Service operation management involves system design for services. It includes operations, marketing and human resources in facilities management. The activities include process, design, layout and location, service quality and also manage capacity and demand ( Priya Datta and Roy,2011). There are various industries where a wide survey of healthcare, financial service, consulting, entertainment, hospitality, airlines, higher education and environmental services is used to attain effective business results. There are various management techniques used to evaluate productivity and operations efficiency services. Milton Keynes Hospital was founded in 1970, it scored the better quality of duty and use of different services. It is famous for high quality care, excellent services and multi-professional education and it is good for both service quality and better utilization of resources. The vision of this hospital is that is provides quality healthcare services in the region with the aim to deliver right treatment at the right time at right place while reducing the waiting time (Peng and Lai, 2012.). 4,000 staff members are working in the Organisation. They will continue to develop effective services to improve pathways and packages of care and reduce medication errors as well. In this report, the terminology and concepts that are used in the various quality process in the healthcare sector will be deployed and will analyse quality theories and models that are utilised in this area of the healthcare industry, various models used by the Organisations will also be examined and evaluated in this report.
Every sector has a different quality process that is used to improve service. Milton Keynes Hospital uses quality processes in the healthcare sector to manage the quality of services, assure them after service delivery and control the quality standards in order to attain the needs and demands of the patients in an effective manner. There are some models that help in improving the quality of services at each stage of quality process. These are EFQM model are mainly focus on improvement in quality of services by refining and reviewing the whole service quality process at each stage. On the other hand, TQM model check the total quality and make improvements if required so, it helps an organisation to deliver high quality of products or services to its customers and satisfy more than its expectation. Along with this, Kaizen quality model is a continuous approach that improves the quality and enhance production efficiency in the quality process with the competitive environment. It eliminate the wastage, minimising the cycle times and maintain daily routine that directly improves the quality in manufacturing process. It also improves little changes that enhance productivity and work is done in an effective manner on daily basis. GAP model helps in identifying the gap that arise between actual and expected service quality at each stage that help in reduce the deviation in future that improves the total quality in whole process. In the quality process there is 3 stage that help the firm to improve the quality and satisfy its customer by delivering high quality products are discussed below:-
Quality Assurance- Quality Assurance includes various task and activities that make sure that products and services quality meet the customer demands in a reliable manner ( Tayur, Ganeshan and Magazine, 2012). Quality aspects in healthcare relate to the service standards and patient needs to attain the Organisational objective in a well-defined manner. In the hospital sector managing the high quality of healthcare practices, is a challenging issue which relates to healthcare practices. It includes quality control, quality improvement, medical audit, quality management and quality development. It aims at continuous improvement as per the healthcare standards. Milton Keynes Hospital plays a great role in quality assurance. Different stakeholders of the Organisation are doctors who provide adequate healthcare to its patient to assure professional quality (Parry, Mills and Turner, 2010). They provide high-value health care services that meet specific needs of the patients and provide a healthy environment for the business (Zomerdijk and Voss, 2010.). Quality is maintained due to various reasons which involve increasing awareness about the health of the people, improved care, reduction in wastage, better team spirit, less staff conflict. This certainly enhances job satisfaction, increased confidence in the clients and fewer customer complaints as well as improved system and standardisation in procedures and better workmanship that give guaranteed quality.
Quality control – Quality control can be done by testing in order to meet output of the business, for this reason, various process and procedures are used. Quality control is a process that ensures that the service performed meets the customer satisfaction and requirement efficiently. Quality control process is controlled by collecting various information and thus demands to undertake corrective action are to be taken as well as repaired poor service without charge of fee to its customers. Milton Keynes Hospital uses various quality methods to control and minimise errors thus enhancing efficiency and effectiveness of service outcomes ( Osborne, Radnor and Nasi, 2013).The total quality is managed by examining total variability in the system and different variations which randomly detect the cause of error in the entire process and removes the same. Quality care puts its primary focus on increasing the value of healthcare products and services while reducing the cost of wastage from the system. Set the system that evaluates various medical technologies and services to improve the treatment and reduce unnecessary procedures. They also improve the quality of health care to its patients by motivating employees through various incentives for general care physicians who agree to serve its patients for a negotiated fee.
Quality Improvement- Overall it is a process that increases customer satisfaction in a systematic way. It improves business performance by re-examining current business practices within the economy. It is a formal approach that analyses performance and makes efforts to improve performance. It helps in collecting data and analysing it to attain high control overall the actions involved in the process. Benefits of quality improvement is that it improves efficiency, patient safety or clinical outcomes (Nagurney, Masoumi and Yu, 2012). It allows the public to participate in quality improvement Initiatives as well. In Milton Keynes Hospital improvement is done by receiving various feedbacks by its clients through the website on daily, weekly, monthly basis. Feedback is properly analysed and use different alternative solution to solve various complaints that enhance quality.
