...1. With the help of process flow diagrams, compare the pre-triage and the post-triage systems in terms of total system time and total waiting times. Is the new system an improvement over the old? 2. Look at the patient arrival rates and compare them to the available MD and NP capacity. An hour-by-hour or day-by-day analysis will show some interesting patterns. Based on what you have learned about waiting lines and utilization, comment on the current assignment fitness between supply and demand? | | | |Patients waiting |Patients waiting | | | | | | | |67% |33% |MD |NP |Availability | |Patients per hour treated | | | |Arrival |MD |NP |Beg of HR |Serviced |End of HR |Beg of HR |Serviced |End of HR |MD |NP |MD |NP | |8am - 9am |18.2 |12.194 |6.006 | - | 6.19 | 6.01 | - | 3.66 | 2.35 |2.0 |2 |3.0927835 |1.8292683 | |9am - 10am |17.6 |11.792 |5.808 | 6.01 | 7.73 | 10.07 | 2.35 | 7.32 | 0.84 |2.5 |4 | | | |10am - 11am |16.8 |11.256 |5.544 | 10.07 | 14.85 | 6.48 | 0.84 | 7.32 | (0.93) |4.8 |4 | | | |11am - 12 noon |15.2 |10.184 |5.016 | 6.48 | 9.90 | 6.77 | (0.93) | 7.32 | (3.24) |3.2 |4 | | | |12 noon - 1pm |11.8 |7.906 |3.894 | 6.77 | 8.04 | 6.63 | (3...
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...University Health Services: Walk-In Clinic Evaluation of The Triage System Implementation ------------------------------------------------- Background and Introduction It had been 1 year after University Health Services (UHS) of Harvard implemented the triage system to improve its quality of service. During pre-triage system, the clinic got a lot of complaint from its patients mainly about the waiting time between sign-in and treatment as some patients (22%) had to wait more than 35 minutes to make first consultation with a nurse. In some cases, patients had to spent more than 55 minutes just to wait for a prescription renewal. Additionally, it was also reported that some patients cancelled their visits to the click due to long expected wait. Patients described the Walk-In Clinic as cold, inefficient and impersonal. Although the last statement could be debatable as the walk-in clinic is not intended as a personal and exclusive health services. Service evaluation identified that some procedures in pre-triage had contributed to the bottleneck and duplicate services which had caused longer waiting time for the patients. It was Kathryn Angell who was hired as assistant director for ambulatory care at the UHS proposed the triage system in order to improve the performance of the clinic in providing services for its patients. Some changes were made to better manage the service quality including to deploy two triage coordinators (selected from highly experienced registered nurses)...
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...University Health Services: Walk-In Clinic Pre-triage organization Organization: - 12 treatment rooms: 4 for nurses and 8 for doctors where 3 of these doctors were permanently assigned to physicians as their UHS offices - Average of 143 patients a day the clinic was staffed on the basis of past experience with peak periods. - Every patient has to go to a nurse first before seeing physician Complaints: - Too long waiting time between sign-in and treatment - Length of the wait not related to nature of visit - Inconsistency and too much variation in treatment between the different nurses - Duplicated efforts for patients who were seen by a nurse and a doctor Consequence: patients avoid visiting the Walk-In Clinic The triage system Differences with before: - Patients fill in an identification form, which includes the reason for the visit - 2 triage coordinators briefly visit the patient and then conclude if the patient is more urgent than others: patients were only triaged to a nurse practitioner if their ailments fell under one of 13 categories. System didn’t work as well as they expected reasons? - Triage coordinators classified patients as MD/NP to maintain the flow - For one-third of the physicians more than 40% of their clinic patients requested them - Two of the five doctors are 100% occupied with walk-in appointments - Patients expect an atmosphere reminiscent of the country doctor’s office Angell’s dilemma: How can she improve the system? How...
