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Relative to the current issues in the healthcare sector regarding the need to improve clinical quality and the safety of patient care, there has been an increase in the use of different methodologies for the promotion and evaluation of performance practices and various quality metrics across different healthcare organizations. These improvements have changed the work environment across different departments including the emergency rooms. For instance, to reduce waiting times in the emergency rooms, experts propose the use of various QI methodologies such as Customer-Inspired Quality, Plan-Do-Study-Act (PDSA), and the LEAN methodologies.
The Customer-Inspired Quality methodology is designed for use in any organization planning to improve performance relative to value delivery to customers. Taking into account that two people involved in a particular process can define it in different ways, this methodology seeks to eliminate the divergence of view-points relative to delivery of services by placing the customers perspective at the center of operations (Shaw Resources, 2011, para. 1-3). Here, the customers view-point provides the guidelines and objectives upon which the organization bases the development of QI processes. Accordingly, the customer-inspired methodology promotes identification, assessment, and improvement of key processes as seen from the customers perspective. This entails deployment of process-change teams whose purpose is to document, evaluate, and analyze the key process components that influence quality as perceived by the primary customers. Subsequently, action items that can give rise to measurable improvement are put in place through the use of the best practices in the industry (Shaw Resources, 2011, para. 4-7).
As opposed to the Customer-Inspired methodology, the PDSA methodology uses a trial-and-learning approach to quality improvement in which a hypothetical solution is tested in a sequence of 4-steps (small scale cycles) before instituting any changes to a process (Prathibha, Reller, & Resar, 2007, p. 736). The use of the repetitive steps eventually leads to an exponential improvement of a given QI process. Basically, the Plan step entails generating ideas for improvement and organizing teams to oversee the testing process. The Do step involves implementation of the action plan and documentation of results or deviations. The Study step is where the results are studied and changes to the plan are made if necessary. Finally, in the Act step, the changes, lessons learned, and decisions from the study phase are incorporated into the process to allow for the continuation of the process by repeating the steps described above (Prathibha, Reller, & Resar, 2007, p. 737).
On the other hand, the LEAN methodology is sometimes regarded to as an umbrella methodology because it incorporates the ideals of the aforementioned methodologies to maximize customer value and minimize resource wastage across the whole organization. This entails understanding the customer values and focusing key processes toward continuously improving the values with the use of fewer resources (Dickson et al., 2009, p. 1). Accordingly, LEAN organizations ensure that the flow of services to customers through value streams occurs horizontally across departments, technologies, and organizational assets. Therefore, the ultimate goal for this methodology is to eliminate waste across the whole value streams as opposed to isolated points. This approach ensures that less time, capital, human resources, and efforts are allocated to service delivery at favorable costs while maintaining the desired quality. With this methodology firmly in place, healthcare organizations can respond to the ever-changing customer needs with low costs, high clinical quality, and fast throughput time.
Overall, having looked at the three methodologies proposed for QI relative to reducing waiting time in the emergency rooms, the LEAN methodology is the most appropriate method for reduction of waiting time because the principles proposed in the method can be easily adapted to the healthcare organizations culture of service delivery. By adapting the LEAN principles to the local culture in a healthcare organization, chances are high that behavioral changes can be achieved with minimum resistance, and thus, sustainable improvement of various quality metrics is guaranteed. Conversely, the methodology has been tested in various emergency departments relative to improvement of various quality metrics including the length of stay, patient satisfaction, and patient flow, and the results obtained are promising (Dickson et al., 2009. pp. 1-7).
References
Dickson, E.W., Anguelov, Z. Vetterick, D., Eller, A., & Singh, S. (2009). Use of LEAN in the emergency department: A case series of 4 hospitals. Annals of Emergency Medicine, xx(x), 1-7.
Prathibha, V., Reller, M.K., & Resar, R.K. (2007). Basics of quality improvement in health care. Mayo Clinic Proceedings, 82(6), 735-739.
Shaw Resources. (2011). Customer-Inspired methodology (Customer-Inspired Quality). Shaw Resources. Web.
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