Operations management | My Assignment Tutor

Managing Quality and Managing People at Queen Mary’s Hospital RoehamptonOperations management is the set of activities that turns an organisation’s materials and labours intogoods and services (Kenton, 2019). It is just as important to firms as finance and marketing as it affectscompanies’ ability to achieve productivity and efficiency within their operations (Heizer et al., 2016).With respect to this, this essay will draw on the key operations, logistics, and supply chainmanagement issues confronted by the operations manager at Queen Mary’s Hospital (QMH). Foundedin 1915, QMH is a community hospital based in the Wandsworth borough of London offering over 60medical services for adults, children, and young people (St George’s University Hospitals, no date). Itis the subject of this essay because it has a reputation as a world leader in amputee rehabilitationservices and is a national leader in research and development of rehabilitation techniques (St George’sUniversity Hospitals, no date).The main areas that will be explored are ‘Managing Quality’ and ‘Managing People’ in operations. Thepaper will begin by examining the current situation at the healthcare firm and then go on to explainwhy services need improvement by emphasising the consequences of the problems if not solved intime. Further, solutions and recommendations will be provided in the context of quality and peoplemanagement theories and techniques that will not only increase the hospital’s overall performancemetrics but will also improve patient’s perceptions of the hospital’s services. The approaches usedinclude Total Quality Management (TQM) and tools (benchmarking, just-in-time (JIT), continuousimprovement, and employee empowerment) as well as Herzberg’s theory of motivators. Finally, adiscussion of Triple Bottom Line (TBL) will be included in the essay and linked throughout whererelevant.In early 2018, the Queen Mary’s Hospital went through an unannounced observation of their routineactivities by the Care Quality Commission (CQC) of England. As a result, the Commission reported theoverall quality of services at the hospital below the required standards (CQC, 2018). Out of the fivemain inspection areas: safety, effectiveness, care, responsiveness, and well-led, the firm was onlyperforming well in the ‘rate of care’ domain, the rest were marked as ‘Requires Improvement’(CQC,2018). Taking ‘safety’ as an example, the reason it was underrated is that the findings suggestedthat there was inconsistent compliance by staff to infection prevention and control best practices.Sometimes some of the staff did not even wash their hands between patients to mitigate risks to them(CQC,2018). Areas such as this can be improved successfully through the advancement of operationsmanagement at QMH.The cost of poor service quality in the healthcare industry is higher than any other industry – due inpart to the patients’ lives being at stake. If patients experience negligence in receiving quality service,besides their dissatisfaction, it could seriously harm their wellbeing. Not only this but it would also actas a barrier to reducing preventable mortality rates around the world (Harvard Global Health Institute,no date). For the hospital, it would mean lost business and a damaged reputation. That is why thehospital should avert the possibility of such a scenario from happening. One way of doing this wouldbe through the implementation of Total Quality Management (TQM) approach in the organisation’soverall operations. It is an essential management technique that requires all aspects of an organisationto focus on integrating the ‘quality-discipline’ into everything that the company does (Westcott, 2013).At the outset, one of the essential TQM tools that QMH can use to improve on their quality of servicesis benchmarking. The tool helps organisations to measure their performance metrics and processesagainst those of other firms that are considered to be the strongest or the best in the industry (Ogidiand Odiba, 2014). In other words, “the process involves looking at standards, best practices, andevidence-based practices and then identifying potential areas of improvement” (West, no date). Forinstance, Queen Mary’s Hospital could look up to Arnold Palmer Hospital (APH) of USA as a successfulexample in applying the culture of quality in their operations; and adopt some of their techniques inimproving its performance. One of the methods that APH use include customer surveys that askpatients and their families to judge the quality of care provided to them (Heizer et al., 2016). Thequestionnaire results then help managers at APH to gain accurate information about how theirpatients perceive them and signpost areas that require attention (Heizer et al., 2016). Having said that,in today’s businesses, customers have a more profound appreciation for brands that take theirfeedback on-board and adhere to them for improvement (Forbes, 2011). Therefore, carrying out dailysurveys like APH could be an effective strategy for QMH in identifying its strengths and weaknessesand discovering which aspects of its operations need prioritising.Since QMH is struggling with providing timely treatments for its patients who some of them have beenwaiting for over 18 and up to 52 weeks for medical care (St George’s University Hospitals, 2019),applying the just-in-time (JIT) concept could be improvising in this aspect. Just-in-time is a methodthat enables organisations to produce only “what is needed, when it is needed, and