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...Several existing problems precipitated the creation of the triage system implemented by Kathryn Angell in an effort to deliver improved medical care. The main problem was a lack of coordination in service delivery. This lack of coordination caused excessive wait times on the order of anywhere from 23 to 40 minutes to see a nurse, 40 to 50 minutes to see a doctor, and as long as 55 minutes to get a prescription filled. The practice of all nurses being involved initially in seeing all patients caused duplication of efforts, including repeated questions and examinations, and resulted in procedural bottlenecks. Additionally, there were inconsistent levels of service and extreme variation in treatment because of the different experience and skill levels of the nurses. Overall, the view by patients was that the clinic was inefficient and impersonal. The triage system was introduced in September 1979 to overcome these problems. One of the immediate changes was to establish a preliminary evaluation and referral system which dedicated two triage coordinators, which are highly experienced nurses, to evaluate the patients and assign them to the next appropriate step in the treatment process. Unfortunately this process did not result in greater procedural efficiency. Wait time for a patient to see a triage coordinator was about 20 minutes, with an additional 38 minute wait to see the nurse or physician. In fact, according to Exhibit 5, the wait time to see physician actually...
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...change in health and social care. This can be achieved by assessing the challenges that the major factors of change bring using the Care Quality Commission of the Quality Care Commission for the Royal United Hospital Bath NHS Trust (RUHB). The second task aims to evaluate contemporary changes being inaugurated in the provision of health and social care services. In addition to this, a strategy and criteria will be devised in order to measure these recent changes including how the impact of these changes can be measured and evaluated. LO1 1.1 Explain the key factors that drive change in health and social care services ‘Change’ within an organization sometimes refers to organizational change in health and social care is the movement from a current state through a state of transition to a state in the future (Richards, 2012). The impetus of change within an organization may come from within and outside. These are known as the internal and external drivers of change. This can be explained using PEST and SWOT analysis. PEST analysis (Political, Economic, Social and Technological analysis) describes a framework of environmental factors considered in the strategic management of an organisation (Friesner, 2014). Political factors of change include change of government and policies within the NHS in the form of legislations. For example, when the Coalition government came to power in 2010, it embarked on reforming the NHS. The flagship of these reforms is the enactment of the Health and Social...
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...K101 Foundation course to health & Social care. I have decided to study the K101 course because I want to develop my understanding of health and social care in order to better my understanding of the elements of occupational therapy; ultimately with a view to applying for a course in the subject at University. By completing this foundation course I am hoping to achieve the credits that are required to secure a place at university. I want to learn in depth the care we can receive within the United Kingdom and how it impacts the individuals and their families. I’m very interested in care homes and measuring the amount of time the nurses and carers can spend with each resident, also how this could affect other health issues and social situations. I am also interested in whether diabetes patients would benefit from more independent care or more help and support at home or with their GP’s. I eventually would like to figure out why some people choose to work in care but don’t actually want to help people. I feel it is an occupation where it needs passion and compassion. However the National Health Service in the UK also works miracles and saves millions of lives per year. The great work that they do has inspired me to work alongside them, with the hope that I can contribute to the constant improvements within the National Health Service. I would like to utilise my skills that I will gain to produce new ideas on how the care system can be improved. I...
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...non-clinical role has often found it difficult to see the impact that sound organisational values and robust stakeholder engagement can directly have on the delivery of patient quality, experience and care, working through Module 3 has been a truly eye opening experience for the author. Having completed Module 1 and 2 of the EGA course and now coming to the end of Module 3, there have been many opportunities for self-reflection and time to make sense of how and why organisational values, engagement and service delivery are all interlinked. Analysis Engaging Stakeholders to Improve Care & Quality “Stakeholder engagement is the process by which an organisation involves people who may be affected by the decisions it makes or can influence the implementation of its decisions.” The notion of engagement with patients in their care has been a growing focus of health and social care policy. In 2000 the NHS published their plan (Department of Health 2000) which spoke of moulding services around the needs and desires where possible of patients themselves. Seven years on,...
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...Purpose - The purpose of this paper is to examine the business case for ethnic diversity in the British National Health Service (NHS). It seeks to contextualise issues around diversity within the current political environment, and identify the barriers to diversity in the NHS. The business case has been very strongly argued as justification for introducing both managing diversity and equal opportunity initiatives - here the paper examines the inconsistencies of using that argument, and maintains that the only justification worth presenting is that based on (deontological) moral arguments. Design/methodology/approach - The paper is conceptual in nature exploring the respective cases for diversity using a broad range of the available literature brought together as part of a rapid evidence assessment. It does so in order to make some far-reaching claims about the future justifications for active diversification of senior management in key public sector institutions. Findings - The distinctions between the business and moral cases are false, in that both have ethical reference points. However, the business case is not only difficult to translate to public sector institutions; there are also evidential problems with its adoption. In light of this the conclusion here is that the moral (deontological) case is the only one that has any long term value for proponents of diversity. Originality/value - The value of this paper is that it examines the confusion that surrounds different cases...
