Managing Modern Healthcare Organizations Discussion Paper

Executive summary

This study examined the role of managers and leaders within healthcare organizations. The study examines the extent to which these roles are seen as legitimate, organic and essential to providing quality care and how they affect procedural knowledge-sharing and decision-making in different settings. The study investigates how managers and leaders influence their staff’s performance, encourage teamwork, access resources, co-develop processes and decision-making structures and impact learning from mistakes. It also explores how managers can become effective change agents by leveraging relationships with front-line staff through effective leadership strategies. To address this challenge, it is crucial to understand the nature of healthcare leadership/management and how clinical staff as managers and leaders may need to be more effective in implementing equitable healthcare. This study uses PESTEL analysis to delve into other contextual factors that potentially undermine equitable healthcare delivery. It evaluates how these factors, if impactful, could be mitigated by better training for clinical staff and how improving this training will help improve health outcomes for patients and providers.

It then emphasizes making recommendations for improvement and justifying the use of IS/IT solutions to overcome such socio-cultural/demographical contexts. It is a brief overview of the literature regarding sociological views on IT and its impacts on society, followed by a discussion about the changes social media brings about in everyday people’s lives, their perceptions of technology, and their fears. Finally, several recommendations will be made for future research or application only after analyzing the viewpoints discussed. To conclude, the report Provides evidence-based solutions with theory mapping to the aims and objectives based on the analysis.

Introduction

The world’s population is rapidly expanding, and medical systems are being stretched to their limits to keep pace. With the rising demand for healthcare services, congestion in emergency rooms and ambulances at hospitals is becoming an increasing challenge. Healthcare leaders have noted that ‘flow’ is of utmost importance. Flow matters as it provides a sense of security and predictability, which patients and families can perceive as a ‘sign of care.’ A series of studies have found that the flow through particular corridors is related to patient satisfaction levels, with lower flows associated with greater patient dissatisfaction. Patients have their preferences on the path to follow; if followed, they may stay caught up. The flow of patients through beds in a hospital reflects the same dynamics as traffic on the road. To reduce congestion and improve patient flow, this project will introduce data analytics solutions to identify which hospital areas are most congested. A real-time dashboard will be constructed so that managers can assess the effectiveness of their traffic management strategies in local areas. The challenge is improving patient flow through beds in a health institution. The organization’s current operation has no particular focus or layout on achieving this, but several initiatives could address this problem, management restructuring, new wings and departments.

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The healthcare setting is a very complex social environment, and it includes a lot of technological components. This makes it even more challenging for hospitals to solve the problem of flow and congestion. Managing Modern Healthcare Organizations Discussion Paper Healthcare organizations should consider that patients are free citizens and members of an economically active population who pay taxes and have certain financial obligations toward their care. Therefore, leaders need to build a special relationship with them and, at the same time, provide high-quality services. To achieve this goal, organizations should invest in innovation to better utilize resources, introduce new technologies that use community knowledge, or improve patient satisfaction.

Patients in a hospital can be regarded as patients, visitors and staff of the same facility. The flow of patients from one step to the next may affect other stakeholders like the business side and even other departments within the organization. An institution has interrelated departments, each with its purpose (Leyenaar & Ralston, 2019). However, if we consider all these departments as individuals, everyone would have their specific reason for visiting the hospital. In order to cope with this complexity, there needs to be a clear demarcation between the types of patients coming into a hospital (e.g., patient visits, emergency visits, and regular visits). For example, patient visits can be categorized based on their age group or location. These categories can then drive staffing levels, and procedures doctors and nurses use in different settings (labor & delivery wards or intensive care units).

The problem of flow and congestion arises from the fact that there are limited beds available, which means that the number of patients may exceed the capacity of existing beds. As a result, it is highly probable for one patient to be transferred to another bed to make space for other patients who come in through the door. In addition, beds can be close together due to patients’ needs and personal preferences. This creates difficulty if two or more patients simultaneously require different kinds of treatment. Since each person has different needs, there should be enough space that enables each patient to receive what they need promptly, so they do not have to compete against each other for those resources.

Both the flow of patients through beds in a hospital and the traffic on the road are characterized by congestion, where waiting times vary depending on the patient requiring care, their urgency, and the location they are at or moving to. This is often exacerbated by various factors such as communication breakdowns, misinformation, and lack of training of staff. Managers and leaders within healthcare organizations can help overcome these problems through better planning and management of their activities and by ensuring that the availability of drugs and equipment is sufficient for every patient and situation (Nkrumah & Abekah-Nkrumah, 2019). These problems can be resolved by improving systematized procedures for emergencies, eliminating bottlenecks wherever possible, and implementing good information flow between administrative staff on all levels and between operational departments.

