Enhancing Quality Improvement In Healthcare Through Reducing Patient Waiting Time

Discussion

At present when the evolution of technology is on its peak, the health care system is also observed several advances. However, when it comes to addressing the needs of the patient, ensuring the safety of the patients, maintaining the efficiency of the system, and quality enhancement, the healthcare sector performs far below the required levels. Therefore, it has become imperative in deliberately redesign the health care system, with quality improvement for reliable, cost effective as well as sustained quality improvement within the sector. Quality improvement in health care is also meant for enhancing the effectiveness, efficiency, and safety. Hence, redesigning the health care system needs incorporation and indulgence in specific methods and tools primarily known for assigning the quality improvement. In simple words, quality improvement in healthcare means a systematic approach by healthcare organizations that observes, assesses, and enhances the overall standards of the quality health care thereby seeking a high level of performance. Quality improvement is directly associated with the service delivery approach, level of patient satisfaction, outcome, and efficiency. Thus, the prime concept and idea behind the quality improvement in healthcare are to address the expectations and needs of the patient and bring these needs and expectations together.

The aim of this proposal is to ensure an effective change in the patient waiting period which in turn would act as the key to the enhancement and improvement of the health care system based provisions. The research believes that at all costs, the patient waiting time requires to be lowered in order to enhance the health care provisions and enhance the satisfaction of the patients. The collected information would be analyzed in order to reach towards a logical or rational conclusion in the end.

The aims and objectives of this project can be enumerated as follows:

1. To comprehend the importance and essentiality of quality improvement in the health care system
2. To understand the importance of project management in the health care sector
3. To find relevance between quality improvement and change management
4. To present quality as one of the critical facets of change management

Hence, the aim of this research is to comprehend the importance of quality improvement in change management as well as project management. The project will further elaborate on the essentiality of project management in the healthcare sector and accordingly establish quality improvement and changes management.

Quality in health care could be defined as the extent to which health services for individuals and populations maximize the probability or likelihood of wanted health results and are constant with the present professional skill and knowledge. Hence, quality improvement and change management in the health care system of the imperative for reducing variation in different aspects thereby attaining anticipated results and also enhancing the results for the patients at the same time. Thus, quality improvement acts as the framework that could be used for systematically enhancing and improving care. As a whole, quality improvement seeks at standardizing the structure and processes and accordingly structure to lower variation, attain anticipated results, and enhance the outcomes for health care systems and organizations. Therefore from proper research, the relevance of quality improvement and change management could be understood in health care. Thus, ensuring change is imperative and successful in healthcare as its acts as the practice and process of assisting and guiding people through effective change thereby creating new ways of working.

Project Goal and Objectives

The researcher aims at conducting the research by making use of qualitative methods of research. This demonstrates the approach of the researcher about initiating the research in the most appropriate manner and getting the most rational outcomes and conclusion to the problem of reducing waiting time in health care organizations (Aburawis & Dokmeci Yorukoglu, 2018). Hence, this needs a better perception analysis process to be implemented for the analysis of the information. The researcher will be adopting the interpretivism research paradigm as it allows the researcher to implement and use the interpretation skills in order to evaluate topic of the research. It mainly deals with a small sample size. In the given research, the researcher will also follow the interview strategy (Molinaro et al., 2019). It assists in obtaining the first hand profound insight about the research topic. As perception analysis requires to be done, an interview strategy is the best alternative to collect knowledge about the reducing the waiting time in the health care sector (Hintzpeter et al., 2019). Primary data will be collected for this research.  In order to collect the data, the researcher will also consider and take an interview with participants of a health care organization, containing questions focusing on the topic of the research. Since interpretivism philosophy is selected for conducting the study; the sample size cannot be large. Therefore, a small sample size is chosen by the application of the purposive sampling technique under non-probability sampling. The researcher will be applying the qualitative data analysis method to conduct the perception analysis of the response data. The analysis will be on the basis of interpretation skills of the researcher along with a thematic analysis will also be done. The outcomes of the perception analysis will be demonstrated through graphs, charts as well as tables for visual presentation and explained.

The prime rationale of this project or change management plan is to enhance the quality improvement in the health care sector by lowering the waiting time for patients in the health care sector. The project has identified several manners and strategies of reducing the patient waiting time, which if implemented by health care organizations could enhance their overall efficacy and allow quality improvement at the same time.

1. Collecting the information of the patient beforehand and submitting it to the registration desk could help in reducing the patient’s waiting time to some extent.
2. Introducing a centralized patient portal in order to effectively utilize technology for marking and scheduling appointments, thereby collecting patient details, accessing required data and others could also help in lowering the waiting time of patients.
3. Implementing a stricter policy in order to eliminate the late arrival of patients in the health care organizations
4. Implementing and introducing a new application such as “Queue App” directly associated with the patient portal could be used for effectively handling the number of patients and efficiently managing them through the centralized hospital system and network.
5. By enhancing or increasing the effectiveness of health care staff and employees as it could lower the waiting time of patients by approximately 60 percent.

