- Background of Organization
Senior Express is located in central South Carolina and provides high-quality services for senior clients and their families for more than five years. Senior Express provides home care services for retirees including assistance in shopping, medical care, home repairs, grooming, pet care, transportation and cleaning. Senior Express cooperates with other senior service providers, their family members, and guardians developing individualized programs targeted better management and monitoring of the client’s needs. Senor Express pays a lot of attention to the recruitment, training, and checking background of their caregivers. The organization is relatively new and various management issues arise quite often (Senior Express, USA, 2014). Recently, Senior Express faced a number of issues related poor resource management and ineffective treatment of the patients. The problems should be identified and eliminated because if not solved, they may bring undesired consequences.
This organization was chosen because services provided by this organization related my profession. I am working for a similar organization and I would like to make a research of the problems that my organization may encounter. Also, I want to try to find solution of the problems that may arise in my organization. Many healthcare organizations providing home services have similar problems and I want to be aware of possible problems in my organization to be able to manage them in case of need.
- Purpose of Risk and Quality Management in Health Care Organizations
The main purpose of quality management in health care organizations is providing patients with excellent care. Risk assessment and management aimed at reduction of the likelihood of errors. It is obvious that in healthcare industry quality management and risk assessment is more than merely a concept because it is essential not only for clinic, but for well-being of patients. Besides, it is important for financial survival of any healthcare organization. Quality of healthcare services can be considered from several perspectives such as patients and their families, healthcare providers, professionals, regulators, employers, and insurers (Caroll, 2009).
Management of quality and risks is important in home care because it influences quality of services delivered and, as a result, financial performance of Senior Express. Quality management at Senior Express is connected with provision of safe services including transportation, medical care, and other related services. The purpose of risk and quality management is to increase the likelihood of desired health and well-being outcomes that are consistent with professional knowledge Senior Express can offer to its patients. Thus, quality of healthcare services consists of the three outcomes namely: increasing the likelihood of desired health and well-being outcomes, should be consistent with professional knowledge available, and meet expectations of the patients. Risk management at Senior Express is connected with reducing the likelihood of undesired health and well-being outcomes connected with provision of home healthcare services provided by the organization (Kelly, 2006).
- Key Concepts of Risk and Quality Management at Senior Express
The following concepts are associated with provision of quality services: effectiveness, safety, focusing on patients, efficiency, services provided in time, and equity. Effectiveness of health care services is connected with level of staff skills, quality of medical equipment used, and volume of patients. Safety means avoidance of any injures from the care provided them and intended to help. Services should be patient-centered and providing home care should be responsive to individual preferences of patients, values, and needs. Reducing the amount of delays in services is important for both parties. Efficiency of the services provided includes avoiding waste of supplies, equipment, energy, and ideas. Equity means providing care that does not vary in quality depending on personal characteristics (ethnicity, gender, location), and socioeconomic status.
- Process of Risks Identification and Management
Process of risks identification and management at Senior Express consists of five key steps as follows: identification of stakeholders, identification of typical risks, analysis and assessment of risks, establishing risk management plan, and provision of testing and monitoring on continuous basis. The first step includes selecting official responsible for risk management and establishing committee consisting of senior management of the home care organization to ensure that the aspects of risk analysis are documented. Identification of typical risks includes identification of critical information needed to assess the risks. Analysis and assessment of typical risks includes establishing guidelines for analysis and assessment of the risks that were previously identified. Establishing risk management plan includes identification of steps to mitigate typical risks reflecting best practices in home health care. The risk management plan should prioritize for addressing typical risks given priority to addressing the most serious risks and the most easily resolved risks including timetable and budget for implementation of the plan. Testing and monitoring of the results on continuous basis includes making adjustments to the plan ensuring its effectiveness. For this purpose appropriate mechanisms should be established to be able to assess risk management efforts on continuous basis.
- Analysis of Three Typical Risks in Senior Express
At the present time Senior Express is exposed to the following risks: poor clinical resource management, poor management of patient flow, and inappropriate care provided by physicians. Inappropriate care provided by physicians for the patients is the most serious risk Senior Express is currently exposed. This type of risk may cause undesired outcomes such as ineffective treatment. Poor clinical resource management may cause increase in variable costs and high-cost procedures. Poor management of patient flow may cause loosing clients and poor reputation of the healthcare organization.
Poor clinical resource management may cause undesired additional variable expenses that could make an impact on profitability of the healthcare organization. Poor management of patient flow may negatively impact on community perception of service quality that may cause damage of the reputation of the healthcare organization. Inappropriate care provided by physicians working on contractual basis may cause negative consequences for patients’ health thus questioning safety of the services provided by Senior Express.
