Selection of Patient Safety Strategy Research Paper

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Strategy

Patient Care and Hospital Management Systems

Question No.1

Question No.

Question No.

The given case study entails the difficulties faced by Langely Mason Health which is a major health services provider in the given district. The management of LMH has decided to upgrade its health services standards in the best interest of patient care. The whole process of upgrading involves extending hospital's facility as well automating the functions of the hospital's departments with the help of integrated system. For this purpose, lengthy planning, asset acquisition, fund raising activities and other activities are performed. The overall upgrading left the hospital management with limited budget for regular operations.

For the purpose of automating the hospital functions, EMR system is purchased in the year 2006. This organization-wide system was expected to become functional and stabilized in the first phase of implementation and the subsequent implementation were dependent on its success. Due to various factors, EMR took longer time than expected, hence delaying the implementations of other automated domains where the other departments were running on the older but stabilized and functional technologies (Wager et al. 2009).

For the better provision of patient service delivery, the nursing staff and pharmacy department suggested implementation of Smart IV system which would have automated these respective functions. This purchase was suggested to be made out of annual budget allocated for LMH's regular operations. The CIO was of the opinion that a suite of softwares which are compatible to each other should be purchased with thorough planning and cost-justification without affecting overall hospital operations. Whereas the director of pharmacy believes that the concerns are valid however instead of performing lengthy planning and purchases of the suite, it is better to perform isolated purchase of this particular software as it is capable of providing speedy and efficient solution (Wager et al. 2009)

There is a conflict between the members of the management. Also the hospital has invested heavily in the earlier hospital management system. Thirdly, the given purchase supports the interest of departments rather than the organization and has a potential of affecting hospital's overall procedures.

Question No.1

Describe the current situation as you see it. What are the major issues in this case?

Considering the situation of LMH, it is going through a typical problematic process of automated system implementation. It is rather common for organizations undergoing automation to face issues while performing implementation. Some of the common issues are budget constraints, organization wise or departmental resistance, customization of the technology in hand as organization's requirement, cost-justification and time constraints. It is usually the cost-benefit analysis and organizational support which play a major and decisive role in evaluating the success of the system implemented in an organization.

In the given scenario, the subject matter revolves around a hospital management system. It is important to note that many hospitals and health service providers consider these softwares integral for providing quality service. The first and foremost issue faced by LMH is the cost justification of Enterprise Wise EMR system which has been implemented in the organization. The module has been implemented but still hasn't become fully functional and justified its cost which constitutes of the major budget allocated for automation. This constitutes the phase one of hospital automation but tedious customization as per hospital requirement is a time-consuming process which is still on-going. Therefore, further modular implementation cannot be initiated (Drazen et al. 1980)

The second challenge faced by the management of LMH is the implementation of smart IV pumps as suggested by the nursing staff and pharmacy. It is important to note that LMH has made heavy investments on an EMR system which was supposed to provide organization wise automation but still hasn't met the standards. Whereas in the pursuit of providing exceptional patient care, the staff of LMH believes that an isolated domain i.e. Smart IV Pumps, would answer the problems related to the particular area of patient care. Firstly, there are budgetary constraints available as such purchase would consume more than half of annual patient care budget. Secondly, there is a probability that if not accepted, the staff might get reluctant to use the actual EMR system putting the success of whole automation process in jeopardy (Farlee, 1981).

Lastly, there is a state of conflict between the two members of hospital management i.e. The CIO and Head of Pharmacy, regarding strategy adopted for automation. There is also a concern that Smart IV Pumps, if implanted, would be difficult to integrate with the other automated domains.

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Lastly, budget constraints as the decisive factor for any decision. And at the given point, there is a possibility that such purchase of isolated domains would leave insufficient budget for hospitals actual operations.

Question No. 2

Marilyn Moore, CIO and Paul Robinson, Head of Pharmacy, have different views of how LMH should proceed. What are the pros and cons of their respective approaches? Which appropriate if either seems like an appropriate course of action to you? Explain your rationale.

Marilyn and Paul are driven by their own departmental needs. Where Marilyn is expected to provide a solution which is suitable for the whole organization from functionality and cost perspective, Robinson believes that meeting his department's and needs of nursing staff are necessary for the overall organizational performance.

As far as Marilyn's solution is concerned, it provides an extensive automation which can be carried out organization wise, can be cost-verified and justified, answers the domain integration concerns and is based on giving enough time for the earlier implantation to be stabilized and become fully functional, hence becoming cost-justified and capable of producing revenues which would be necessary for the further implementation. Also, it emphasizes on a long-term approach necessary for patient's welfare. The negative aspects of this approach are the lengthy time period which is required for planning, purchase and implementation. Also, if opted, the organizational acceptance if one of the major concerns that this comprehensive implementation may have to face (Herbst et al. 1981)

On the other hand, Robinson's approach is well-accepted and appreciated by the pharmacy and nursing staff and has their complete support. Furthermore, it provides an immediate solution which would have significant positive effects on overall patient care which is the prime concern and responsibility of LMH. It provides immediate results and justifies the whole rationale of patient care. However, this approach has various cons as well (Hendrickson, & Kover, 1990). Firstly, it consumes the major budget which is specifically allocated for the necessary hospital operations and patient care, thus endangering the going-concern of overall hospital operations. Secondly, the implementation of Smart IV Pumps justifies the requirements of Pharmacy and nursing staff only which are rather isolated areas of automation. Integration of this system to the main EMR system, in the later phase, may make the whole automation process even more laborious and time consuming. Thirdly, it has a tendency of giving rise to a culture where department's needs become prior to organization's vision.

Considering the pros and cons offered by these two approaches, the approach suggested by the CIO seems more appropriate. The basic rationale behind this judgment is the long-term and stabilized solution that this approach offers. It is coherent with the organizational perspective, is cost-justified and provides a permanent solution required for patient's care. Besides, pharmacy and nursing domains are already performing well on the older technologies.

Question No. 3

Assume that you are to mediate the discussion on this issue, and the participants are to come to consensus on how best to proceed. What would you do?

Considering the given scenario, it is important that both the parties are made to have a several rounds of discussion. In such as state, the mediator is expected to be well-aware of the situation in hand and pros and cons offered y both the approaches. For mediation, it is important that the cost-analysis of both the solutions is also maintained.

In the given scenario, the mediator is not expected to have loyalty for one party one. Rather, mediation requires presenting a solution which is equally acceptable to the parties involved in discussion. he/she should perform financial and statistical analysis which involves calculating the cost-implications involved and projecting the outcomes of both the solutions. Time constraints and organization-wise outcomes instead of departmental approach should be made the core of discussion.

Also, it is the responsibility of the mediator to turn the sessions of discussions into long-term planning. This means that parties should be made to discuss the long-term implications of their respective approaches instead of providing short-term solutions to the pressing issues. Such approach is the basic essence of strategic management that LMH is currently going through. Secondly, in the given discussion, the possible reasons for the difficulties faced by EMR system should also be discussed in order to evaluate the reasons behind the overall delay faced by the whole stabilization process.

Lastly, the mediator would be expected to make both the parties be well-aware of the pros and cons offered by both.....

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