient’s ability to receive care in a timely manner is very important. It is the capacity of the health care system to provide quick care after the patients’ needs are recognized (Tamburini et al, 8). The measures of timelines include the time that is spent waiting for the doctor, the time spent between emergency departments and the interval between specific tests and treatments that is received.
Efficient
Dialogues on improving the quality of healthcare should focus on efficiency and how it should be measured. There are several approaches to examining quality improvement programs. The factors that should be considered include evaluating the success of program implementation, for example, through the use of employee suggestion system. The other factor that should be considered is how to detect that a health program or system is failing (Glied et al). The workers in the hospital play a key role in determining patient safety failure. The inefficiencies can be reduced by assessing the number of gains that may be achieved before deciding which type of quality improvement that may be implemented by the hospital successfully.
Effective
Effective healthcare provides evidence about the comparative effectiveness of differing interventions. The objective of this is to make health providers, consumers and other in making informed choices among the treatment alternatives that are available. Through comparative effective reviews, the health system or program may support appraisal for the existing scientific evidence about treatments of high priority conditions.
Equitable
The best ways to make sure that the hospitals deliver good care is through imposing fines on them if they deliver a bad care. Ending the disparities in healthcare access is important. It is essential to look for the necessary data to evaluate health programs and target needs. Thus, improvements in healthcare in overall rates and to be more specific, the payment system in healthcare may be associated with closing the gaps that attribute to disparities (Bentacourt 2).
Works by the Institute of Medicine have attempted to define healthcare quality in relation to standards.
Patient Safety
Patient safety means how the healthcare organizations, including hospitals, protect their patients from errors, accidents, injuries, and infections. Some hospitals are good patient safety while others are not. It has been estimated that as many as 440,000 die due to errors in the hospital that are preventable. It’s upon people to ensure that patient safety is practiced since there are hidden dangers in hospitals.
In some hospitals, patient safety has been given a big priority. Strong healthcare teams have been established to reduce the rates of infection, to prevent mistakes by putting checks and to ensure good communication between the patient, hospital staff and the families (Mitchell, 3).
Some hospitals, however, don't have teams that work in a good manner to promote patient safety.
Measures to Improve Patient Safety
When a person sees an error made in the hospital, the person should be able to do the following;
Talk to a person immediately. The closest person a patient can talk to is the personal care because the bedside nurse is not a bad place to start the complaint.
It is important not to go reporting an incident if the persons known by the patient are not around. All members of the hospital staff ranging from physicians to custodial crew serve the purpose of making the patients care as safe as possible (Mitchell 6).
Be assertive and respectful when discussing the issue. Nobody is prepared to make a mistake and so the caregiver assigned to the patient should quickly address the problem.
In case any error happens, the patient should be able to talk to a hospital worker who can resolve the problem through investigation. The patient should be clear on the expected information to be heard back and if seeing anything being done to address the problem.
If the patient does not receive any feedback during the stay or shortly after the discharge from the hospital, the patient should contact hospital’s customer service, patient & family relations or patient advocacy. The patient should seek a neutral party if uncomfortable asking directly within the unit.
Many hospitals have put up a suggestion box or a hotline as a reporting system. The problems that are not channeled through these ways will not be addressed.
Ways of Ensuring Employee Responsibility
The management process should truly support employee performance, success, and development by getting everyone involved. By informing everyone in the organization, managers always have high participation rates that lead to better quality performance (Gottfredson & Bob 1). It is therefore important to communicate with everyone that is responsible for the management process. Here is a list of responsibilities of each stakeholder group such as managers, executives, Human Resources, and employees.
Senior Leadership and Executives Responsibilities
Senior leaders and executives need to be senior champions in the organization (Gottfredson & Bob 3). They should be enthusiastic in the new management process. Executives and senior leaders should make sure that they are participative and supportive in the process. As well, they should engage and communicate values of the management process so that others can participate. The support should be shared through various communication models and should also be fully prepared to answer questions posed by the different groups. The information extracted from the management process should be used in guiding strategic decision making within the organization.