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...Part A Issues in the workplace affecting staff behavior and patient care Radiographers bear a great deal of responsibility in supporting the forward progression of the field and maintaining the high standards expected by the professional bodies and by the public. The scenario given presents different situations that radiographers and radiography students may face in the workplace; the main issues are professionalism, continuing professional development and bullying at work. All these in turn have an effect on the level of patient care staff provide since staff attitudes and team-working do influence this. A profession can be described as ‘A vocation...esp. one requiring advanced knowledge or training’ (p2386, Brown, 1993, vol 2), linked to this is the definition of professionalism which is ‘The body of qualities or features, as competence, skill, etc., characteristic of a profession or professional’ (p2368, Brown, 1993, vol 2). There are instances within the scenario in which each character does not adhere to the Code of Conduct and Ethics presented by the Society and College of Radiographers (SCoR; SCoR, 2008). SCoR states that you should engage in the teaching and training of other members of staff, however both Rob and Asha fail to support staff within their team: Asha fails to support Rob, and Rob in turn fails to support the radiography student. SCoR specifically states that radiographers should develop the skills to be a good teacher and trainer which neither Asha...
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...and responsibilities of the professions involved, the importance and difficulties of interprofessional collaboration and the effects of this on person centred care will also be explored. A conclusion will be drawn as to whether the event provided a person centred approach. The observed consultation (Appendix 1) took place in an elderly care clinic held in a hospital outpatient department. Outpatients Clinics are provided by the local NHS Primary Care trust on a regular basis as part of ongoing care for clients. A consultant, a nurse, the client and her carer were present. The client had an appointment to review her ongoing treatment of Parkinson’s disease. A publication to support the National Framework for older people (Department of Health, 2001) regarding the implementation of medicines endorses the monitoring of treatment to ensure the medication remains appropriate and to raise awareness of any adverse effects. The lady was in her eighties, frail and hard of hearing. A carer accompanied her from the residential home where she lived. Her mental state was assessed: she was aware of her surroundings and had some degree of understanding, although communication was difficult due to her hearing problem. During discussion with her carer it was established that she was having difficulty sleeping due to nightmares. The consultant explained that this was a common side effect of the medication...
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...Purpose ROCR Ref: Title Author Publication Date Target Audience Best Practice Guidance 0 Gateway Ref: 14641 0 ESSENCE OF CARE 2010 DEPARTMENT OF HEALTH 1ST OCTOBER 2010 PCT CEs, NHS Trust CEs, Care Trust CEs, Foundation Trust CEs , Directors of Nursing, Local Authority CEs, Directors of Adult SSs, PCT PEC Chairs, Special HA CEs, Allied Health Professionals, GPs, Communications Leads, Emergency Care Leads, Directors of Children's SSs, Universities UK, RCN, RCM, AHPF, SHA Lead Nurses, SHA AHP Leads, Patient Organisations Circulation List PCT CEs, NHS Trust CEs, Care Trust CEs, Foundation Trust CEs , Directors of Nursing, Local Authority CEs, Directors of Adult SSs, PCT PEC Chairs, Special HA CEs, Allied Health Professionals, GPs, Communications Leads, Emergency Care Leads, Directors of Children's SSs, Voluntary Organisations/NDPBs, Universities UK, RCN, RCM, AHPF, SHA Lead Nurses, SHA AHP Leads, Patient Organisations Description Essence of Care 2010 includes all the benchmarks developed since it was first launched in 2001, including the latest on the Prevention and Management of Pain. All the benchmarks have been reviewed to reflect the current views of people requiring care, carers and staff Cross Ref Superseded Docs Action Required Timing Contact Details Essence of Care 2001, Communication, Promoting Health and Care Environment Essence of Care 2001 Gateway No. 4656 and 8489 0 N/A 0 N/A Gerry Bolger CNO Directorarte - PLT 5E58, Quarry House Quarry Hill, Leeds...
