Modern Hospitals: Complexity & Cost of High Quality Care - Essay Sample

Introduction

Hospital activities are known for their complexity, based on a chain that incorporates a multiplicity of actions defined for the generation of its products/services. The high costs of a hospital are linked to the top professional qualification required to deliver complex products/services with quality. However, it is necessary to pay attention to the cost of inputs, which are increasingly sophisticated, numerous, and with high representativeness in costs (Lee, McFadden, and Gowen III, 2018). In this regard, the effective management of hospitals depends on how good it manages its operations, logistics, and supply chain.

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This paper presents an analysis of people management in operation and supply chains at BMI The Alexandra Hospital, including lean management as two of the most critical areas in managing operations, logistics, and supply chain. Opened in 1981, The Alexandra Hospital is one of the largest private hospitals in the UK. It has gained global recognition as a provider of safe and effective outcomes across its wide range of treatments, from complex cardiac cases to minor surgery.

Managing People at The Alexandra Hospital

The Alexandra Hospital is one of 51 hospitals managed by BMI Healthcare, the leading private healthcare group operating in the UK and with its headquarters in London. The hospital seeks to offer high quality in the health area, with unique and humane treatment that sets it apart, in addition to being economically accessible to the Cheshire and Manchester community in general. The analysis of people management at the hospital will identify external sources of recruitment, discuss the effectiveness of the hiring process, and make new proposals according to the situation of the case. Among the aspects that will be taken into consideration will include the flow of human resources and the integration process in the health institutions, the recruitment and selection process: techniques and selection tools, induction and training programs, and the ethics committee involvement in the selection of personnel.

The human resources are a critical aspect of operations management in the health sector, with knowledge and competence required for the effective performance of various tasks within the hospital settings (Cogin et al. 2016; McDermott et al. 2019). The selection of The Alexandra hospital's health personnel is based on two items: behavior and professional practice according to the information that may be collected from other professionals and from the institutions in which they performed. Likewise, raising the awareness of all staff to treat the patient ethically and with quality is one of its fundamental pillars. An Ethics Committee established in the hospital meets once a month throughout the year with the purpose, in addition to ensuring the ethical performance of all staff with patients, to raise awareness with workshops or talks to all the staff.

Personnel Selection Criteria

In the hospital meetings, the Medical Directorate is institutionalised to discuss institutional matters to which they attend: the Executive Director, the General Coordinator (who acts as operations manager), the General Manager, the Medical Director, the Director of Scientific Research, and the President of the Medical Corps. The management committee reviews the incorporation of the doctors to the hospital, including the hiring of non-medical personnel that the institution requires.

The system of the admission of doctors at the hospital has changed over the last 15 years. Initially, the system contemplated the proposal of the new doctor was generated by the doctors from the different services of the institution, who sent a letter of introduction, and the documented Curriculum Vitae (CV) was attached to be evaluated at the management meeting. That is to say, the doctors of service generated the request for the incorporation of a doctor recommended by them, this being understood as the relationship of friendship or extra-institutional labor closeness that the medical applicant should have with any of them. At the management meeting, it was approved for the evaluation to continue in the following instances: the doctor was undergoing a psychological profile examination; the results and documentation were sent to the medical staff so that the Ethics Committee could rate it and verify if there was any problem with the incorporation of the doctor. The approval or disapproval of the Medical Corps was issued through its ethics committee. This decision was referred to at the Medical Directorate meeting, and the final incorporation was made or not.

This system brought problems because the services became power groups, necessitating modifications in the following aspects: To qualify as a new doctor, one needs to be presented by one or two doctors from the institution, whether or not they are from the same service or the same specialty before the medical director and the corresponding administrative route is carried out. Also, the doctor's requirement is modified: fundamentally, it is the demand on which the requirement is based. The CV is evaluated, and the documentation is brought to the Director meeting where a presentation is always made.