Medical Department – The medical department include internal diseases and has specialities of cardiology, diabetics, dermatology, digestive system, endocrine system, haematology diseases, infectious disease, internal disease, neurology, kidney and urology unit, psychiatry clinic, lung diseases and rheumatic diseases( Metters, Zhao, Bendoly, Jiang and Young, 2010). Total patients visit the hospital 89,209 persons. Surgery it includes generally orthopaedics unit, surgery unit, plastic surgery unit, urinary tracts surgery, children surgery and ENT surgery. The patient who visited the hospital in these Total 73.331 persons and operations made total 11.780 surgical operations among 3.982 operations that are made in surgery rooms, and Anesthesia case totalled 10.517.
Gynaecology Department- Patient who visit the hospital for this unit total 45.785 persons among whom 5.925 were delivery cases.
Paediatrics Department- Patient who visit the hospital for this unit total 33.190 persons.
Dentistry Department- Patient who visit the hospital for this unit total 30.656 persons.
Emergency Room – Patient visits the hospital in this unit total 156.001 persons representing 16.5 % of total visit patient of the Hospital ( Metters, 2010). The patient in the emergency room totals 16%.
Nursing – In the medical care nursing service are the most important aspects that are to be considered. Nursing is divided into various units that provide patients at general as well as specialised clinics and specialises care service in all units to inpatients. Increasing in the number of nurses massively and growth constantly, as an increase in number reached to 215 nurses a year 1405H, 300 nurses in 1406H and 363 nurses in 1407H (Martinez, Bastl, Kingston and Evans, 2010).They provide specialist nurse as per international standards in a various unit of the hospital.
Support department- In this department, it includes Pharmacy, Laboratory and Blood Bank and X-ray. Pharmacy unit is responsible for providing medicine to patients that are prescribed by physicians and services that are correspond to drug precautionary. Also, this Pharmacy unit provides specialised physicians and pharmacists that deal with various medical treatment. In, Addition quarterly test to Pharmacists ( Lusch, 2011). Laboratory and Blood Bank which depend on accurate scientific data that are available in the laboratory. Laboratory investigation is done for all patients, students, primary care clinics who seek medical care. In every year laboratory and blood bank service are to be provided as per the international standards. This unit has success by analysing in the year 1421H total 1900.226 analyses.
X-ray- The basic mission of X-ray unit is that it support the medical doctors. This unit contains various advance X-ray equipment- CT- Scan, endoscope group, four modern group of X-ray, Digital group, Ultra sound scan equipment( Lewis and Brown,2012.). This unit also contains modern and advanced equipment. X-ray test made in the year 1428H total 130.623 test, while patients who done X-ray test made total 140.902 persons.
Physiotherapy Department- The service is to be provided to inpatients this unit has number of assistants and physiotherapist that contains 137.300 physiotherapeutic sessions in the year1428H.
Medical Maintenance and Engineering Department- This department is responsible for maintaining hospital equipment and facilities (LaGrange, 2011). It also makes planning, execution of various projects of the hospital, technical studies and it also support workshops of electricity, air conditioning, steel work, joinery to maintaining such facilities. This department also performs various activities are maintaining medical and office equipment in the hospital. The highest degree of information is to be taken to the hospital.
Catering and food services- This department provides catering and food service to individuals as well as hospital staff.
Information technology and communication- This department adopts latest technology '' smart use of IT and communication'' that help to achieve hospital mission and various strategic goals that help to deliver high quality of services to its patients( Subramanian and Ramanathan, 2012).
Administration Department- This unit coordinates, arrange and prepares admissions to its patient inside various divisions as per classification which helps to achieve the maximum use of clinical capacity (Khanna, 2015). The visitor’s patients who admitted to this hospital in the year 14278H total 33,258 patients.
There are various model used by hospital sector Milton Keynes Hospital used to model SERVQUAL model and SERVQUAL model in different area in the Hospital sector are discussed below-
EFQM model – European Foundation for quality management (EFMQ) established in 1989 to increase competitive in the European country that provides a self- assessment framework. It is developed for the private sector; it can be used by voluntary as well as community organisation ( Bardhan, Demirkan, Kannan, Kauffman and Suggested, 2010.). It covers almost nine area of quality that is reliable for the small, medium and large organisation. This system is used to check the health of the group, but it can be very expensive. The main purpose of this framework is that it allow the organisation to determine the level of excellence the main focus on improvement in quality
(Gambeson, Lusch and Vargo,2010). This model provides its users various performance tools for achieving and sustain result and Excellence. Strength of EFQM model are Satisfied and loyal customers , successful leaders, Common sense of purpose throughout the organisation, motivate people as well as stakeholders, constant and well managed change , upward flow of ideas , efficient and effective use of data and operation , pride and the desire that drive further improvement and excellent results as well as good financial performance.