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...The head of the United Kingdom's National Health Service (NHS), Sir David Nicholson, has refused to accept responsibility for the needless deaths that occur daily at NHS hospitals by claiming that these deaths are not a result of mismanagement but instead are due to inherent "systemic" failings. A Look at the UK’s NHS—A Cautionary Tale by Al Kaltman A single payer health care system was the original goal of President Obama, and from his perspective while the Affordable Care Act was a step in the right direction, it fell short of what was needed. Should the Democrats regain control of the House in 2014, the President is likely to get the single payer system he desires. But some among his followers, and perhaps even the President himself, want to go even further and create a US National Health Service (NHS). In view of this, it is worth taking a look at the current state of the United Kingdom’s NHS. The final report of the inquiry into the UK’s Stafford Hospital scandal was published on February 6 and contained 290 recommendations for improvement in hospital operations and staff training. It is generally accepted that between the years 2005 and 2008 as many as 1,200 persons died needlessly at the hospital, and that these deaths were due to shocking lapses in patient care. The horror stories do not need repeating, but what is clear is that the NHS Trust that oversaw the hospital focused on reducing expenses and not on patient care. Prime Minister Cameron has...
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...Public sector = the part of an economy that is controlled by the government. Private sector = the part of the national economy that is not under direct government control. The two business I have chosen are NHS and Nike The NHS (National Health Service) is located in the public sector as it is financed and controlled by the government. The NHS is solely located in the United Kingdom, and provides free health care for the citizens of the United Kingdom. The NHS was found out of a long-held ideal good healthcare should be available to everyone no matter the wealth. The National Health Service started on July 5 1948 by Aneurin Bevan. As the NHS is controlled by the elected government there are no shareholder or stakeholders, it also is a PLC. The second Business Nike is Private Limited Company (LTD) this means that Nike is owned privately and financed by its customers, without any customers the business Nike will shut down. Nike is a company which sell its goods to create profit. Its products are sold to the general public. Nike was founded in 25 Jan 1964 by Phil Knight and Bill Bowerman. The company aims to sell to its customer’s clothes, shoes and many different more materials. The main stakeholder of the NHS (National Health Service) is the government because they are the main way of their funding, and is one of the remaining national bodies. The government finances the NHS through tax. For the years of 2015/2016 the NHS has been provided with a budget of £115.4 billion...
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...SDO Project (08/1501/94) Changing Management Cultures and Organisational Performance in the NHS (OC2) Research Report Produced for the National Institute for Health Research Service Delivery and Organisation programme April 2010 prepared by: Russell Mannion (University of Birmingham), Huw Davies (University of Dundee & St Andrews), Stephen Harrison (University of Manchester), Frederick Konteh (University of York), Ian Greener (University of Durham), Ruth McDonald (University of Nottingham), George Dowswell (University of Birmingham), Kieran Walshe (University of Manchester), Naomi Fulop (King’s College, London), Rhiannon Walters (King’s College, London), Rowena Jacobs (University of York), Paula Hyde (University of Manchester) Address for correspondence: Professor Russell Mannion Health Services Management Centre University of Birmingham Park House 40 Edgbaston Park Road Birmingham B15 2RT Queen’s Printer and Controller of HMSO 2010 1 SDO Project (08/1501/94) Contents Acknowledgements ....................................................8 1 Introduction .......................................................9 1.1 Aims and objectives of the study ..................................... 9 1.2 Research design and project overview .............................10 1.3 Structure of the report ..................................................11 2 Policy and Organisational Culture in the NHS: An Overview ..........................................................
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...Everybody benefits Surrey and Sussex Healthcare NHS Trust Library and Information Service which consists of two libraries (Crawley and East Surrey - Redhill), is part of the Kent Surrey and Sussex Healthcare Libraries group. I have been working there for just over four years and have had the pleasure and opportunity to work and lead a partnership between a UK and an African library. The partnership is specifically between the Albert Cook Medical School Library, Makerere University, Kampala, Uganda and Kent Surrey and Sussex Healthcare Libraries (formally South Thames Library and Information Service). It has existed informally since about 1994. This was made formal in September 2000, under the guidance of the registered charity Partners in Health Information (PHI). The aim of the partnership is to encourage the free flow of health related knowledge between nations. For further details see: http://www.surreyandsussex.nhs.uk/lis/documents/Ugandaleaflet.pdf During the span of this partnership a number of visits have been made to UK and to Uganda. I have been specifically involved with the visit that took place in January 2005 to set up the website for the Albert Cook and more recently in March 2009 to update the site. The main aims of the latter visit was to change the site from a static Hyper Text Mark Up Language (HTML) to a dynamic website with the potential for added functionality. The improved website would also facilitate library staff updating...
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