Notes to Customer:
I decided to use my own experience working in Healthcare and one of the main issues are the data entry of patient data. For the most, it begins in patient registration, however, if the discrepancy is not caught in the other departments as the patient goes to one unit and/or doctor to another, it can cause problems. I have uploaded the main report and this document titled Notes to Customer. The notes to customer is a breakdown of my answering each question and instruction, so that you can follow.
Thank you in advance.
Module Title: Decision Making & Problem Solving
Instructions: Answer the following questions.
Word Limit: 4,000 words
Part A 10%
Select and outline a recent major decision / problem / issue tackled by your organisation or one with which you are familiar; Part A 10 % = 400 words. This section was where you should have defined and specified the problem you would be reviewing. It basically related to the ‘ASK’ part of my model so should have covered then organisation, whose problem it was, size, scope, importance, urgency. Most students did this reasonably well, but some did not make it clear exactly what the problem was. This made it very difficult to answer other sections – as in real life, where it is hard to correctly solve a problem if it is ill-defined.
The ultimate goal of any healthcare administration is to provide the best of patient care, however, when there is an ineffective delivery of processing patient data a problem occurs to reaching the initiative. The National Health Services (NHS), a publicly funded healthcare organization that was founded fifty years ago in the UK. At the National Health Services, a problem of assuring patient data information was being transferred to the corresponding department of staff during the phases of initiation. The occurrences of imperative data not sufficiently administrated provided concern to implement a needed departmental change in the process of flow of documentation and transferring the data (Fullan 2006).
Management at National Health Services identified the problem when staff members could not verify certain criteria associated with the patient. The details ranges from particular characters’ such as, actual age, symptoms, previous physician diagnosis, and other related data. The decision by senior management was to incorporate a streamline of the initial documentation of the patient entering the facility. The streamline will as well as make a difference into the subsequent phases and/or department staff that channel the data to one staff member to another. Included in the initial implantation also created a “middle review vantage point” that in mid stream of the transferring process, the data will be checked, verified, and signed off.
The issue raised outlined the broad scope amongst the organization in adhering to policies that illustrate concrete information. The problem of mishaps from the patient registration department showed loop-holes in the delivery of data. The major decision made from senior management to be effective in executive leadership by sealing off loop-holes by connecting the necessary dots in order to sufficiently correcting the occurrences of mishaps (Norton 2004). The often instances of relaying certain data created uncertainly of professionals and members of staff to make decisions for that particular patient.
Furthermore, the documentation of patient data is the first steps in identifying and organizing the data to be sorted accordingly. The ability to manage and process information in a concise way, in order, to provide the organization’s professional staff the ability accurately interpreted the data. The conflicting transferring of the patient data that occurs due to tremendous entrants into the organization creates this faulty process flow. Therefore, a need for senior management implementing a major decision to infuse portals of “phases of review and approval” allowing the mishaps to be at minimum.
Part B 20%
Establish and analyse the approaches adopted by the organisation to tackle it; Part B 20 % = 800 words.
Here, you were to look at what the organisation did to solve the problem identified in part A. Did they use a systematic process, if so, what were its stages? Was a team approach adopted, or was it left to an individual? What analysis took place etc. This part should be setting the scene for part D, where you criticise what they did. There was some confusion here between the solutions adopted as opposed to the ‘decision making’ process used. Re-reading the question makes me see how it could be interpreted that way (although it does not fit well with part D), so I have been generous with the marks.
In the initial decision making process of the National Health Services senior management team, the mission was to demonstrate a heuristic two-phase approach implemented to address the concerns of the organization (Beauchamp & Bowie, 2004). The senior management team began coordinating several meetings with supervisors of the patient registration department to start the first phase. In the first phase, of the two-phase approach, the senior management conducted an analysis session to identify a new direction of the new process flow for review periods. After the analysis of gathering the necessary information from the patient registration supervisors; the identification of where improvements to be address thru the basis of the team members of registration department.
The second phase was the roll out of procedures that the patient registration supervisors to incorporate the new policy to team members. The team members were responsible to start the process accordingly. The senior management team instructed to the supervisors to communicate effectively to their teams the importance, the details of ways to incorporate new process flows, and the proactive tactics to improve results. The senior management team continued the channeling of direct communication of the decision making – resolution protocol with supervisors of the patient registration.
The communication model created to incorporate report findings that will collide with mandatory meetings with supervisors (Hicks, 2004). The mandatory report findings and meetings entail monthly opportunities for feedback and adjustments within the patient registration department. These opportunities of gathering to share progress of the new process flow also provided comments from the team in the patient registration department. The final analysis from the supervisors, although, would be communicated to the National Health Services senior management for consideration in relation to the new process flows.
