Managing healthcare performance in analytical framework

Purpose – The purpose of the paper is to develop an integrated framework for performance management of healthcare services. Design/methodology/approach – This study develops a performance management framework for healthcare services using a combined analytic hierarchy process (AHP) and logical framework (LOGFRAME). The framework is then applied to the intensive care units of three different hospitals in developing nations. Numerous focus group discussions were undertaken, involving experts from the specific area under investigation. Findings – The study reveals that a combination of outcome, structure and process-based critical success factors and a combined AHP and LOGFRAME-based performance management framework helps manage performance of healthcare services. Practical implications – The proposed framework could be practiced in hospital-based healthcare services. Originality/value – The conventional approaches to healthcare performance management are either outcome-based or process-based, which cannot reveal improvement measures appropriately in order to assure superior performance. Additionally, they lack planning, implementing and evaluating improvement projects that are identified from performance measurement. This study presents an integrated approach to performance measurement and implementing framework of improvement projects.

Managing healthcare quality using combined SWOT and the analytic process

Improving healthcare quality is a growing need of any society. Although various quality improvement projects are routinely deployed by the healthcare professional, they are characterised by a fragmented approach, i.e. they are not linked with the strategic intent of the organisation. This study introduces a framework which integrates all quality improvement projects with the strategic intent of the organisation. It first derives the strengths, weaknesses, opportunities and threats (SWOT) matrix of the system with the involvement of the concerned stakeholders (clinical professional), which helps identify a few projects, the implementation of which ensures achievement of desired quality. The projects are then prioritised using the analytic hierarchy process with the involvement of the concerned stakeholders (clinical professionals) and implemented in order to improve system performance. The effectiveness of the method has been demonstrated using a case study in the intensive care unit of Queen Elizabeth Hospital in Bridgetown, Barbados.

Innovation management using logical framework in hospital-based healthcare units

Innovation is part and parcel of any service in today's environment, so as to remain competitive. Quality improvement in healthcare services is a complex, multi-dimensional task. This study proposes innovation management in healthcare services using a logical framework. A problem tree and an objective tree are developed to identify and mitigate issues and concerns. A logical framework is formulated to develop a plan for implementation and monitoring strategies, potentially creating an environment for continuous quality improvement in a specific unit. We recommend logical framework as a valuable model for innovation management in healthcare services. Copyright © 2006 Inderscience Enterprises Ltd.

Managing healthcare quality in project management framework

Healthcare professionals routinely deploy various quality management tools and techniques in order to improve performance of healthcare delivery. However, they are characterised by fragmented approach i.e., they are not linked with the strategic intent of the organisation. This study introduces a holistic quality improvement method, which integrates all quality improvement projects with the strategic intent of the healthcare organisations. It first identifies a healthcare system and its environment. The Strengths, Weaknesses, Opportunities and Threats (SWOT) of the system are then derived with the involvement of the concerned stakeholders. This leads to developing the strategies in order to satisfy customers in line with the organisation's competitive position. These strategies help identify a few projects, the implementation of which ensures achievement of desired quality. The projects are then prioritised with the involvement of the concerned stakeholders and implemented in order to improve the system performance. The effectiveness of the method has been demonstrated using a case study of an intensive care unit at the Eric Williams Medical Sciences Complex Hospital in Trinidad. Copyright © 2007 Inderscience Enterprises Ltd.

Managing healthcare quality using logical framework analysis

Purpose - The purpose of this paper is to develop an integrated quality management model that identifies problems, suggests solutions, develops a framework for implementation and helps to evaluate dynamically healthcare service performance. Design/methodology/approach - This study used the logical framework analysis (LFA) to improve the performance of healthcare service processes. LFA has three major steps - problems identification, solution derivation, and formation of a planning matrix for implementation. LFA has been applied in a case-study environment to three acute healthcare services (Operating Room utilisation, Accident and Emergency, and Intensive Care) in order to demonstrate its effectiveness. Findings - The paper finds that LFA is an effective method of quality management of hospital-based healthcare services. Research limitations/implications - This study shows LFA application in three service processes in one hospital. This very limited population sample needs to be extended. Practical implications - The proposed model can be implemented in hospital-based healthcare services in order to improve performance. It may also be applied to other services. Originality/value - Quality improvement in healthcare services is a complex and multi-dimensional task. Although various quality management tools are routinely deployed for identifying quality issues in healthcare delivery, they are not without flaws. There is an absence of an integrated approach, which can identify and analyse issues, provide solutions to resolve those issues, develop a project management framework to implement those solutions. This study introduces an integrated and uniform quality management tool for healthcare services. © Emerald Group Publishing Limited.