According to Aburayya et al., 2020, waiting time in the health care sector could be defined as the total time any individual or patient spends in the facility starting from arrival at the registration desk to the time the patent leaves for the last service. In the majority of the health care organizations, the waiting time in the hospital specifically in the outpatient department is lengthy. As a result, the longer outpatient waiting time has become a severe concern. In addition this, the problem of long patient waits has also attracted several public attention due to the adverse impacts of waiting on the satisfaction rate of the patients.

Scope and Deliverables

According to Bhat et al., 2019, long waiting times for patients are usually observed in outpatient facilities and this complexity contributes to a range or series of public health issues including interruption of Hospital Work Patterns, impaired access to patient care, and increasing dissatisfaction rate of the patients. Among numerous public health issues that are associated with the long patient waits, the issue of patient dissatisfaction with care has been the center of most of the attention. Wait times are adversely linked with the clinical provider scores of patient satisfaction and every aspect of patient experience primarily confidence in the health care sectors and perceive the quality of care associated negatively with huge or lengthy wait times (Lot et al., 2018. Waiting times are a serious phenomenon in the health care systems that are publicly funded and this usually results due to unavailability of the stock demand and appropriate optimization of scare supply of the medical instruments and skilled or qualified employees and staff.

Overall enhancement of the performance and quality in the health care environment could help providers with cost effective reliable as well as sustained health care practices and enable the health care organizations in attaining their respective goals of enhancing the care delivery thereby improving patient outcomes (Atella et al., 2019). It has been globally agreed that an effective and well designed health system is capable of delivering timely as well as convenient access to the health services for all the patients involved in the process (Reichert & Jacobs, 2018). Long waiting times have always been considered as frustrating to patients and therefore, appear to be a significant and consistent potential cause of dissatisfaction among patients and their associated members. There is a strong inverse relationship between the patient satisfaction and waiting time at the health care organization. Hence, it is imperative to lower the long hours of waiting in order to increase the rate of patient satisfaction (Drouin, D’Angelo & Gravel, 2020). In addition to this, the rapidly increasing demand, as well as restricted health care resources, need health care systems to rely on the enhanced flow control with better capacity allocation in order to lower the adverse effect of long waiting times for patients. Many interventions focusing on lowering the waiting times for consultation, filling prescriptions, and tests have been executed in different healthcare organizations. This research proposal aims at reducing the wait times of the patients using and by creating new applications that would enhance and improve the quality of the health care system.

Research Methodology

According to Biya et al., 2022, patient satisfaction is responsible for affecting the clinical outcomes, patient retention, as well as medical malpractice claims and it also impacts the timely, efficient as well as patient centered delivery of quality health care to a great extent. Thus, patient satisfaction is considered as a proxy however a very effective determinant for measuring the success of the hospitals and doctors. In the health care step, there are several factors and elements that are directly associated with the satisfaction level of the patients (Alarcon-Ruiz, Heredia & Taype-Rondan, 2019). These include age, gender, education level, number of visits, the waiting time of patients, communication behavior, trust of the patient, along with the interpersonal skills of doctors. Hence, keeping a thorough check and motoring on these factors will help in developing the quality of the health care system in a positive manner. According to Yew, 2020, patient experience comprises of the range of interactions that patients have with the general care system incorporating the health plans, physician practices, doctors, nurses, staff, and other facilities associated with health care (Lee et al., 2020). Therefore, an imperative element of healthcare quality, patient experience incorporates several aspects of health care delivery that patients value highly when they look to forward to receiving care (Maylor et al., 2018). These are usually in terms of getting appointments timely, easy and better access to the information, and better or effective communication with the health care providers. According to Sulistyaningsih & Qomarania, 2020, comprehending the patient experience is an imperative step or approach in moving toward the patient centered care and by considering several aspects of patient experience, an individual would easily assess the extent or degree to which patients are obtaining care that is respectful and responsive to their individual preferences of the patient’s values and needs. As a whole. Examining the experience of the patient with other elements such as effectiveness and safety of care is imperative in offering an entire picture of equal health care.

The terms patient experience and patient satisfaction are usually used inter changeably however, are different things. Hence, in order to assess the experience of the patient, it is imperative to identify from patients directly where something stat should happen in a healthcare system such as setting a clear communication channel with a provider or how frequently any meetings happen. This would help in identifying the actual or real expectations of the patent and thereby researcher could generate a standardized and validated measure of patient experiences. Project management in health care is responsible for enhancing how medial facilitates any function or operation. Hence, the prime objective of project management in health care is to identify and resolve the prevent issues and implement strategies and policies that could enhance the level of patient care and promote positive relationships with the associated stakeholder group.