The senior management team identified the problem when occurrences of professional staff were unable to collaborate what is applied of the conditions of the patient. The senior management team incorporated a roll out to the patient registration department to begin measures of individual team members to spot check each other. The supervisors in the patient registration conducted the roll out procedures for protocols to be enforced. The team members began to follow the measures to ensure minimum mishaps of data entry.
The senior management team instructed the supervisors to provide an update on the patient registration department performance. The report was to show an outline activity schedule that has the previous work flow process compared to the new integrated process (PMBOK, 2004). The initial findings of the report showed areas that could prevent misrepresentation of patient data. The supervisor also included a section of discovered conflicting data from original stat sheet to system reports. The results did show an improvement of the transferring of data to the company’s national IT system database.
The senior management chose to conduct review meetings with supervisors of the success or failure of the new process flow. The progress report was then communicated to the professional staff, in order, to assure the issue was being addressed to minimize their department concerns. The patient registration department initially presented an opportunity for an in-depth analysis to the reasons causing miss-representation of data. The supervisors analyzed the different instances of when the miss-representations occurred, in which, during the morning hours.
Due to the amount of new entrants coming into the National Health Services on a daily basis is massive, therefore, the supervisors in the patient registration department noted that additional review is needed within the team. The findings outlined areas that individuals of the team attempted to remedy any previous such factors led to mishap occurrences. The individuals of the team were communication of the lineage of effects to other areas of the National Health Service organization. These effects accounted for audit status reporting that accumulates to additional increases across all departments’ protocols (Institute of Health Service Management 1990: 45).
The onset of periodic review of the teams was to notate any problems with the organization’s system during each registration of a patient. The notation report intention was to document any issues arising out of the attempt to input correct data. The system report findings were communicated to senior management in order to identify and analysis any future adjustments. The team members of the registration department recorded difficult in troubleshooting when the input of data did not match up with original report.
In addition, the patient registration team stated that certain clearance fields in the system did not work properly. With the initial decision for addressing the problem, the team revealed that in pursuit of meeting the new process goals of intervals for individual team review – which the number of occurrences could occur if other departments were not challenged. The team requested feedback on the mandatory progress report of their concerns. By doing so, the patient registration team felt that it will show that the new process was being followed; however, at times the IT systems will falter to accomplish senior management goals.
Part C 10%
Establish the degree of success achieved; Part C 10% = 400 words. How successful was the adopted solution? This requires objectives to be known, so they should either be stated here or earlier, or the point made that they were not stated or unclear. Overall level of success should be identified, but also possibly the success of specific elements or aspects. Most people did OK on this section, but perhaps under-valued its importance.
The new approach by senior management achieve in the identification of the start of the problem, in which, the patient registration department begins the process for potential mishaps of occurrences. The adopted solution instructed by the National Health Services senior management team addressed the notion that review mechanism of system documentation compared to actual data from patient should be sufficiently. Furthermore, the constant follow up meetings with the supervisors of the patient registration team would continue the conversation. These conversations with status report findings would guarantee that the initial decision to redirect old department process flow will address the concerns not previously stated.
The approach is workable with good intentions starting from the patient registration department into resolving the concerns of inaccurate data by error or a system clinch. The decision that associated the particular occurrence demonstrated a willing effort to seal loop-holes that could be considered successful. The success of starting where enormous chances for instances to occur resulted in the ability for the complete organization at National Health Services to being accountable for their entries in the departments (Holliday 1992:12). In most cases, the potential for any backlash for being single out could result in patient representatives to be resentful.
The behavior analysis of the patient representative’s team members represented resentfulness from the team members in the patient representatives could have reflected not a solid effort in implementing the new process flows (Cyert and March, 1963). The senior management team at National Health Services did creatively provided a feedback opportunity on the progress. Although, the supervisors were the only ones that were allowed in the regular meetings to provide follow ups on the progress. This limited opportunity could pose a problem to hearing substantial critique of the new process. In addition, the restriction of actual team members in the patient representatives prevented the more real vantage point from their level.
Moreover, the review of the communication plan does create a one sided view of the actual progress in the pursuit of success to remedy the situation (PMBOK, 2004). The outlook for the plan to being effective is solely supported on the basis of the profound feedback from the supervisors. The critical analysis from the report findings will be able to show milestones to the senior management team to determine any adjustments are warranted. The benefits of the communication plan are having the opportunity by eliminating for potential problems.