Integrated approach to healthcare quality management:a case study

Purpose - The purpose of the paper is to develop an integrated quality management model, which identifies problems, suggests solutions, develops a framework for implementation and helps evaluate performance of health care services dynamically. Design/methodology/approach - This paper uses logical framework analysis (LFA), a matrix approach to project planning for managing quality. This has been applied to three acute healthcare services (Operating room utilization, Accident and emergency, and Intensive care) in order to demonstrate its effectiveness. Findings - The paper finds that LFA is an effective method of quality management of hospital-based healthcare services. Research limitations/implications - This paper shows LFA application in three service processes in one hospital. However, ideally this is required to be tested in several hospitals and other services as well. Practical implications - In the paper the proposed model can be practised in hospital-based healthcare services for improving performance. Originality/value - The paper shows that quality improvement in healthcare services is a complex and multi-dimensional task. Although various quality management tools are routinely deployed for identifying quality issues in health care delivery and corrective measures are taken for superior performance, there is an absence of an integrated approach, which can identify and analyze issues, provide solutions to resolve those issues, develop a project management framework (planning, monitoring, and evaluating) to implement those solutions in order to improve process performance. This study introduces an integrated and uniform quality management tool. It integrates operations with organizational strategies. © Emerald Group Publishing Limited.

Innovation in healthcare services: a customer focused approach

Although the various tools and techniques of quality management are routinely deployed in order to improve healthcare quality, an integrated approach is lacking, which combines the customer focus to identify quality issues, analytical techniques for prioritising improvement measures and a project management approach to plan, implement and evaluate the improvement projects. This study develops an innovative framework using Quality Function Deployment (QFD) and a logical framework in order to address this issue, and demonstrates its effectiveness using a case study on the intensive care unit of a hospital.

Managing healthcare technology in quality management framework

Healthcare services available these days deploy high technology to satisfy both internal and external customers by continuously improving various quality parameters. Quality improvement in healthcare services is a complex and multidimensional task. Although various quality management tools are routinely deployed for identifying quality issues in healthcare delivery, there is absence of an integrated approach, which can identify and analyse issues, provide solutions to resolve those issues and develop a project management framework to implement and evaluate those solutions. This study introduces an integrated and uniform quality management framework for healthcare services. This study uses the Logical Framework Analysis (LFA) to improve the performance of healthcare services. LFA has three major steps - problem identification, solution derivation and formation of a planning matrix for implementation and evaluation. LFA has been applied in a case study environment to three acute healthcare services (Operating Room (OR) utilisation, Accident and Emergency (A&E) and intensive care) in order to demonstrate its effectiveness. Copyright © 2007 Inderscience Enterprises Ltd.

Cultural impact of wireless networks:emerging experiences in the healthcare sector

Culture defines collective behavior and interactions among people in groups. In organizations, it shapes group identity, work pattern, communication schemes, and interpersonal relations. Any change in organizational culture will lead to changes in these elements of organizational factors, and vice versa. From a managerial standpoint, how to cultivate an organizational culture that would enhance these aforementioned elements in organizational workplace should thus be taken into serious consideration. Based on cases studies in two hospitals, this paper investigates how organizational culture is shaped by a particular type of information and communication technology, wireless networks, a topic that is generally overlooked by the mainstream research community, and in turn implicates how such cultural changes in organizations renovate their competitiveness in the marketplace. Lessons learned from these cases provide valuable insights to emerging IT management and culture studies in general and in wireless network management in the healthcare sector in particular.