The Rationale of the Project

The environment of medical facilities and the health care sector is experiencing constant and continuous changes. Hence implementing quality improvement projects in order to lower the waiting time of the patients and enhance the satisfaction rate has become imperative. This would enable the health care organizations in maintaining the overall productivity and provide a better direction to prevent dissatisfaction among employees and patients associated with the health care facilities.  The ability to effectively handle bed allocation along with staff resources lowers or reduced the overall workload of stress and workload, thereby resulting in enhanced quality of patient care. As a consequence, the lowered waiting time for the patient in the departments like emergency care will help health care organizations in attaining enhanced health results thereby lowering the overall time spent in the specific hospital. Since access to reliable public health care is the foundation of social and economic well being and health of any nation. Therefore, improving the concerns of the patients will help in addressing the objective of increasing demands on the stage and resources in the hospital or health care system. Lowering or reducing the average waiting time of the patients is highly responsible for including how people feel about their doctors and this, in turn, impacts the consumer engagement rate of the health care system in a [positive way. In addition to this, it also creates a better correlation between the wait times and doctor ratings thereby decreasing the overall costs of operations for the health care organizations.

The ability of adapting and changing is critical and imperative to modern health service delivery in order to meet the changing needs of the population, changing demands of increasing life expectance, and critical health conditions. Increasing prioritization of health care quality across major domains of patient centeredness, effectiveness, efficiency, safety, and accessibility has given broth to the accelerated change, both in the uptake of initiatives as well as the realization of their respective outcomes to address the external targets at the same time. The modern health care system thrives on efficient models of effective resource utilization and care and therefore, it is imperative for the health care organization to implement the required strategies that would enhance the efficacy and patient reported experiences and results.  For this, it is imperative for the health care individuals, teams along with health care organizations to quickly adopt, implement and integrate well as renew their behaviors, approaches, and activities towards the new service planning. In the same manner, achieving patient centered care needs a revitalization of the system along with a holistic change in the manner of working. This would enable and integrate the contribution of patients, experiences, preferences, and outcomes to form care delivery. This realization of different health care systems and organizations as the intelligent system would help in developing better chances of learning and improvement thereby possessing a better, integrated, and continuous quality enhancement as business as usual for the health care sector.

Justification For Change

Stakeholders in the health care industry play a significant role in guiding the entire health care industry towards a specific or certain point. This support is imperative and vital as stakeholders of the health care sector are also responsible for offering required funds, assistance, strategic solutions, and direction and enhancing the overall functions and operations of the entire health care industry. Therefore the prime or main objective and role played by stakeholders in the health care sector is to address the strategic objectives by contributing towards the perspective and experience of a project. The stakeholders are also responsible for offering required materials and resources to the new change management of the project plan. The key stakeholders in the health care sector incorporates patients, health care providers (such as institutions and professionals), policymakers, and payers. However, there are other groups such as regulators, the research community, media, and other industries (biotechnology, pharmaceutical, and medical equipment) who are responsible for shaping the overall decision making of the health care system in a quite possible manner.

The stakeholders in the health care industry hugely differ in several aspects that include need, interest, assistance, influence, and attitude. Thus, it becomes imperative for the organization to address the changing needs of these stakeholders and thrive in developing a long term collaborative effort (Pereno & Eriksson, 2020). Therefore, prioritizing the stakeholder is essential as it allows and assists in understanding where to invest the resources in order to gain maximum value to it. It also allows health care organizations to make better decisions and make sure that a positive relationship is maintained throughout the project. The interrelationship among the different stakeholder groups in the health care system is complex in nature (Mukherjee, 2019). Therefore it is imperative to identify and accordingly determine the level of influence of every stakeholder associated with the health care facilities. These primary and secondary stakeholders of the healthcare sector are responsible for determining the success of the organization. Hence, it is imperative to make the required efforts by auditing the evolving nature of the primary and the secondary stakeholders’ preferences and expectations through various structured methods (Chukwu & Garg, 2020). The stakeholder is responsible for determining the changes included and influencing the decision made within the health care organization as involving the wrong stakeholders will reduce the overall value of the project and the contribution made making the entire project unimportant and inconsequential.

