unit 7

Running head: TECHNIQUES AND TOOLS

TECHNIQUES AND TOOLS

2

Techniques and Tools for Strategic Management of Quality and Performance

Purdue Global University

HS450-01: Strategic Planning and Organizational Development

Todd Kane

February 20, 2020

Running head: TECHNIQUES AND TOOLS

1

TECHNIQUES AND TOOLS

Techniques and Tools for Strategic Management of Quality and Performance

Part 1

Compliance in healthcare is the method of observing guidelines, rules, and regulations. Healthcare compliance can cover a wide range of activities, which comply with internal and external regulations. These rules and regulations are put in place to protect patient safety, patient information, and billing practices. Examining quality management, this is a process to improve treatments, outcomes, satisfaction, and the delivery of care. As quality management is put into place, this can help organizations and the healthcare industry identify other policies needed to be implemented to continue towards the goal of improving the overall delivery of care. Quality management tools can be utilized to support compliance efforts throughout an organization and industry. 

One type of quality management tool that can be used as a process control technique to support compliance is a control chart. This type of tool is a graph used to study processes and how they change over time. These types of charts can be used with ongoing processes and help by correcting problems as they arise (ASQ, n.d.). Utilizing this tool can help monitor and help set regulations in areas such as hospital-acquired infections, pre and post-operative complications, and mortality rates. This type of tool involves process thinking, learning through data, study, use of experimentation, measurement systems, and methods of data collection (Suman & Prajapati, 2018). When utilized correctly, it can help the organization to determine how successful processes are before and after the implementation of a new EHR system. It can also help create regulations and determine if additional compliance-related regulations are necessary for the future.  

The next type of quality management tool that can be beneficial is fishbone diagrams. This type of diagram is a structured approach that helps with identifying problems and sorting different ideas into categories. It can help as a visual tool to display cause and effect and is often also referred to as a cause and effect diagram. At the head of the diagram is the problem with contributing factors branching off separated into the various categories. This tool can be used to help promote an atmosphere of brainstorming and identifying issues that could have potentially been looked over otherwise (API, n.d.). Applications for the organization as it pertains to the implementation of a new EHR system is that it can help identify issues related to the process as well as help understand other factors that might be aiding to the problem. Once these are identified, new processes and regulations can be put into place to improve the success of the project.

Part 2

An essential aspect of implementing any new system is being able to measure and manage how well the organization is doing with the new processes put into place. This is where benchmarking techniques should be utilized to provide feedback. These types of techniques can help the organization track performance over time as well as identify and prioritize goals. Benchmarking can also help to determine the effectiveness of changes that have already been made and help to understand better where performance is falling short compared to others. This can be used to help promote healthy competition and help individuals in the organization have a more accurate picture of their performance (AHRQ, 2013). Utilizing these types of tools will be beneficial in implementing the new EHR system and allow the organization to see the progress that is being made.

One type of tool that will be utilized as a benchmarking technique is the use of report cards. Report cards can help to show outcomes after the implementation of the new EHR system compared to other similar providers in the area. Data from the report cards typically come from two different sources. The first source of the data can be collected directly from the patients, and the other data can be collected from medical and financial systems (Ireson, Ford, Hower, & Schwartz, 2002). The type of information that will be included from the data and put on the report cards will be metrics such as mortality rates, billing errors, patient satisfaction, medical error, and productivity. Once the data is obtained, it will be compared to other facilities in the area that have also implemented EHR systems and allow the organization to see how well it is performing. Since the report cards will be a comparison to outside organizations, this will be an example of an external benchmarking tool.

The next type of benchmarking tool that will be utilized will be dashboards. Dashboards can be a valuable tool to help manage performance and help guide users in the right direction. This type of tool is a data-driven support tool that can query multiple databases and provide a visual display of important performance indicators. One of the best aspects of a dashboard is the ability to provide an overview of crucial information (Khairat et al., 2018). To measure performance targets for individuals in the organization, this type of benchmarking will be an internal tool. The information displayed on the dashboard will be a comparison of others within the organization, so they can see how they are performing in key areas compared to the rest of the facility. It will also provide managers a one-stop-shop visual display to track their employees as well as how their department is performing.

Benchmarking tools will be an asset for implementing a new EHR. Still, they will also be beneficial going forward for the organization to ensure we are meeting regulatory and performance standards. As stated previously, these tools can help the organization have an overall picture of how they are performing towards key metrics. These can include tracking of readmission rates, facility acquired injuries, infection control, billing/ coding errors, and other key performance and compliance-related issues. Having tools that will show how well we are performing in key areas will help give the organization a clear picture of what areas need to be focused on and prioritize goals. It will also allow the organization to implement new policies and regulations to ensure performance and compliance issues are being corrected.

Part 3

One of the areas that implementing a new EHR will be beneficial to the organization is through improving workflows. Improving workflow will help the staff be more efficient, will enhance the quality of care, remove chaos and disorganization, and enhance coordination of care. Until the organization can fully implement the new EHR and train staff, there could be issues with workflow while making the transition. This is where workflow concepts will be beneficial to ensure a smooth transition from day one until the project is fully completed, and the new EHR is fully in place. Two examples of workflow concepts that could aid with this conversion are swimlane diagrams and use cases.

