Assignment

RADS 4633 CQI

Module III

The Management Model

Terminal Performance Objective  

Upon completion of this unit, the student should be able to recognize the importance of identifying customers and understand the effect of professional standards on meeting both customer expectations and operational requirements.

Enabling Objectives

Upon completion of this unit, the student should be able to:

 
• Define specifications for a management model.
• Explain customer-driven management.
• Identify customers and their expectations.
• Differentiate between internal and external customers.
• Discuss the importance of initiating cyclical steps in the management model.
• Summarize the importance of the role of customer expectations and professional standards in customer driven management.
• Explain the use of focus groups and interviews.
• Identify professional standards necessary to satisfy customer needs.
• Develop a flow chart which identifies the steps of a process needing improvements.
• Develop a critical path for the previous process.

Specifications for a Management Model

A management model is a blueprint of a design for Quality Improvement processes. The specifications are those items which specify or identify the process outcome. The model is a plan for how your services, (the radiology department) will satisfy the customer (patients for example), and maintain the high-quality standards you have set.

Most of today's hospitals will be using a customer driven management model as illustrated below.  The plan is developed institution-wide and then passed from department to department. If everyone in the institution uses the same model, then the desired outcomes should be the same. This way, teamwork is solidified and it becomes easier to accept change as well as make changes.

Customer Driven Management Model

Customer Driven Management

Start-up Steps

As you can see by the illustration of the management model, there are 8 specific steps.  Steps one through four are identified as the start-up steps.

Identifying professional standards will come into play as you deal with your customers.  Additionally, what kinds of working or operational issues will help you align customer expectations with what is reasonable and cost effective?  How will you measure whether or not you are actually meeting the needs of both customers and the organization?

Steps 1- 4 start the process and will be discussed in detail later in this unit.

1. Identify customers and perceptions.
2. Identify customer expectations and professional standards.
3. Balance customer needs, expectations, and standards with operational requirements.
4. Decide on outcomes/process measures.

The extent to which you define each step will determine the thoroughness of your management plan. For example, if you identify the customer as only the patient, then all other receivers of services will be left out of the model.

Decisions that you make during these start-up steps have to answer questions concerning the makeup of your customer base, their expectations, and what professional standards will come into play as you deal with your customers.  Additionally, what kinds of working or operations issues will help you align customer expectations with what is reasonable and cost effective?  How will you measure whether or not you are actually meeting the needs of both customers and the organization?

Cyclical Steps

Steps 5- 8 are concerned with the implementation of decisions made in steps 1- 4. These steps are the "do" part of the process. What kinds of things that need to be done to satisfy steps 1-4 will be determined here?

1. Measure performance.
2. Report results. Provide feedback to key players.
3. Draw conclusions.  Identify improvement opportunities.
4. Pursue improvements: plan-do-check-act.

Remember that steps 1-4 of the start-up will need to be reviewed and updated or the process will stagnate or worse, deteriorate.  Steps 5- 8 are cyclical because you will follow them over and over to ensure your process is working.  That will also enable you to review and revise the first four steps.  See why it's called "Continuous Quality Improvement"?

Step 1 - Identifying Customers and their Perceptions

Who matters? An easier question might be, "who doesn't matter?" Would you be willing to identify anyone that you have contact with, no matter how minor, as unimportant? Probably not, but think about all of those individuals with whom you have contact in a single day. How does your perception of them as a customer affect their perception of you as a care provider? As the text points out, your standards of quality may have been well met, but do those standards meet your customer's expectations? These questions can be answered through a better understanding of customer expectations and perceptions.

a. Identify and rank your customers

Customers are people whose satisfaction with your services or products affects your ability to achieve your organization's objectives. Customers may differ from each department as will supplies, but all need to be identified in order to make the quality process as easy and efficient as possible.

b. Identify your Customers

To identify your customers, look at your main process or functions and follow the path of the results or outputs of these processes to those who benefit from them--your customers.  Ask the following questions:

• What are the major outputs of the processes?
• What is each service produced?

Then, for each service, determine who the immediate customers are and who the customers are down the line who have expectations about the quality of the services.

c. Types of Customers

There are two basic types of customers: Internal and External. 

Internal customers are people employees or departments within the organization and who depend on your processes and outputs for their external customers.  For internal customers, you are their supplier. 

External customers are people outside of your organization.  They use your services but are not employed by your organization.  This category includes patients, their family and friends, referring physicians, vendors, and others.  These people often have the choice of using your services or seeking business elsewhere.

Remember that service to the customer may be direct or indirect depending on the service required and its origin.  For example, the pharmacy may never see your arteriogram patient but indirectly serve that patient by supplying medication.

Look at the following table. The example for radiology lists patients as external customers.  Remember that the terms internal or external do not refer to direct or indirect service, but rather whether or not they are actually organization members.

Table of Internal and External Customers

Department	Internal Customers	External Customers
Radiology	Nursing floors	Ordering physicians
	Medical records	Patients
	In-house physicians	Patient's family
	Unit clerks	Outside reviewers
	Radiographers
Unit Clerks	Nursing floors	Patients
	Pharmacy	Physicians
	Housekeeping	Visitors
	Radiology, Lab, etc.	Outside reviewers
Business Office/Billing	Nursing floors	Patients
	Information systems	Insurance companies
	Admissions	Vendors
	Administration	Auditors
	Medical records	Physicians