in the amountneeded” (Toyota, 2017). The principle is to remove any activity that is not value adding to anorganisation’s end products or services and boost efficiency in operations (Becker’s Hospital Review,2009). For instance, according to the Institute for Healthcare Improvement (no date), a commonapproach that healthcare firms use for completing daily tasks is to put some aside and process themlater in a batch. One negative outcome of such an approach is the increased workload on staff andthus the increased net amount of time to process them. Therefore, QMH should attempt to performeach day’s work on the same day (just-in-time processing) instead of leaving it for later. The systemwould not only ensure a continuous flow of the tasks but could also reduce from referral to treatment(RTT) waiting times. That being said, transitioning from batching to real-time processing may not beeasy for employees as it would require to perform all tasks immediately. Hence, it is the operationmanager’s responsibility at QMH to find out the right balance between immediately addressing tasksversus leaving some for later.Another essential component of JIT is to reduce costs and increase profitability (Li, 2015). It is reportedthat the St George’s University Hospitals NHS Trust that runs the QMH has been struggling in reducingits financial deficit (St George’s University Hospitals, 2019). This means the Trust has been spendingmore than it is making. Implementing the JIT concept could ease this burden by reducing the coststied up in inventory and storage. It would encourage the firm to keep the stock levels minimal andrequest for replenishment only when needed. Logistically, less inventory means more space, betterorganisation of stock, and improved cash flow within the organisation (MazikGlobal, 2015). Hence,implementing JIT at QMH would not only improve customer services (Gupta, 2012:20) but it wouldalso improve responsiveness. In other words, as employees would be more focused on primary tasksthan stocking medicine or equipment, they would have more time to respond to patients’ needs.That being said, generating excellent financial outcomes should not be the only objective oforganisations, and in particular the healthcare bodies. It is imperative to consider sustainability in itstrue essence as well. According to Elkington (1998, cited in Yu et al., 2014:684), sustainabilityencompasses the economic, social, and environmental dimensions that are commonly referred as thetriple bottom line (TBL) framework. Every organisation should integrate these elements into theircorporate accounting structures rather than cost alone. However, healthcare firms should adhere tothem the most as their responsibilities go beyond other sectors due in part to having a more significantimpact on patients’ wellbeing. Altogether, by paying attention to these TBLs, hospitals would be ableto achieve these triple aims: patient care (social), reduced energy usage (ecological), and reducedexpenditure costs (economic).Furthermore, the implementation of Kaizen, also called the continuous improvement concept, can befundamental in assuring service quality and sustainability in QMH. It is a TQM concept that is basedon the principle that small, incremental changes can result in substantial improvements over time(Slack and Brandon-Jonas, 2019). The focus is that managements should not wait for problems tooccur to take actions but instead seek for constant improvement of the operations to prevent them.The hospital can do this in several different ways. For instance, using widespread feedback frompatients as well as from all employees can help in recognising issues in services and highlighting growthopportunities for the hospital. Once the problems are identified, managers should then encouragetheir subordinates to come up with creative solution ideas to tackle them. The best solution shouldbe selected amongst the proposals and then implemented in operations. However, for this to have abetter outcome, managers should continuously monitor the progress and analyse the results. If resultsseem positive, the hospital can expand it to every relatable aspect of the organisation and then repeatthe whole process in other areas. The resulting changes from this would not only enhance employeeengagement and communication, but it would also increase the safety of services to patients.Moreover, in regards to managing people at QMH, it is evident that the firm has had some seriousissues when inspected by the Care Quality Commission (CQC) of England. Following the CQC (2018)report, the overall staff appraisal rates at QMH were stated below the Trust’s target of 90%. Althoughthe staff turnover had reduced from 19% to 16%, a sense of isolation and lack of motivation wasobserved amongst the staff (CQC, 2018). Together, this is worrying as it interprets to poor delivery ofservices, and insufficient support from managers for staff development. Managers at QMH shouldunderstand that staff are one of the most important assets in any organisation, and they representthe basis of any competitive company (Gabčanová, 2011:1). It is mainly for them that a company canstrive for success. For that reason, operations managers at QMH should take the initiatives inimproving their employee performance and reconstructing a strong bond of communication withthem. The TQM approach could be instrumental in here as the philosophy supports the notion that inorder to achieve efficiency within a business, a strong focus on employees is mandatory. Hence, in aTQM