Case Study: Total Quality Management

 

 

Case Study: Total Quality Management: The Patient Process at East-Southern Kentucky Community College Medical Clinic
Dr. William Jones has been the director of the health center clinic at East-Southern Kentucky Community College (ESKCC) for about six months. Having been a part of a much larger medical center in the past, he has seen the benefits of total quality management (TQM) and feels that it would help improve the operations at the ESKCC clinic. He has made some positive changes to the staffing of the clinic, but now feels that he must tackle making improvements to its operations. Consequently, he has created a TQM team (of which you are a part) and has made certain that they have received the necessary training to start examining the various processes within the health center’s operations. The ambulatory health service department of the ESKCC health center clinic has received increased complaints from the ESKCC student body and staff concerning the services it offers in its walk-in urgent care clinic. Dr. Jones feels that this center would be an excellent starting point for the TQM team.

The Data
The team is presented with the following data regarding student/staff complaints: Patient Complaint DataMonthComplaint Type 1Complaint Type 2Complaint Type 3Complaint Type 4Complaint Type 5Complaint Type 6Total VisitsSeptember3141174813115841October21278411152971November1148112428311175December7144121738121042January153012141741671February21626128511631March27951623641512April4734313153781May421217182473Total248402872091543119097 Complaint Type DescriptionsComplaint TypeComplaint Description1The quality of service received.2Waiting time was too long.3Follow-up care was not available.4Clinic was hard to find in the health center.5The medical care/treatment took too long.6The medical center could not find the individual’s medical records.

The Patient Review Process
The process for a patient (either a student or a staff member) coming in because of a problem is as follows:

When a patient arrives at the clinic, the patient first sees the receptionist, who checks to see if the patient was seen before. If so, the receptionist pulls the medical record from the file. If the patient is new, the receptionist has the patient complete the necessary forms and creates a medical record.
Patients are seen by the physician in the order they arrive. If one of the two examination rooms is empty, the nurse escorts the patient to the examination room and records the patient’s medical complaint. If no examination rooms are available, the nurse escorts the patient to a waiting area until an examination room is available.
When the patient is in the examination room, the nurse performs routine tests. The nurse then writes the complaint and findings on a medical examination form, a form that will be subsequently filed with the patient’s medical record.
The physician examines the patient and orders medical tests, if necessary. A diagnosis and treatment plan is presented to the patient by the physician; a written copy of this plan and any other appropriate instructions are written on the medical examination form.
When the physician releases the patient, the patient returns to the receptionist, who prepares a bill. If the patient has health insurance, the bill is sent to the health insurance carrier.
The patient leaves after either paying the bill (by cash, check, or credit card) or signing the forms to authorize payment by his or her health insurance company. If the health insurance company refuses to pay or partially pays the bill, the receptionist bills the patient by mail. Any patient with an unpaid bill or bad credit history is refused subsequent treatment until the old bill is paid.
Instructions
As a member of the ESKCC TQM team, you are asked to put together a report that recommends improvements to the overall patient process. Create a 4–6 page report in a Word document (copy and paste any charts created in Excel) addressing the following tasks:

Construct a Pareto Chart for the data regarding complaints to the health center that is presented in Table 1. Describe two conclusions from examining this data.
Develop a control chart for the waiting time complaint (complaint #2). Explain how the control chart is developed and show the calculation process.
Illustrate the causes for Complaint #2 in a fishbone diagram. (Note: refer to the readings for examples.)
Develop a flow chart for the process that the clinic uses for a patient who comes into the ambulatory center. Draw two conclusions from examining the flow chart regarding either or both of the following:
How the process affects the patient.
Potential sources of unnecessary complexity.
Determine three improvements to streamline the patient process based on the insights that you gain from examining the process flow chart as well as your understanding of total quality management concepts from your course readings.

 

 

 