Medicines management across the primary-hospital healthcare interface: a study of paediatric patients

A comparison of medicines management documents in use by NHS organisations in the West Midlands confirms that there are important differences between the primary care and hospital sectors in respect to medicines management interface issues. Of these, two aspects important to paediatric patients have been studied. These are the transfer of information as a patient is admitted to hospital, and access to long-term medicines for home-patients. National guidance provided by NICE requires medication reconciliation to be undertaken on admission to hospital for adults. A study of paediatric admissions, reported in this thesis, demonstrates that the clinical importance of this process is at least as important for children as for adults, and challenges current UK guidance. The transfer of essential medication information on hospital admission is central to the medication reconciliation process. Two surveys of PCTs in 2007 and again in 2009 demonstrate that very few PCTs provide guidance to GPs to support this process. Provision of guidance is increasing slowly but remains the exception. The provision of long-term medicines for children at home is hindered by this patient population often needing unlicensed drugs. Further studies demonstrate that primary care processes regularly fail to maintain access to essential drugs and patients and their carers frequently turn to hospitals for help. Surveys of hospital medical staff (single site) and hospital nurses (six UK sites) demonstrates the activity these healthcare workers perform to help children get the medicines they need. A similar survey of why carers turn to a hospital pharmacy department for urgent supplies (usually termed rescue-medicines) adds to the understanding of these problems and supports identifying service changes. A large survey of community pharmacies demonstrates the difficulties they have when dispensing hospital prescriptions and identifies practical solutions. This programme concludes by recommending service changes to support medication management for children.

The knowledge-based perspective of risk management in healthcare organisations

The aim of this research is to investigate how risk management in a healthcare organisation can be supported by knowledge management. The subject of research is the development and management of existing logs called "risk registers", through specific risk management processes employed in a N.H.S. (Foundation) Trust in England, in the U.K. Existing literature on organisational risk management stresses the importance of knowledge for the effective implementation of risk management programmes, claiming that knowledge used to perceive risk is biased by the beliefs of individuals and groups involved in risk management and therefore is considered incomplete. Further, literature on organisational knowledge management presents several definitions and categorisations of knowledge and approaches for knowledge manipulation in the organisational context as a whole. However, there is no specific approach regarding "how to deal" with knowledge in the course of organisational risk management. The research is based on a single case study, on a N.H.S. (Foundation) Trust, is influenced by principles of interpretivism and the frame of mind of Soft Systems Methodology (S.S.M.) to investigate the management of risk registers, from the viewpoint of people involved in the situation. Data revealed that knowledge about risks and about the existing risk management policy and procedures is situated in several locations in the Trust and is neither consolidated nor present where and when required. This study proposes a framework that identifies required knowledge for each of the risk management processes and outlines methods for conversion of this knowledge, based on the SECI knowledge conversion model, and activities to facilitate knowledge conversion so that knowledge is effectively used for the development of risk registers and the monitoring of risks throughout the whole Trust under study. This study has theoretical impact in the management science literature as it addresses the issue of incomplete knowledge raised in the risk management literature using concepts of the knowledge management literature, such as the knowledge conversion model. In essence, the combination of required risk and risk management related knowledge with the required type of communication for risk management creates the proposed methods for the support of each risk management process for the risk registers. Further, the indication of the importance of knowledge in risk management and the presentation of a framework that consolidates knowledge required for the risk management processes and proposes way(s) for the communication of this knowledge within a healthcare organisation have practical impact in the management of healthcare organisations.

Speech recognition use in healthcare applications

Speech recognition technology is regarded as a key enabler for increasing the usability of applications deployed on mobile devices -- devices which are becoming increasingly prevalent in modern hospital-based healthcare. Although the use of speech recognition is not new to the hospital-based healthcare domain, its use with mobile devices has thus far been limited. This paper presents the results of a literature review we conducted in order to observe the manner in which speech recognition technology has been used in hospital-based healthcare and to gain an understanding of how this technology is being evaluated, in terms of its dependability and reliability, in healthcare settings. Our intent is that this review will help identify scope for future uses of speech recognition technologies in the healthcare domain, as well as to identify implications for the meaningful evaluation of such technologies given the specific context of use.

Photonic crystal fiber Bragg grating based sensors : opportunities for applications in healthcare

We review the state-of-the-art in photonic crystal fiber (PCF) and microstructured polymer optical fiber (mPOF) based mechanical sensing. We first introduce how the unique properties of PCF can benefit Bragg grating based temperature insensitive pressure and transverse load sensing. Then we describe how the latest developments in mPOF Bragg grating technology can enhance optical fiber pressure sensing. Finally we explain how the integration of specialty fiber sensor technology with bio-compatible polymer based micro-technology provides great opportunities for fiber sensors in the field of healthcare.