Responsibilities of the Manager in Performance Management Process
The manager has the responsibility of reinforcing and recognizing strong performance among the employees (Woods, 4). He/she should encourage and identify improvement in cases where needed. The manager needs to view performance management as a two-way discussion that is continuous throughout the year. The workers should not be surprised by the feedback and ratings that they receive in a formal performance review. The manager is therefore expected to do the following
1. The manager should determine an appropriate schedule for performance conversations. It is advisable for the manager to conduct short meetings whose aims are to discuss successes, accomplishments, and challenges that are experienced within the organization. This can proper monitoring of goals and coach the employees as required. The short meetings are also advantageous in that they reduce the time that will be taken to conduct and prepare annual performance reviews. These reviews are used to check achievements, development, setbacks, and training that have been discussed throughout the year. This information can be used to establish a development plan and goals for the subsequent year (Roberts & Stuart, 8).
2. The managers deliver constructive and positive feedback. For example, they will always give the employees feedback during one on one meeting and by informal means. The managers commend employees, make performance summary for every employee during conversations. Managers remember that it is not necessary to dwell on undesirable behaviors but to describe the desirable behavior as the goal of the feedback.
3. Managers continually check the goal progress
These leaders conduct regular check in with employees on their progress towards goals. In encouraging that, they can offer assistance or coaching or revise goals due to the necessity (Roberts & Stuart, 8).
4. Managers revisit and communicate performance expectations.
As one of the manager roles, s/he should communicate performance standards and expectations of his/her employees in order to differentiate between unacceptable and acceptable behaviors and results as a way of reducing misunderstandings. The manager should also gather employee performance from multiple sources.
5. Improving management and leadership skills. The manager should take some time to learn on how to be a better coach and manager and to invest in his/her own development.
6. The manager should coach employees to reinforce and to strengthen a two-way communication. The manager should coach when here is need to focus attention on a given aspect of the employees’ performance. The employees should be advised ahead of time on the issues that should be discussed. The manager should focus much on describing her expectations and the desired behaviors and not describing the gaps. It is important to understand the reason why their performance is that way and should be introduced to performance improvements.
7. It is important as a manager to support employees' career and professional development. In doing this, the employees should be asked their career aspirations, and if possible, they should be helped to identify areas where they can improve. It is also recommended that the manager ensures that employees have a well-defined job description and truly understands the skills required of them to execute their duties. They must also be reminded of their competencies to move up the ladder (Roberts & Stuart, 7). As well, these employees need to be given time and flexibility that is needed for them to properly learn and develop. The development should ensure that there is a consequential impact on the development.
8. Giving feedback to the employees
The coworkers need feedback so that they can improve just like any other employee would need it. It is important to give feedback through verbal means and other communication tools available within the organization. Through copying managers on the written feedback, they can gain more insight into their performance of the workers.
9. The managers should complete the self-appraisal within a specific deadline. The manager can do this by being honest about performance and not underestimating the abilities. He should, therefore, be objective and have quantitative/qualitative facts for rating himself. It is recommended that the manager provides details of how s/he accomplishes the goals, work products are delivered and the milestones are met.
Responsibilities of the Human Resource
The human resources also play important roles in the performance of management process. The human resource can provide training to all the executives, employees and managers on the steps and processes that are involved in the responsibilities that are assigned to them. They can be educated on the benefits of addressing each group.
The human resource can explain the performance rating scale and the difference between levels of performance and the expectations on how the ratings should be used (Roberts & Stuart 2). For example, which rating is used for bad performance and which for good performance? What are the additional actions to improve performance? This also contains the way performance is judged below and above expectations.
The human resource should provide managers and executives with regular training on giving feedback as well as coaching to help develop the employees. They should thus launch and manage their own management processes with analysis and review of results while identifying things such as; areas to improve the processes, participation rates, and areas where performance rates are good or poor. The strategic results of the management process should be communicated to the entire organization.
Employees Responsibilities
The roles of the employees in performance management process sis to do the following
The employees should work towards achieving the individual goals in order to help the organization meet its objectives (Roberts & Stuart 6). Normally, objectives are set ant the organization and at an individual level. Those of the organization are too broad as compared to individual objectives. The employee and the manager should, therefore, create these goals collaboratively as activities of performance management. At the individual level, the employee should be able to keep track of progress in meeting individual goals and status of these goals communicated to the manager (Levension 4).