Part D 50%
Critically appraise the approaches used, suggesting how they could have been improved, or other approaches that could have been used, and how this would have improved the degree of success achieved. Part D 50 % = 2000 words. This is clearly the most important part of the assignment, so should be given most attention. Where the approaches used the most relevant for the type of problem? Were they used correctly? What other approaches could have been used? How would their use have improved the degree of success? Most people did OK here, but there was a tendency to ‘throw evderything at it’ i.e. refer to all sorts of approaches/techniques without showing their alidity/relevance or how they would have led to a better decision. ‘How would they have improved…’ was generally poorly answered, if at all.
In the actual analysis of the decision making of the National Health Services senior management team was a good approach in the right direction, however, a more in-depth investigation should have been considered. The initial approach was only directed to the start of the potential problem by focusing solely on patient registration. At a much different vantage point, this outlook might have been considered the choice to be considered in order to being effective in relation to the corporate culture management style (Black and Champion, 1976). However, if the National Health Services senior management team allowed the additional options in their approach that focuses on a broader intellect to be included in the brainstorming; relating to the decision making process.
In the brainstorming of the decision making process, the concerns from not only the actual team members in the patient registration department but other areas could have been included. The feedback from the team members in the registration department could have provided imperative suggestions and concerns. The notation, although, from the team members relating to the IT system issues came thru in the feedback section of the report findings -stating the potential for not successfully flowing the new process with systems problems present. However, a wider scope of adjustments in making sure verification and review is made accordingly on data entered in the systems.
Where the approaches used the most relevant for the type of problem?
The approach that the National Health Services senior management team should have taken was to expand their focus from the patient registration department teams. The expansion should have been better organized and included not only the patient registration but the physicians, the nurses, the emergency department, and other departments (Bennett, 1994). The forum will have provided the senior team to hear details of the “cause and effect” from other departments as well as the opportunity to express unnoted concerns. The expansion would have been more relevant in the pursuit of effective decision making for change in the organization.
Furthermore, the overall approach by the senior management team was tailored more on centering the core adapting of implementing the change on the team members in patient registration. The faulty of this approach is not allowing the team members being a part of the interval meetings with senior management and department supervisors. The team members clearly demonstrated interests in being an integral part of the discussion. These discussion meetings would have allowed the team members their own ability to express their feedback, rather than, their supervisors relaying their concern.
Were they used correctly?
Within the feedback section of the report findings, the National Health Services senior management team was only able to take into account of one department area. The approach used by only demonstrating a tight framed vantage point on a potential large scale problem. The objective should have been more focused and more of the overall occurrences, in order to insure that the matter could be resolved. The limited approach for only the supervisors to express any concerns did warranted a full pass on the actual plan of action instructed by management.
The National Health Services organization has millions of patients coming and going on a daily basis that services the community as a whole (Holliday, 1992). Therefore, the senior management team could have used the initial plan to be a more approachable landscape in providing additional feedback from other medical units and departments would eliminate any un-identification of problems. The new process flow only addressed one section of the complete problem areas. The patient registration department was the first stage front for possibly creating the transferring of data that leads to different departments.
What other approaches could have been used?
What the senior management should have decided is to have all effected departments in the initial meeting, in order to project the streamline of each problem from different ranges of a vantage point. This method would have opened the platform to demonstrate from management to personnel that everyone thoughts, concerns, and ideas are important (Barrett & Fudge, 1981). The approach the senior management should have conducted similar process flow changes in the other department areas. The process with the addition of including other department areas would encourage participation on a positive note; instead of any uncover resentment for being heard.
Therefore, the add-on approach to the National Health Services senior management plan is to include all departments for the communication planning sessions. This is not only for the report findings sessions but for the communication planning meetings that also provides in-depth review of the new process flow as well as the administration directive. The ability to show exceptional communication is the key in order to direct any thought out plan for success. The communication planning could easily provide the detailed feedback sessions from every employee that outlines how the mishaps in one department causes a problem in another.
How would their use have improved the degree of success?
Because in order to measure success, a well thought out plan includes all integral parts that are a part of the problem in an organization. Therefore, the ability to master the measurement of potential degree of success is to be able to have a balance playing field. With so many individuals employed at National Health Services, the difficulty of concluding what is working in eliminating the issue will be a challenging obstacle. Furthermore, the ability to make good sound decisions at the senior management team will be based on limited availability of status reports.
The ultimate goal of the senior management team was to investigate and implement a solution to fix the confusion and other potential problems when data is matching with the particular patient. The mission of the senior management is to have a workable plan from the brainstorming meetings to better work out the issues. In the analysis of the report findings, the senior management could only speak on the degree of success by the patient registration department viewpoint and experiences. The history of National History Services does provide insight into the thinking and decision making going forward to resolve issues.