The evaluation is approved by the steering committee, which verifies the CV, recertification, and certification of the CMP to practice. It evaluates two aspects of the proposed professional: behavior and professional practice according to the information that can be collected from other professionals and from the institutions in which they worked. If an ethical problem is found, it is evaluated by the ethics committee. If there is no problem, the document is returned with the signature of the president of the medical body to the meeting of the board of directors for its definitive incorporation.

The selection of non-medical personnel occurs when a vacancy appears for any reason, whether it is health or cessation of functions, license, or resignation. For nursing personnel, nursing technician, and nursing assistant, the selection is by recommendation, and the priority is given by the staff of the same service for people known to them. Thus the general hospital coordinator receives the recommended documents: CV and cover letter. Generally, the aspects to consider for selection are the technical preparation concerning the service to which you are applying and the history of good relationship that they must have with the patients. If its incorporation is approved in this instance, it is only reported at the steering committee meeting. In general, there is a trial period in the institution for these personnels, which is no more than one month, in which skills and abilities for service are evaluated, as well as the quality and friendly relationship that they must have with patients.

Awareness of All Staff for the Good Treatment of the Patient With Ethics and Quality

The hospital has an Ethics Committee, with the functions of ensuring the ethical performance of all staff with patients, solving personal problems between doctors and participation in the development of clinical research; It also coordinates with staff awareness services with workshops or talks on some more relevant topics; From time to time the "Valuation Assessment" talk is made (at least twice a year) working with all the staff; in addition to socializing the concepts of "Quality in Care."

Training of Non-Medical Personnel

Included in the framework of the Education Program, these trainings have as main objectives: have the necessary knowledge to be able to perform the tasks assigned, differentiating each service, and keep trained and updated in auxiliary diagnostic and treatment procedures. Since effective functioning depends on teamwork and coordination and collaboration between teams, trainings are designed in which personnel from different services participate, taking into account areas where there were interpersonal problems between work teams. In addition to improving performance, the courses are the indirect instrument to identify critical points for better teamwork.

People management at the hospital constitutes a competency-based recruitment and selection process with continuous training to facilitate effective functioning. As a proposal, it is recommended to have more scheduled meetings for continuous improvement of systems in patientcare by multidisciplinary teams. Also, new methods for patient care should be implemented to improve service with personalised attention through necessary elements for the knowledge of the institution and its position (manuals, instructions, organisation chart, etc.)

Lean Management at The Alexandra Hospital

The hospital supply chain represents 25% to 40% of the financial resources of hospitals (Abdulsalam and Schneller, 2019; Almutairi, Salonitis, and Al-Ashaab, 2019). The supply chain value chain is inserted in all processes of demand forecasting, purchasing, inventory management, storage costs, transportation, distribution, term, quality, quantity, information flow, materials, and processes (ARONSSON et al., 2011). Thus, the lack and delay in any of the processes can generate negative consequences regarding the end function of a sector, a fact that is enhanced if the availability of the operation is considered 24 hours a day. Hospitals are concerned about their costs, which are in a spiral of growth (Zhu, Johnson, and Sarkis, 2018), with the adoption of tools that make hospital services more efficient. The use of tools such as lean healthcare is an option, considering that it is a simple and efficient methodology (Anuar, Saad, and Yusoff, 2018). It aims to create value and eliminate waste, to satisfy the client, who in hospitals is the patient.

Lean healthcare (LH) is based on the lean methodology, which began its journey in the automotive industry and later extended to other industries, having reached the health area in the mid-nineties, with implementation in British and American hospitals. Lean healthcare proposes tools such as the value flow map, Kanban, and 5S, which promote viable solutions to reduce costs and increase efficiency in healthcare services (Hussain and Malik, 2016).

Implementing Lean Healthcare at the Hospital

Currently, the lean culture is developed by hospital employees under the supervision of quality management. The implementation of Lean Healthcare is linked to strategic planning, with lean goals compatible with strategic ones. At the beginning of the implementation of the LH, a Balanced Scorecard (BSC) was developed and focused on outpatient and specialised medical services, chemotherapy, radiotherapy, and tests. The objectives of the BSC were related to Lean from four perspectives: customers, internal processes, knowledge and learning, and financial.

Lean Healthcare Implementation...