The employee should be able to take full responsibility for his/her own professional/career development. This can be done by defining how the individual would like to be professional. The person should as well understand the experience and skills wanted from him, and that needs to be developed. The individual can alternatively seek opportunities for career and professional development.
Being open to feedback improves individual’s performance by accepting the constructive feedback given and taking the initiative of improving. The development plans should be completed as assigned and further applications for learning to be made. If possible, the employee should seek the report that is required.
The employee needs to work and establish a healthy relationship with the manager to ask for manager's feedback. As well, the employee can solicit feedback and guidance on performance from the coworkers (Woods 3).
Keeping an individual record is very important. These records include those of achievements, performance, successes, and challenges. Thus, keeping documents like performance journals that share success, feedback and recognition has the potential to improve employee performance.
Motivating Employees to Achieve Organizations Goals
Goals are higher level statements that give employees of an organization a framework for excelling in their workplaces. Some employees may need assistance to excel and reach the goals. Success of an individual may begin with him/her writing the goals that should remain achievable but challenging. One these goals are in place, they serve as the monitor and motivator of the employee to keep in progress. The following ways will help the employee to achieve the organization's goals (Shelley 1).
Set own goals individually and for the organization. After doing so, the individual should demonstrate the efforts and motivation to reach both of these goals. The performance of the individual should be measured on both the achievements for individual and the organization’s goals.
A celebration of success also motivates the employees. The manager of the organization should use a recognition system in celebrating workers who achieve both the organizational and individual goals. The achievers should be announced and recognition bulletin made on the board (Shelley 1). Such kind of information should be published on the company website or newsletter to offer small incentives.
The manager can as well encourage creativity or innovativeness in employees. This can help them in achieving common goals. Through doing so, this will create a supportive working environment that communicates to other employees that their talents are considered (Con 4). When the manager gets to be innovative in such a manner, this can motivate some employees.
Employees with similar goals should be paired to work together. When such employees come together, they may work together for the push towards meeting their objectives.
The manager can as well motive his/her employees by initially writing the organization goals with the employees so that they can get more invested in achieving the goals (Woods 2). Together, the employees and the manager can help narrow the objectives that are specific and measurable. The time needed to complete the objectives can be defined (Shelley 2).
The employees of the organization should be met individually on a regular basis because it is useful in evaluating the extent to which they are reaching their goals. The meetings can provide a suggestion for getting back on line in cases of any deviation
Standards of Quality Treatment
Many people normally view patient safety to be residing in quality healthcare. For example, patient safety is considered indistinguishable from quality healthcare delivery. Quality is therefore defined as the optimal balancing of possibilities realized and framework of values and norms. It is important to assess the healthcare services against quality standards (Mitchell 6). When the initial assessment is conducted, several statements can be generated to mean standards each standard describe areas of improvement and helps in understanding.
How the services can be compared to the statement, the source or the evidence to support the statement, the resources or the actions that would be needed to improve the service to meet the requirements of the statement, and the initial high-level risk assessment associated with the not making such improvements.
These standards should be developed after consultation with the health sector which is piloted by the available services that are being offered. The quality standards framework has been used in many ways that include the following areas; clinical interventions, support recovery, quality of practice, staff management and other involvements such as family members,
The service is determined that carries out all the described activities and should also start considering the evidence of demonstrating that it carries with itself activities of the best practice. The standards describe the evidence that can be used. Most of activities and services in healthcare should identify where the evidence is located but not a system of its development. This evidence should not be copied and used only in one place as this can generate big amounts of unnecessary papers.
Quality standards in the clinical intervention should teach of what is required at the community level regarding a particular case. The clinicians have to make sure that they are delivering what is in line and specific to the subject of healthcare given. It should also be able to address and ensure that these services are received by the patients in a safe manner during the clinical intervention. In the clinical intervention standards, it contains such things as needle exchange provision and safe prescription of drugs that are used in the clinical intervention. The providers who comply with these standards will have written procedures and policies regarding the particular clinical intervention. These people will also ensure their test for service takes informed procedures and protocols. They will also review the prescription and manage medicines at intervals as planned (Painter 35).