For instance, the senior management style attempt to reorganized process by incorporating new methods of strong communication objectives. The National History Services communication model streams from the trust board meetings – that recently have offer meetings to be open to members of staff. In addition, the senior management would administer a team briefing process similar to the concept of the trust board meetings approach; in the effort to gather all supervisors in the respective departments. These communication initiatives could pose intent to being able to address the concerns expressed by all staff members (Beauchamp&, Tom L. and Bowie, Norman E. (2004).
The National Health Services seemed at that the time to take the results from the questionnaire seriously. However, the actual decision making on the issue of effective patient registration transferring of data, in order to provide subsequent departments to execute their jobs effective, the roll out of instructions for correction felled short. The change to not follow the previous model steaming from the board of trust board meetings – that includes other individuals for a complete opportunity for a conversation of change.
Many of the noticeable difficulties related to the senior management of the National Health Services communication plan approach was not to consider the importance of having others involved in the process. The difficulty came about to use an approach that limits the playing field to investigate what is working and what is not working. In addition, the identification of actual issues within departments of the organization would identify the breakdown of communication to reaching the core objective of senior management. The departments would had the chance to show potential problems related to not catching the discrepancy due to not communication from the registration department.
The final point in regards to the importance of communication effective planning is to demonstrating a willingness to share and suggest ideas that benefits everyone involved. The skill to do so can be difficulty; however, in the long run it is utmost importance to resolve the fundamental problem before the management team. The influx of all departments does present an issue of manageability but it is critical in the decision making process (Hicks, 2004). The key is to being up to the challenge to express the terms and concrete objectives. It would be very difficult in succeeding in the decision making process without a solid and formidable communication plan.
The communication plan should not only stop from the senior management, supervisors and staff members but to include all related individuals involved to continue to have followed up meetings. The purpose of the communication plan is to offer the opportunity to outline the issues that affect new patients, current patients, and future patient registration data. The communication plan with a wider execution for the inclusion of other professionals would be a recommendation to the senior management at National Health Services. The refocused approach submitted to the senior management team will assure that future adjustments needed within the organization, as a whole, and departments.
If the communication plan was executed in away previously stated, the actual rising cost in a healthcare could be reduced more rapidly. This discovery is when the issues were brought to the senior management team and supervisors, the notations of recorded issues that relate to mishaps of data, for instances, insurance data that creates billing issues. These billing issues can transform to billing to incorrect insurance carriers that will delay in return income incoming. In addition, the income not coming in on a timely basis due to the issues from the registration stand point, can offer a dim dilemma for the department as well as the healthcare establishment.
The billing data that is entered in the organization system pose opportunities that extend concerns with potential not identifying uninsured. The uninsured patient compared to insured patients creates additional costs of rebilling initiatives. The ongoing effort to reprocessing the insurance claim forms for proper payment slows down the process. The identification of uninsured not being accountable often of times leads to an extensive costs that affects the organization bottom line (Bennett, 1994). The importance of having the other departments to outline the billing issue of an extension of initial problem for data transferring mishaps – is crucial to seeing the overview of the landscape.
The concern of the other department staff also related to the uses of medicines to be instrumental in addressing the concerns of the patient creates another chance to address the issue. The diagnosis in put based on the original input of data from registration could offer an unclear of assessment of the overall makeup of correlating the designation of medicines being used. The corresponding duty of the department staff is to interpret the data based on what is provided via internal systems as well as a personal professional assessment. The staff member’s intention is a protocol that goes with the job duties; however, the ability to achieve that objective is challenge with the onset of large number of incoming patients.
With issues raised from the core intercept of an extending execution of the initial senior management decision making of a workable plan- to open up the communication channel for a more solid plan. The effects of not doing so leads to the previous issues that stem from that decision in the organization within the National Health Services. One additional effect is the medical audit that can reveal the extent of variations between differential data recorded (Holliday 1992: 12). In the pursuit to establish a more reliable way to ensure that any mandatory known medical audit or unexpected medical audit- that discrepancies are not identified. The medical audit accounts for several exposure that can increase, therefore, the need for addressing the additional effects of the initial problem (Institute of Health Service Management 1990: 45).
The medical audit is ? critical and vital organization makeup for the complete balancing sheet that projects the senior management decision making. For instances, if the final reporting of such audits showcases “opportunities” the focus will be towards the senior management team at the National Health Services to elaborate why such matters not taken into account. These matters would need to be accountable for as well as addressed accordingly. The response by what was decided and the initial plan to only focus on one part of the problem will not suffice if in deed a medical audit states otherwise.