SERVQUAL model- It is a service quality model that is to be managed within the business to ensure quality aspects within the services. It is first developed by American authors in 1985 to measure the quality in the service sector. Organisation uses SERVQUAL model to measure and manage the quality service that measures both customer expectations and their perception. Additionally, it is also used as management tools. The gap arises due to poor trained and unwilling to meet the set service standard. Another reason for gap is improper evaluation and compensation system, failure to match demand and supply, lack of proper customer education and training, inability to match customer expectations (Drake and Spinler, 2013). The gap is fulfilled by using this model and increase service quality. The strength of SERVQUAL model are:
EFQM MODEL use in the psychiatric department to improve the quality of service at Milton Keynes Hospital. The main objective of EFQM model is that to improve the quality of psychiatric hospital ward. Along with this, it is also used in the Clinical department, emergency as well as administration department (DeHoratius and Rabinovich, 2011). The model used in the various area in this sector help a lot increase the high degree of satisfaction level also increase the number of admissions in the hospital and reduce the length of waiting and delay in the surgical waiting list. Re-admissions of the emergency department also increase that resultant into increase cost effectiveness, improve the admissions process and reduce unscheduled returns to the hospital. On the hand SERVQUAL model used in medical department to deliver high quality of service to its patients and meet their expectation and needs. It is also used information technology and communication ( Metters, Zhao, Bendoly, Jiang and Young, 2010). The quality is assessment by the SERVQUAL questionnaire to ensure reliability, responsiveness, assurance, empathy and tangibility and various test used the Wilcoxon test and Kruskal -Wallis test (Brown, Bessant and Lamming, 2013). There are various gap arise between expectation and perception of patients that will help to improve the quality of healthcare by using various policies result in good responsiveness, access to health workers and delivering healthcare in less time.
Milton Keynes Hospital face several issues in the healthcare sector there are some suggestion or recommendations used to solve various use that is presently faced by this sector which is discussed as follows-
Issue that are faced in hospital sector
Suggestion to improve various issue
Align organisational process with external pressures – External pressure includes Collaborative audits, comparative performance, government inspection and the public media, etc.( Barratt, Choi and Li,2011). It improves too much unnecessary care by media raise of high profile events about the safety the main aim is to minimise the legal risk of taking opportunities from the review that reflect the culture, performance and systems. It ensures varied safety such as patient safety, staff safety and provides building, maintenance, hotel services and environment, etc.
Michigan model- They should apply Michigan model that helps to Avoid harm to patients issue are resolve by Milton Keynes Hospital it is a new policy for handling medical malpractice claims it helps to reduce the number and size of their claims( Bardhan, Demirkan, Kannan, Kauffman and Sougstad,2010). The major principles of these model are that it give fair and quick compensation when there are unreasonable medical care causes to patient injury. Physicians and other healthcare professional improve its communication skills by proper training, use of various mediation to settle the potential claims that meet the patient needs that ensure that different policies and procedures are changed to reduce similar errors occur.
Online learning – Milton Keynes Hospital should Improve staff knowledge in this sector by using online learning due to change in environment various advancement in technology and clinical techniques ( Gummesson, Lusch and Vargo, 2010). It forces the hospital sector to provide continue training and education that improve knowledge and skills by using on-line learning management system which is an efficient and effective way that improve the staff skills. There is many benefits employee can easily access i.e. education when they need to prefer and take a test by their own, and it can help the staff across multiple locations ( Akkerman, Farahani and Grunow, 2010 ). It can be used to keep track staff certification and notify its expiration dates, and it also provides flexible training, user -friendly system that help the organisation.
Improve transparency- Milton Keynes Hospital Should enhance transparency in its healthcare organisation, so the administration, advanced analytics, radiologists and staff can seek various information related to Results turnaround time providers, average procedure duration, patient flow cycle time and utilisation of each piece of equipment. It will improve the quality efficiently, results in a reduction in variability , quality improve and cost rescue and improve patient that leads to staff satisfaction( Gummesson, Lusch and Vargo, 2010.)
The above analysis reflects that that Milton Keynes Hospital should use various models such as SERVQUAL model and EFMQ model in the various area of this hospital within Administration department, medical department, IT and communication department, Medical and engineering department to improve credibility, responsiveness, security. Various methods are used to improve the issue that arises in the hospital sector these days which involve On-line learning, improving transparency, Aligning organisational process with external pressures and Michigan model that resolve issues. These hospital doctors provide the adequate healthcare to its patient to assure professional quality, use various statistical methods to control to minimise errors that enhance efficiency and effectiveness and is an improvement is done by receiving various feedback to its clients in the website on daily, weekly, monthly basis. Feedback is properly analysed and use various alternative solution to solve various complaints that enhance quality. In the mentioned hospital, the issue can be rectified through developing new policies for handling medical malpractice claims. It helps in reducing the number and size of their claims, improves the quality more efficient, reduction in variability, quality improve and cost reduce and improve patient. It certainly leads to staff satisfaction and the safety measure steps are taken so, the main aim is to minimise the legal risk of taking opportunities from the review that reflect the culture, performance and systems.