The quality of practice is also important in watching/measuring the standards as involve the following; how is the medication purchased? Who supplies it? Who and how is the medication administered? It covers all aspects of the medication ranging from the process of ordering for the medication to how the audit is conducted using medical records.
This section of standards sets out what the health care services need to do to make their services to be delivered in a way that’s transparent and reflective to the best practices. It can address how the health services make plan and develop itself in making sure that the interventions offered to comply to with good practice and can be reviewed by all the staffs. The section also contains clearly comprehensive information that's presented to the prospective customer to enable informed choices and decision making (Painter 30). The section also examines how information is regarding client’s needs are gathered on a particular service. This information can help in planning the support and care received by the client when still in the service.
This section, therefore, contains critical components such as service approach, care planning, clinical governance, contracting, service information, assessment, organizational government and therapeutic environment
Compliance statutory requirements are very important in monitoring the quality of health care standards. The section sets out what the healthcare providers have to consider in making sure that they deliver all aspects of their service in accordance with the regulations and national guidance. The standards under this section fall under the safe prescription of the available medicine.
Contents of the programs section clearly define the services that will be offered by a particular health program or health care service. It mentions how the service will be supporting the client when entering and leaving the service. The contents of the programs also clearly outline the steps taken in any case a service user exits in an unplanned way (Painter 33). Further, the section also identifies how the service aims to provide support, advice and information clients’ health and wellbeing. The section considers the service in working if it is integrated with other services in caring and supporting clients.
Contents of the program contain standards on joint working, client journey and the health and wellbeing. Client journey is about entering and leaving the service. The client is expected to receive information about the service before joining and a timetable of how the program plans to run (Betancourt 16). This is because the providers who comply with the standards will do the following; the providers will provide a contract before the admission of the client into the service; they will make sure that the clients get a place for safety when quitting the service before completion of the program.
The providers will be tasked with the provision of harm reduction when clients quit the service and to ensure continuity of the care being provided by timely referral of these clients to other organizations where they will continue with care after self-discharge or unplanned quitting.
Joint working is the process through which the client and the service work in a coordinated way to ensure that clients can access the services that are not provided with the health service you are enrolled in. The client is ensured of having all the information needed about the services before admission into the program. Also before leaving the service, it will be much interested in knowing the support that may be required by the customer. They will contact and service that can offer the support after customer exit.
The providers who comply with the joint working standards will be able to provide comprehensive information about the service in offer. As well, these programs will be able to work and liaise with the organizations that prepare the clients before joining the service (Painter 42). As a result, the service provider will be developing effective and strong relationships with the joint organizations. The service providers will also be able to identify and create contacts with the external organizations.
Health and wellbeing of the client should be considered, looked at and if possible should be improved. This can include looking at ways of reducing the harms to the client's health and well-being and those that risk the health of the client. The health service can be expected to work with organizations that can access to services that are not provided by that particular health service (Painter 45).
The providers who comply with the standards on health and wellbeing of the clients are able to promote health and wellbeing with both clients and staff, the services can offer reduction to any harm or information, they are capable of supporting clients where they can access other health services that are not currently provided with the particular program.
Patient band significant involvements that include family members, care providers and others section of standards states what the service will do to ensure that they are in the planning, review, development, and delivery of the service. This section of standards defines how a service can be developed to support its clients to take part in the involvement activities and outlines the strategic approach to conduct the activity. The standards are also used in examining how the family members and significant others safely involve themselves in caring and supporting the client (Tamburini et al. 12). This section contains standards on developing and managing family members and ways of developing and managing client involvement.
When developing and managing the client involvement, the service can be expected to consider the views and experiences of improving and developing the service. Those who are asked to participate in the client involvement can expect that the service in charge will offers to them training that might be needed during client involvement. If all the clients take part in client involvement, it’s clear that the service will set out the expectations about confidentiality.
The providers who comply with the standards on client involvement will be able to do the following; offer training to clients in developing them to be effectively involved, taking strategic approaches to client involvement in the service and they will also be clear on the ways on boundaries of the client involvement (Painter 58)


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