Swimlane diagrams are a type of flow chart that shows the steps in a process and examines handoffs that might occur within the process. This type of tool can help define a process as well as determine what individuals departments and groups might be involved with completing the process. This type of workflow concept can help show areas that can be improved, give a visual aid to staff allowing them to see their roles, assign who completes what tasks, and can help to facility remove any redundancies in the process (AHRQ, n.d.). Converting from a paper system to an EHR, there will be steps in the current process that will no longer be needed, and this type of workflow concept will help the organization clearly define what those new steps in the process are. These will also be essential in informing staff of new duties that could arise as part of implementing the EHR.

The next concept that can be used is use cases. Use cases are a type of workflow designed for capturing the potential requirements of a new system. Use cases are a narrative that walks users through steps to complete a task. Each use case has a specific starting point with interactions and descriptions on how to get to the end result. This type of concept can help new users of the EHR get through steps such as adding a new patient into the system, inputting a patient’s demographic information, or even how to access labs once uploaded into the EHR. These will be utilized to provide staff with a quick reference guide while they are learning the system and help improve everyday workflow. They will help guide users towards the end goal while helping to eliminate frustrations and errors in the process. 

Part 4

To ensure that the transition from the current system to the new EHR is going as planned, project management techniques will be utilized, ensuring efficient workflow and outcomes are being reached. Project management techniques can help be the glue that holds a project together, giving the leader tools to help managers assign tasks, track progress, project expected budgets, create timelines, and completion dates. There are different types of project management tools that can be utilized, but the two that will help with this current project are Gantt charts and risk analysis. Proper use of these tools can help the organization make adjustments during the project and ensure that it stays on course.

Gantt charts are designed to outline the project while measuring performance and progress towards achieving the goals. It also helps aid in understanding how tasks of a project overlap, identifying the order in which each step needs to occur. It can help the organization to monitor the project’s progress as well as identify if the project is ahead or behind the projected schedule. This tool assists in creating realistic timelines and goals for the project as well as help outline who will be responsible for accomplishing each task (AHRQ, 2019). With the implementation of a new EHR system, it is going to be essential to ensure the project stays on track and identify issues when it is falling behind schedule. Gantt charts will allow the organization to compare the current progress to what was initially projected and make adjustments along the way. Timelines can be created for the selection and acquisition of the EHR, testing phase in a controlled environment, training, and full roll out to the facility. 

Risk analysis is another tool that can be utilized to ensure that the project stays on course and avoid any potential surprises that could arise. It is impossible to predict all of the issues that can arise from adopting a new EHR system. Still, a good risk analysis can help to ensure the organization is better prepared for these issues (Lavanya & Malarvizhi, 2008). The type of risk analysis that will be used is SWOT. This is an acronym that stands for strengths, weaknesses, opportunities, and threats. Strengths can be characterized by the internal processes and resources the organization possesses to complete to project. The weaknesses will be aspects of the organization that could negatively impact the completion of the project. Opportunities are the conditions suitable for achieving the goals, and the threats are external issues that could hinder the organization’s plans. Having a good assessment for each of these categories should help the organization spot potential issues and plan for them before they arise.

Project management techniques can also be beneficial, ensuring that the organization is achieving outcomes while also maintaining regulatory compliance. They can help the company prioritize compliance initiatives, set timetables for implementation of new regulations, audit and monitor the processes that are put into place, as well as help support these initiatives. It will also help the organization complete a complete risk analysis of regulations in place and assess the companies’ ability to achieve compliance as well as identify any issues that could hinder the facility from remaining in compliance with policies. 

References

AHRQ. (n.d.). Flowchart. Retrieved from http://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/all-workflow-tools/flowchart

AHRQ. (2013). Measuring and benchmarking clinical performance. Retrieved from http://www.ahrq.gov/ncepcr/tools/pf-handbook/mod7.html

AHRQ. (2019). Gantt chart. Retrieved from http://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/all-workflow-tools/gantt-chart

API. (n.d.). How to use the fishbone tool for root cause analysis. Retrieved from http://www.cms.gov/medicare/provider-enrollment-and-certification/qapi/downloads/fishbonerevised.pdf

ASQ. (n.d.). Control chart. Retrieved from https://asq.org/quality-resources/control-chart

Ireson, C., Ford, M. A., Hower, J. M., & Schwartz, R. W. (2002). Outcome report cards a necessity in the health care market. Retrieved from http://amanetwork.com/journals/jamasurgery/fullarticle/212037

Khairat, S. S., Dukkipati, A., Lauria, H. A., Bice, T., Travers, D., & Carson, S. S. (2018). The impact of visualization dashboards on quality of care and clinician satisfaction: intergrative literature review. JMIR Hum Factors, 5(2), e22. http://dx.doi.org/10.2196%2Fhumanfactors.9328

Lavanya, N., & Malarvizhi, T. (2008). Risk analysis and managment. Retrieved from http://www.pmi.org/learning/library/risk-analysis-project-management-7070

Suman, G., & Prajapati, D. (2018). Control chart applications in healthcare. International Journal of Metrology and Quality Engineering, 9, 1–21. Retrieved from http://www.metrology-journal.org/articles/ijmqe/pdf/2018/01/ijmqe170050.pdf