Analysis/Recommendations

The nature of healthcare leadership/management

The nature of healthcare leadership is much the same as that of other organizations with similar environments and challenges. However, most hospitals and medical practices have one major difference in their leadership structure: they must manage traffic flow in their physical infrastructures. In this way, hospitals are much like complex road systems where congestion occurs. Indeed, if one were to study how traffic flows through different roads, using cameras and wind direction influences to provide better insight into how vehicles move down a given street, one would soon realize that certain roads only sometimes behave consistently. Daily traffic can be comprised of many cars, trucks and taxis traversing the same streets daily. It would seem logical that each car has its own unique set of rules for travel (with stops at intersections) which leads to predictable behavior from individuals within this group. However, these rules often need to be more easily understood by other drivers approaching an intersection, causing them to cancel out or modify their actions based on what is happening around them and expectancies about traffic patterns and synchronicity between cars slowing down suddenly or speeding up by unexpected variables.

Organizations lose money and experience even short-term death rates and patient satisfaction when they do not effectively manage the flow of patients through their health systems (Anders, 2021). While the hospital bed was used long ago as a unit of measure to describe waiting times between hospital admissions in the US, diagnosing this issue can be more complex. The analysis of data from a single hospital needs to be revised to understand why certain types of treatment are indispensable for patients (such as emergency surgery), and others (such as chemotherapy) have been proven to have huge impacts on outcomes.

Healthcare informatics is the application of information technologies in an organization’s healthcare system. This can include storing and processing medical data, helping clinicians with patient management tasks using information systems, and providing support to other health professionals (e.g., pharmacists). Healthcare informatics has traditionally been used within organizations as a cost saver to minimize paperwork and paperwork and improve efficiency. However, since the late 1990s, it has increasingly become more about improving the quality and safety of care for patients through aiding in decision-making and preventing medical errors that occur due to human error, staff workloads, or insufficient data. Health informatics is the application and use of information technology in healthcare, usually to enhance patient care. It is the application of computerized data analysis and information systems to monitor and improve processes or deliver services and information accurately, efficiently, and rapidly. Health informatics is an important component of healthcare delivery, but it has been slow to grow in many parts of the world due to a lack of qualified staff and funds.

Several factors need to be addressed within the healthcare system to ensure that patients are treated on time and in the optimum place of care. The first key issue, which researchers have studied extensively in recent years, is the need to manage the flow. Flow refers to the rate at which people move through the healthcare system (Kichloo & Chugh, 2020). A common assumption is that if patients have more choices about where they receive their treatments, this will result in better patient satisfaction. Unfortunately, this does not appear to be true; instead, effective flow management should focus on improving throughput speed (reducing wait times) to improve overall patient satisfaction with care received. Faster throughput can also lead to reduced costs for employers and public and private healthcare insurers as their monthly bills from all patients who received services during any given month are reduced by the same amount.

The role of clinical staff as managers and leaders

The role of clinical staff is one of the most critical aspects of the operation of any hospital. As managers, they are expected to ensure that everything runs smoothly and efficiently in order to keep up with patient demands. They do this through developing plans, monitoring current trends, identifying new opportunities and controlling costs associated with service delivery. In addition to this practical focus, healthcare staff is also expected to be leaders within their departments or areas. As such, they should take an active interest in helping improve processes or procedures. In this case, clinical leadership is focused on patient flow. Staff must view flow as a strategic problem to be solved with specific information systems, management skills and leadership competencies. In order to accomplish this, staff must start with a plan for development or improvement in clinical flow.

Clinical staff can improve traffic flow at the hospital by using appropriate information technology resources and acting as managers and leaders (Martinez & Levin, 2018). They should analyze traffic patterns, identify bottlenecks, and periodically monitor real-time data outside their department so that they can respond quickly to changing circumstances as they emerge. As leaders and managers, clinical staff plays an important role in managing the issues that affect these patients’ experiences. They should ensure every patient gets a good bed and hygiene (prevention). If too many patients wait before the normal time, they should get an early start (self-organization) on their next working day.

The flow of patients through beds in a hospital reflects the same dynamics as traffic on the road. Thus, clinical staff guides and manages individuals through the hospital system. Clinical staff members are responsible for knowing whom they care for and the circumstances requiring attention. These members should be professional, efficient, effective in providing care and responsive to patient needs. Mechatronic devices or simulators may help patients from home receive better care at home or even in emergencies (national importance in deploying robotics for emergencies) (Sokullu & Demir, 2019). Using informatics could improve data management and communication through electronic means, especially in medical records. However, it is difficult to determine which patients could benefit from automation compared to those who cannot adapt well because of disabilities or other reasons.