concept, employees should be given empowerment to work however they like and get activelyinvolved in decision-making processes (Gul, 2012:4). In fact, when employees are empowered, andtheir contributions being valued, the morale increases amongst them, and so does productivity andcommitment. This goes in line with Maslow’s hierarchy of needs that says employees need some sortof self-actualisation to encourage them to demonstrate quality performance (Maslow, 1943:379).Therefore, QMH must give their employees the opportunity to have a say in services and operationsdevelopment. It would not only improve employee satisfaction rates but would also create a cultureof inclusivity and belonging at the hospital.Lastly, another way to better manage people in organisations is implementing Herzberg’s dual-factortheory. According to this theory, two factors influence employees’ job satisfaction. One is ‘hygiene’which incorporates basic extrinsic factors such as decent salary, safe working conditions and jobsecurity (Herzberg, 1968). The other is the ‘motivator’ which involves challenging work, autonomy,recognition, advancement, and growth (Herzberg, 1968). The absence or inadequacy of ‘hygiene’factors can cause demotivation within employees, but their presence does not necessarily add to thelevel of satisfaction (Herzberg, 1968). Conversely, the presence of ‘motivators’ result in motivationand satisfaction between the employees, but their absence rarely causes dissatisfaction (Herzberg,1968). At the moment, factors that result in employee dissatisfaction at QMH include lack ofprofessional support from specialists and lead nurses to subordinates and the poor relationship ofsenior managers with their low-level employees (CQC, 2018). Since Herzberg’s theory of motivation isa two-dimensional paradigm, operations managers should first eliminate the job hygiene stressors,and then focus on creating conditions that make people happy. Practically, to reduce employeedissatisfaction at QMH, managers should make it a priority to develop a strong bond of communicationbetween the employees, and create a supportive environment of working relationships. Moreover, inregards to motivators, the staff at QMH lack job growth as they lack basic training and knowledgeabout some basic principle at the hospital such as the Mental Capacity Act 2005 (CQC, 2018). Althoughthe lack of job growth as in training might not be demotivating to employees, they would undoubtedlyresult in the ineffectiveness of services to the patients. Therefore, the hospital should consideroffering extensive training courses for its staff and increase their awareness of their responsibilitiesand hospital principles. Besides, providing feedback after incidents to the employees would not onlyimprove their confidence in their roles but would also help in preventing them from recurrence, andthus in service effectiveness to patients.In conclusion, the issues of operations and supply management at Queen Mary’s Hospital can beeliminated. It will, however, require managers to adopt some new approaches and techniques in thecontext of ‘quality and people management’ to fight poor service quality. With the hospital’s overallservices graded as ‘requires improvement’ by CQC, the implementation of TQM can be pivotal incarrying out the required changes. This is because TQM ensures the flow of ‘quality’ into everythingthat a company does. At the outset, the hospital should benchmark itself against those of the best inthe industry like the Arnold Palmer Hospital, and take on some of their techniques to boost its ownperformance. As well as this, tools such as JIT and Kaizen would aid the hospital in loweringexpenditure costs and achieving sustainability in operations. It will help the firm in becoming a triplebottom line company by reducing wastes and constantly improving services. Small and simple steps,such as continually collecting feedback from employees and patients, would indicate areas thatrequire attention and ensure service effectiveness to patients. Concerning people management, QMHshould follow Herzberg’s dual-factor theory. It should first erase factors that are responsible foremployee demotivation and then introduce opportunities that positively influence their satisfaction.Employees at QMH require empowerment, and the autonomy to be able to get involved in decisionmaking processes. They also require growth as in their abilities to carry out tasks effectively, whichcan be achieved through extensive training courses and workshops. If adhered to all these factorseffectively, QMH would not only attain satisfied, motivated, and productive employees, but it wouldalso achieve efficiency in operations and quality in services.Word Count: 2,435.Bibliography:Becker’s Hospital Review (2009) 5 Key Principles for Hospitals From Toyota’s Lean Production System.Available at: https://www.beckershospitalreview.com/news-analysis/5-key-principles-for-hospitalsfrom-toyotas-lean-production-system.html (Accessed: 08/12/19).CQC (2018) Queen Mary’s Hospital: Overview and CQC Inspections. Available at:https://www.cqc.org.uk/location/RJ731#accordion-1 (Accessed: 19/10/19).Forbes (2011) 3 Reasons to Ask for Customer Feedback. Available at:https://www.forbes.com/sites/theyec/2011/12/14/3-reasons-to-ask-for-customerfeedback/#3af9f4c14700 (Accessed: 01/12/19).Gabčanová, I. (2011) The Employees – The Most Important Asset in the Organizations. HumanResources Management and Ergonomics. 5(1) PP. 1-12.Gul, A. et al. 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