- Identification of Internal and External Factors Influencing Service Quality
Major external factors influencing home healthcare organizations are Medicare legislation and its changes, community perception of services quality provided by the healthcare organizations, and economic decline. Among internal factors influencing quality of the services provided by Senior Express are organizational culture, organizational structure, and human resources (Sollecto and Johnson, 2013).
Healthcare organizations may not be able to adapt to the changes in Medicare and home care legislation quickly that may make negative impact on service quality. Community of South Carolina may negatively perceive service quality delivered by Senior Express as a result of complaints related delays in delivering services, inappropriate behavior or incompliance of services with clients’ requirements that could make negative impact on service quality and even damage reputation of the healthcare organization. Economic decline may cause harm to the home healthcare organization because it would influence financial opportunities of the clients making negative impact on financial standing of the organization (Sollecto and Johnson, 2013).
The culture of Senior Express is built on internal communication. Internal communication includes interpersonal, availability of training materials, compliance of staff actions with organizational mission and vision, and development of internal policies aiming to improve services quality. Poor interpersonal communication may negatively influence quality of services because unfavorable internal climate in the organization could be the reason of weak morale of employees discouraging them deliver excellent service to the clients. Absence of training programs or unavailability of training materials may cause ignorance and poor services provided to the clients. Organizational structure is an internal factor that influences every day operations. The structure of any healthcare organization make an impact on a number of employees to be hired, the level of hierarchy, and the extent of collaboration of organization and employees. All of the components of this factor can make an impact on the end product - healthcare services. Quality of human resources is one of the most important internal factors taking into account the nature of services provided by Senior Express. Professionalism, skills, and education of the personnel are the components of this internal factor that could make negative impact on the service quality. For example, low professionalism, inappropriate or insufficient education, poor skills of staff providing home care can negatively influence the number of clients, their satisfaction, and increase the number of complaints (Sollecto and Johnson, 2013).
- Long-Term and Short-Term Goals of Senior Express
Long-term and short-term goals of Senior Express are shown in the Table 1 below.
Recently, Senior Express faced the following fundamental risks: the relationships between physicians and patients disrupted as a result of lack of information about the clients, distraction from clinical challenges, and disempowered patients.
One of the main problems at Senior Express is that physicians know little about their patients despite of sufficient quantity of doctors and caregivers causing the risk of losing clients. This problem can be eliminated by establishing policies related completeness of the data in customers’ database.
Distraction from clinical challenges is harmful for organizational internal climate. Challenges and risks must be addressed as soon as possible to avoid aggravation of the problem. Among the most frequently met challenges are provision of effective, scientific, and high-quality medical and care services. This risk can be eliminated by establishing appropriate system of reporting. This system is supposed to help address current issues effectively not letting these issues to become troubles (Caroll, 2009).
Business ethics encourages healthcare organizations to be accountable to the organizational stakeholders, but not to the patients. Restricting options available for patients reduces the effect of choice which the strongest leverage of quality. Disempowered patients threaten with increasing level of dissatisfaction that may cause reputation damage. Availability of variety of choices supported by appropriate ethics policies will help eliminate this risk (Kelly, 2006).
- Relationships between Risk Management and Quality Management in Senior Express
Quality management in healthcare is the process of designing services effectively, economically, and efficiently. Effectiveness involves the ability of services to meet clients’ expectations while efficiency means providing services thriftily. Economic component of quality management involves ability to generate revenues from organizational operations (Caroll, 2009). Risk management is the process that involves identification, addressing, prioritizing, and mitigating or eliminating potential risks aiming to achieve organizational objectives. Applying risk management means being proactive, predictive, and preventive. Risk management supposed to predict the likelihood of events to be happen caused by the risks the healthcare organization is exposed and determine which of the unexpected events should be addressed first. Process quality depends on presence of risks. Risks mean more variances, higher variation, and lack of service uniformity. By reducing the risks the healthcare organization reduces variations and objective gaps thus increasing quality of organizational processes making impact on quality of services delivered (Caroll, 2009). Previously, quality was seen as a function of risk. However, this approach is reactive rather than proactive. Shifting to proactive approach to the risk management helped better identify, address, prioritize, and eliminate potential sources of failure at Senior Express (Senior Express, USA, 2014).
References
Carroll, R. L. (Ed.). (2009). Risk management handbook for health care organizations. San
Francisco, CA: Jossey-Bass.
Kelly, D.L. (2th ed.). (2006). Applying Quality Management in Healthcare. Chicago: Health
Administration Press.
Senior Express, USA. (2014). Senior Express of the Midlands. Retrieved from
http://www.seniorexpressusa.com
Sollecito, W. A., & Johnson, J. K. (2013). McLaughlin and Kaluzny's continuous quality
improvement in health care (4th ed.). Sudbury, MA: Jones and Bartlett.