Pestle analysis

Political factors

Political factors can affect the delivery of equitable healthcare services through capacity constraints and lack of political will. Managing Modern Healthcare Organizations Discussion Paper The positive side of political factors is their capacity to deliver greater quality, better value, flexibility and responsiveness to citizens. A negative side of political factors is that they may hinder innovation by impeding change which can, in turn, limit healthcare delivery. The analysis identifies different types of political risk and suggests focusing on three areas that promote good governance and growth: 1) transparency, 2) accountability 3) sharing power and decision-making.

Factors like population pressure and industrialization have negatively influenced many healthcare systems globally. However, the emergence of electronic health records (EHR) and modern technology have helped reduce these factors over the last decade. EHR has contributed immensely towards improving the quality and safety of patient care. EHR tools include electronic medical record systems or other mobile devices which connect with various data systems (laboratory results, imaging reports).

Economic factors

Resource allocation instability is the dominant economic factor that can undermine healthcare service delivery. This instability is caused by changes in demand and the availability of human and physical resources necessary to ensure that healthcare services are provided at all times. The lack of predictability in future demand for healthcare services results from moving target strategies such as “healthcare spending” and “quality” metrics (Cutler & Wennberg, 2019). Another key issue impeding decision-making is a need for more clarity regarding the relative importance of different healthcare providers’ problems (e.g., social equity and medical accuracy).

For example, if patients cannot move through beds in a hospital, then there is the potential that the flow of traffic on the road could be compromised. Suppose patients cannot afford a particular procedure, which is not reflected in the cost of treatment/treatment options offered by the health system (there have been suggestions that overall healthcare spending has outstripped GDP growth in some countries). In that case, this may impede access to affordable healthcare services. Problems could also arise from changes in regulation affecting medical research or drug development which disrupts implementation.

Social factors

Social factors that can undermine equitable healthcare delivery include Population growth, an aging population and increasing health needs. Hospitals need to manage these social issues especially given their limited resources such as workforce and real estate. As a result, the healthcare system should continually strive to improve its sustainability by utilizing information technology to assist with managing patients’ records, patient care instructions and other relevant services.

Technological factors

Technological factors that can potentially undermine the delivery of equitable healthcare include 1) Healthcare Information System (HIS) as it plays a key role in informing/informing/otherwise encouraging or evaluating health professionals about patients’ conditions to make a decision based on their information; 2) Communication between the doctor and patient(s) which can be enhanced with better communication tools; 3) E-healthcare driven by an individual’s capability thus changing from gatekeeper to patients who are in charge of their health and thus expects quick, easier and accurate information from their doctors thereby leading to too much reliance on technology.

The demand for healthcare is increasing exponentially. To meet this demand effectively, hospitals must implement wider and faster communication and information systems (CIS) (Islam & Li, 2018). However, CIS implementation is constrained by a need for more human capacity and financial resources. This limits the flow of patients through beds and the capacity of each hospital to manage its patient load. The result is congestion in hospitals and reduced quality of care.

Environmental factors

Humidity, temperature, and air quality are all environmental factors that can undermine the delivery of equitable healthcare potentially. Humidity can introduce contaminants and viruses into a building, negatively impacting the environment. In addition, a lack of modern ventilation and cold temperatures can put patients at risk. While environmental factors such as climate, rate of population growth, and media reporting are important, it is estimated that the greatest threat to the delivery of equitable healthcare comes from an expected economic increase in the country’s GDP.

Legal factors

New legal developments that can undermine healthcare delivery include the EU legislative developments, universal health coverage initiatives and other health regulations. These legislative initiatives can be applied legally to big corporations. Proper legal filing and compliance with terms, conditions, and services could help minimize hospital congestion (Sunpuwan & Wertheim, 2019). The legal factors that can potentially undermine equitable healthcare delivery are as follows: (1) adverse selection, which is when individuals who value a particular health benefit more than others value it. This is usually caused by uncertainty in health care costs or the required action from an individual. (2) Moral hazard, where individuals are given access to a service that does not fit their needs.

Recommendations

For each patient, there is value to the experience, meaning doctors and nurses must move quickly and efficiently. The use of technology has been an important part of solving this problem by providing effective means for managing patient flow and improving communication between doctors, nurses and patients. However, these initiatives have encountered challenges related to socio-cultural/demographical contexts. Social aspects play a key role in determining people’s perceptions of technology and willingness to adopt new solutions to improve efficiency. Thus, it is important to utilize various IT solutions depending on the context one is dealing with: understanding your customer requirement in order.

In both situations, the problems are caused by unplanned admission, overcrowding of beds and staff resources. If we want to reduce congestion at peak hours, we need to get at least one more bed for each patient admitted at the start of a working day so they can be discharged within 24 hours. Towards this, healthcare organizations should consider investing in appropriate IT solutions (such as optimized hospital theatres) (Carnero & Gómez, 2017). These solutions can help improve efficiency and medical outcomes by enabling better communication between clinicians and other healthcare professionals, increasing monitoring and quality assurance functions and reducing waste time caused by inefficient management practices.