Handling change is about managing the challenges of the project process. One of the key concerns in the healthcare management is the management of change aligned with the associated healthcare professionals obliged for undertaking the task at their respective levels (Xyrichis et al., 2021). Handling change and overcoming the resistance to change in the healthcare sector is about monitoring and evaluating the planning along with the implementation process, tactics, operations, and strategies which ensures that the change is relevant and worthwhile (Olczak et al., 2021). Managing change is complex, dynamic, and challenging in nature. Resistance to change can be common and inevitable in nature (Joseph et al., 2020). Hence, it is essential to carry out and implement effective strategies that would effectively address the resistance and enhance the productivity of the project as a whole.

Following strategies can be implemented in order to overcome the resistance to change:

Communication issues and misunderstandings are common while considering any project. Fear of the unknown among the health care employees and the stakeholders must be kept in mind while implementing any change management scheme or strategy within the organization (Barcelona, 2021).  Individuals will accept change within the project only when they find that the risk of doing nothing is more than the risk of changing direction. Communicating the results and steps of the change process and making sure that the individuals and the team obtain appropriate information for making positive judgments is imperative. This is only possible through effective channels of communication thereby communicating the pros as well as cons of the change plan to be implemented.

Organizational transformation is generally assisted and accompanied by the change to routines and bringing individuals out of their comfort zone in the health care sector. Hence, this might result in the exhaustion of employees and other health care members that is directly subjected to frequent change or evolution in the health care business (Williams, 2019). Therefore, in order to overcome this resistance to change, it is imperative for the health care systems to develop the emotional intelligence of the leaders and connect properly with the individuals associated or involved in the change management process. This will help in offering the required support by employing better and more effective coaching tactics considered to be the most effective ones while handling change within the health care system.

After communicating the change initiative, considering the weaknesses and strengths of each team member is imperative and suggested to overcome the major resistance to change (Panch, Mattie & Celi, 2019). Establishing how team members are best suited towards adding to the change initiative and considering different manners in which it might assist the individual to enhance personal weakness thereby taking advantage of the identified strengths would also help in overcoming the resistance to change. It is essential that the team members are given appropriate responsibilities and roles that enhance the skills of the individual and take the best advantage thereby developing the personality of the team in a positive manner (Talukder et al., 2020). This personal collaboration would allow health care leaders and professionals in attaining the attainable or desired targets using a better and more systematic approach.  

Effective communication is the key to success and acts as a major player in implementing strategies that could help the project grow and evolve in the long term. Therefore, prioritizing communication at every stage of the project in the health care sector is imperative for keeping the health care systems, employees, and the stakeholders informed and aware. For this health care quality improvement process, the project managers and the leaders of the healthcare department could use several tools and methods that would help in outlining the communication efforts and collaborate with the key personnel required.

Being clear about the change management plan and keeping the involved person aware of the details is another strategy that project managers could use for communicating the goal and objectives of the change plan appropriately. Inviting communication through different or multiple channels is also imperative and suggested. This would help in keeping the individual aware of the current happenings and accordingly strategies could be implemented to enhance the overall efficacy of the change management plan.

Quality planning	Quality control (QC)	Quality assurance (QA)	Quality improvement
Plan	Do	Check	Act
Determining what would be the project quality and how it would be measured	Evaluating specific project products and elements to determine if it meets the performance measurement threshold defining the quality of the reducing waiting time	Determining measurement of quality evaluating performance frequently thereby enhancing satisfying the patients	Increase the efficiency and effectiveness of the project plan when corrective actions such as change initiatives are identified. Changes to the quality improvement plan.
Project planning process Practices: a.      PMP development b.      Scope and requirements of project c.       Establishing teams d.      Estimating resource development e.       Waiting time lowering development strategy	Project execution and control phase a.       Lessons leaned	Executing of project a.       Project control	Planning mode a.       PMP development

Resource planning is considered as an imperative factor for successful project (Samiei & Habibi, 2020). It is helpful in anchoring the project management in a broader sense thereby identification of the resources is required (Sutduean et al., 2019). The resources required for this project includes:

1. Material resources: raw materials, machines, equipment, resource management software and tools
2. Financial resources which primarily includes the budget of the project
3. Time resources such as time invested, project schedule, and project plan
4. Human resources: health care employees, staff, team members and others (Barik, Jaiswal & Das, 2021).

	Month
Task	1	2	3	4	5	6	7	8	9	10	11	12
Making a strategy
Making a framework
Literature review
Primary data collection
Conducting questionnaire
Data analysis
Presenting the findings and discussion
Providing the conclusion
Thesis submission

Items	Amount
Arranging equipment	$         75.00
Visit to the library for literature study	$         45.00
Designing the interview questions	$                –
Visit to one health care organization of system for conducting the interview	$         55.00
Translations of the audio transcripts of the interview responses	$         150. 0
Miscellaneous expenses (For example. Purchasing of a book, journal, or annual report of Bank of New Zealand, cost of print out, subscription charges, etc.)	$      250.00
Total	$      675.00

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