Part E 10%
Outline how you would ensure your suggestions in Part D would be acted upon for future decisions of this nature. Part E 10% = 400 words. This is the ‘learning’ part of the model. How could you ensure the organisation made better decisions in future? This could include communication, training, risk awareness, managing change, ‘learning organisation’ ideas, creation of guides/manuals…
The senior management team does demonstrate the needed attribute of “willing to communicate” so that if the additional suggestions made are included into the game plan as well as evidence showing that the problems are still present – the organization can continue succeed in the near future with regards to the operational mainframe. In addition, the suggestions being offered would strongly influence the organization to practice and have guidelines that means for the communication encouraging doctors and additional staff members to being apart of departmental changes for a better operational platform (Cyert & March 1963). Case in part, is that the highly likelihood that other departmental issues will still be unaddress and force a resolution that includes more departmental participations.
The bottom line is for awareness in other departments to not only notice issues and take a non-proactive approach but to voice their concerns to department heads for resolution. The new process flow, if extended to include other departments, would allow specific audits within their own department. Even with time availability at a strain due to doctors, nurses, and assistant constantly on “fast past” the National Health Services could incorporate a voluntary audit system.
The voluntary audit system would compose of individuals from charity organizations or the gathering of a team that consist of employees at National Health Services. The concept is to widen the view of the initial problem, in order to have a valid assessment of where resources to be applied. Because the potential mishaps that could reflect instances in an audit that touches on a wide range of medical services not sufficiently documented in file. Therefore, the focus of staff members to being involved and mindful on being instrumental in catching occurrences due to known notation – that the medical audit is extremely important and worthy (Institute of Health Service Management 1990).
In the final analysis, the senior management team made a major decision to address the issue steaming from patient registration by implementing a new process flow that actually did not address the complete spectrum of the issue. The scope of the problem extended to other areas and needed to be included in the brainstorming and decision making meetings (PMBOK Guide, 2004). This conclusion is verified due to the other department heads expressing concerns and complaints – steaming from the registration department that lead to the investigation, staff meetings, and the decision to implementing the new process flows. By doing so, the changes could take a moving forward momentum from registration to the corresponding departments that the data is transferred.
Furthermore, the costs of implementing the appropriate resource management that involves staff members could seem higher at first glance but the end result is well worth the implementation. The idea is to encourage senior management and department managers to commit on priorities and identify responsibility for the accountability to issues that are arise from one department to another. The senior management team at National Health Services should avoid from the habit of choosing a select few in the decision making process and instead precede with the initiative for inclusion with all warranted staff members. Therefore, the new rolled out process flow to be effective thru the long haul within the organization.
Beauchamp, Tom L. and Bowie, Norman E. (2004) Ethical Theory and Business. Pearson Prentice Hall
Cyert, R. M., and March, J. G. (1963) ‘? behavioral theory of the firm’. Engelwood Cliffs, NJ: Prentice-Hall
Fullen, Michael (2007). Leading in a Culture of Change. Jossey-Bass; Rev. Ed Edition
Holliday, I. (1992) The NHS transformed. Manchester, England: Baseline Books. 12
Institute of Health Service Management (1990) Models of clinical management. London: NHS Management Executive, 45
Norton, Scott M. (2004). Executive Leadership for Effective Administration. Allyn & Bacon
PMBOK Guide (2004) A Guide to the Project Management Body of Knowledge. Third Edition. PMI Global Standard
Barrett, S. and Fudge, C. (1981) Policy and action. London: Methuen
Bennett, R. (1994) 2nd edn. Organizational behavior. London: Pitman, 128
Black, J. ?., and Champion, D. J. (1976) Methods and issues in social research. London: Wiley, 234
Child, J. (1984) Organization: ? guide to problems and practice. London: Harper and Row
Hicks, M.J. (2004) 2nd edn. Problem Solving and Decision Making Thompson Learning
Personal Feedback on the Assignment.
“While this is quite an interesting review of a range of NHS issues, it is NOT directed at answering the questions set as the assignment. Students were asked to:
• Select ONE major decision + outline its scope etc. 10%
• Establish approaches adopted by the organisation. 20%
• Establish degree of ‘success’. 10%
• Critically appraise the approaches used, possible improvement or alternative approaches; how this would have increased ‘success’. 50%
• How to ensure your suggestions were acted upon. 10%
The mane focus should be on the PROBLEM SOLVING APPROACHES/TECHNIQUES, not so much the problem itself. Nevertheless, if the answer is refocused, much of the content may be relevant, so the low mark should not be viewed as irredeemable. “