Also, items move at their fastest rate in both cases, with the slowest-moving items being rejected from entering the system. I recommend tracking and quantifying fluency, predicting wait times, and providing real-time feedback to physicians on patient flow and wait times. Graded pathways for patients also help increase efficiency and reduce bottlenecks, especially at peak hours when many people are waiting. Besides, the implementation of electronic tools such as electronic medical records (EMRs) makes it possible to track patient metrics like length of stay, health status and doctor visits, among others (Rexhepi & Huvila, 2018). An IT solution can help overcome challenges faced by hospitals compared to how we did it decades ago during my previous experience as a manager in the healthcare industry

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Drivers of healthcare system cost is an increasing unmet need for care, with almost half of Medicare beneficiaries reporting that they do not get all the health services they need. The lack of availability of physical therapists to patients has become a major issue in the United States; reportedly, 65-80% of Medicare survey respondents are willing to pay a copayment or deductible until their LBS/LVN visits with their primary care physician. Current federal mandates for Medicaid reimbursement for LVNs suggest that reimbursement for these visits may not be enough to make them feasible for many patients. Implementing an Electronic Health Record (EHR) and maintaining it well can help ease these issues by improving the quality and affordability of healthcare (Katurura & Cilliers, 2018). It is proposed using commercial off-the-shelf software such as Virtual Family Practice Suite (VFPS) run on a purpose-built healthcare website called Health Navigator (HNV), aggregating care management information from multiple systems and interfaces this data into one place for better decision-making based on clinical guidelines and patient preferences.

Conclusions

In conclusion, a better system needs to use an alternative intelligence approach. This alternative intelligence approach consists of artificial wisdom and analytics by modern data science, artificial intelligence, natural language processing and predictive modeling techniques. A patient flow management system is needed under the following conditions: (1) longitudinal records should be available for each patient; (2) there should be high availability of opportunities to interact with patients; (3) patients need to change their routine and remain alert during visits; finally, (4) there must be a facility where staff is informed about relevant information relating to surgeries, also known as ‘patient handbook.’ Patients are moving from their homes to their destination hospitals and clinics when they might need help to move properly through the hospitals. Overcrowded hospitals and clinics need to be differentiated by the time needed for reaching treatment procedures or surgeries, waiting time, health services availability and geographical considerations. Moreover, overcrowding affects patient satisfaction by creating long waiting times, leading to dissatisfaction amongst patients, ultimately leading them to look for alternative treatments outside their community, ultimately increasing costs on both ends.

The healthcare industry is one of the most technologically advanced industries in the world. The continuous evolution and disruption of healthcare delivery have been driven by technological development and policy changes. The increasing demand for high-quality healthcare services, at relatively low cost, in a timely manner is driving hospitals’ need for informatics solutions. Encouragingly, there has been significant progress toward realizing these requirements with the introduction of electronic patient records, intelligent medical devices and accurate diagnostics via telemedicine. However, several challenges hinder further innovations, such as poor availability of human resources, limited access to genetic information, unstable regulatory environment and lack of transparency regarding data ownership/use by stakeholders. Furthermore, there is a “warehousing problem” where patients are often moved between different parts of hospitals without having any electronic connection or continuity between these locations.”

References

Anders, R. L. (2021, October). Patient safety time for federally mandated registered nurse-to-patient ratios. In Nursing Forum (Vol. 56, No. 4, pp. 1038–1043).

Carnero, M. C., & Gómez, A. (2017). A multicriteria model for optimization of maintenance in thermal energy production systems in hospitals: A case study in a Spanish hospital. Sustainability, 9(4), 493.

Cutler, D., Skinner, J. S., Stern, A. D., & Wennberg, D. (2019). Physician beliefs and patient preferences: a new look at regional variation in health care spending. American Economic Journal: Economic Policy, 11(1), 192-221.

Islam, M. M., Poly, T. N., & Li, Y. C. J. (2018). Recent advancement of clinical information systems: Opportunities and challenges. Yearbook of medical informatics, 27(01), 083-090.

Katurura, M. C., & Cilliers, L. (2018). Electronic health record system in the public health care sector of South Africa: A systematic literature review. African journal of primary health care & family medicine, 10(1), 1-8.

Kichloo, A., Alberta, M., Dettloff, K., Wani, F., El-Amir, Z., Singh, J., … & Chugh, S. (2020). Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Family medicine and community health, 8(3).

Leyenaar, J. K., Andrews, C. B., Tyksinski, E. R., Biondi, E., Parikh, K., & Ralston, S. (2019). Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management. BMJ quality & safety, 28(3), 215-222.

Managing Modern Healthcare Organizations Discussion Paper