Sample Solution

System DEVELOPMENT OF NON-CORE BUSINESS The examination is expected to cover some significant issues concerning non-center resources, their administration and system improvement. The target of this venture is to depict their job in the business achievement and explore the effect of non-center resources money related pointers on monetary consequences of the organization. Concentrates like coming up next are proposed to be effectively adjusted to functional purposes and yield increasingly clear aftereffects of looking through interrelations between these issues. The field of information about non-center resources has created over the previous decades, however this issue still anticipates itemized investigation, so further research around there of studies is critically required. Presentation Foundation. Today, in the data age, numerous terms, at first utilized uniquely by barely engaged masters, have turned out to be broadly utilized and are seen as independent and reasonable things that don’t require clarification. Non-center resource is one of these financial terms. A serious number of specialists register widening of the job of non-center business in an organization’s prosperity (Kondaurov, 2012; Tiwari et al., 2015). In any case, the response to the subject of what is implied by this term stays obscure. All things considered, by opening any wellspring of data, an individual can discover a translation of this term, and not one. The issue is every one of the definitions will depict the wonder for the most part. Regardless of the way that the discussion over this issue appears to pick up ubiquity, numerous inquiries still need further examination. It is important to think about a model from the life of the organization to give further comprehension of this issue. Generally expressed, we have to research what non-center resources are significant for and what job do they play in the organization’s prosperity. Issue Statement. The significance of the arrangement of models of the board and improvement of non-center resources is to a great extent because of the quest for satisfactory arrangements identified with the administration of this kind of advantages. In this way, we can infer that the subject of the board and advancement of non-center resources is significant for us the same number of issues remain inadequately comprehended. A definitive objective of this will be to endeavor to investigate the ways to deal with the issue of procedure advancement of non-center resources that different agents have upheld and test the accompanying theory: The nearness of a non-center business at the Lukoil-Uralnefteprodukt LLC service stations, for example, a bistro, a vehicle wash, a staple shop, has a positive connection with their money related outcomes and friends’ prosperity. Delimitations of the Study. The present investigation will be restricted in the measure of data to be gathered. There is various solid confinements to be considered. Most importantly, accessibility and precision of data got ought to be referenced, as only one out of every odd business visionary is prepared to give significant information all alone business. Another imperative is the constrained extent of respondents, since it won’t be conceivable to draw in the whole Lukoil initiative, yet just the chiefs of Lukoil-Uralnefteprodukt LLC. In addition, the exploration is constrained to business territory, one city and one organization, so we can’t make an induction for a substantial viable ramifications of the discoveries. Proficient Significance. The reason for my work is to look at and thusly to decide the effect of non-center resources on the center business all the more absolutely and give important bits of knowledge into their job in the association. It will be pertinent to recognize a lot of methods utilized to recognize monetarily invaluable non-center resources from non-beneficial ones. Having characterized the sort of non-center resource, directors will have the option to take activities to create non-center resources with further benefit from them. In addition, the investigation will give a case of either negative or positive effect of non-center resources on the center business. Writing audit The present writing audit will be created through methodical method for contemplating the current writing regarding the matter. A lot of work has been as of now done to explore the pith of non-center resources and methodology advancement independently, yet we will likely connection these examinations. Late examinations unequivocally bolster the possibility of the conspicuous job of non-center resources in organization’s prosperity and endorse the significance if their vital improvement. Be that as it may, learning needs further advancement. Drawing up an improvement technique is the establishment for the effective activity of any endeavor. Right now, all long haul objectives that are dependent upon the administration of business people are generally ascribed to vital administration. At the end of the day, the development of a procedure in an endeavor is a piece of vital administration, without which organization can’t effectively contend in the market (Kyshtymova, Medic, 2017, p. 83). Above all else, we see it important to think about a few ways to deal with characterizing a procedure. “Strategy” has changed its importance over a significant stretch of time. It originates from the Greek word “strategos” which signifies “armed force general” when actually interpreted. At first, it was utilized solely in military issues, yet after some time, it started to be utilized by different associations, utilizing it in the feeling of accomplishing their own financial advantages and battling different associations for restricted assets and clients (Fairbanks, Buchko, 2018, p. 6). The term business technique was well known at the turn of the 80s. It is important that frequently it is seen inaccurately. Regardless of whether the assignment to build up a business technique is given to individuals considered to be proficient around there, advancement process frequently doesn’t continue appropriately because of a misconception of this term. In this way, Craig S. Fleisher gives the accompanying definition to the term: business system, as he would like to think, is an idea that depicts how an association will contend and connect itself with different partners (Fleisher, 2018, p.2). As indicated by Alfred Chandler, the procedure is assurance of the fundamental long haul objectives and targets of the venture and the endorsement of the strategy, just as the portion of assets important to accomplish these objectives. Chandler accepts that the idea of methodology should essentially incorporate three parts (Chandler, 1962, p. 68): Long haul objectives and targets of the association, for example deciding the heading the association needs to pursue; Line of exertion, for example activities planned for accomplishing recently set objectives; Allotment of assets, which are isolated into: budgetary assets (cash required for interests in capital and current resources), HR (workers of the association), material assets (land, structures, premises, hardware, inventories) and scholarly assets (information bases, grouped materials, know-how, substantial licenses and licenses, logos, and so on.). The significance of non-center resources is a broadly acknowledged point of view, however a portion of the examiners hold inverse assessments. Robert Jonas states that system of business advancement has nothing to do with objectives and targets (Jonas, 2000, p. 141). The scientist accepts that it decides the way toward accomplishing these outcomes. As it were, a business technique is a sort of bit by bit plan including a progression of activities that enable the organization to achieve its crucial. This arrangement needs ordinary correction, checking and the executives just as some other business procedure. S.A. Zahra and J. G. Covin have a comparable conclusion and keep up that business procedure characterizes a long haul activity plan that an organization can achieve so as to accomplish its objectives (Zahra, Covin, 1993, p. 454).

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