Whilethe overall goal of healthcare delivery is to provide exceptionalquality of care, performance management helps in the evaluation ofthe achievement of the goal. Through the integration of differentperformance management protocols, an organization is able to reviewthe extent by which it has stuck to its predetermined goals. Theinformation on performance is important to a broad range ofstakeholders and can be utilized in the improvement of care delivery.As the new risk manager at Quality Health Solutions, I have the dutyto develop policies associated with performance management.
Statementof goals:Quality Health Solutions intends to provide a safe workplace for allits staff through the reduction of potential risks besides exploringopportunities for the improvement of health care quality.
Underworkplace safety some of the goals will include:
Reduce the injuries among healthcare providers by 10 percent from the last year’s OSHA recordable injuries.
Conduct quarterly workplace safety audits based on monthly inspections in all departments of the facility.
Reduce the time of response to critical cases of safety by 5 percent.
Investigate and analyze all workplace safety incidents promptly and develop necessary protocols to reduce occurrence within 48 hours.
Conduct monthly meetings and briefs with employees in each department to provide updates on progress and any other important information pertaining workplace safety.
Theprimary objective of integrating workplace safety protocols is theprevention of fatalities, injuries, and illnesses not only among theemployees but also the clients (Kines, Andersen, Andersen, Nielsen, &Pedersen, 2013). In this regard, the workplace safety managementshould emphasize on the development of specific strategies that willresult in the achievement of this objective. However, specificobjectives are more effective primarily because they are measurable.One of the specific objectives of workplace safety management will beto develop and implement a five-minute response to workplace safetyissues in the emergency unit over a period of one month beforeassessment and review. This objective is specific with regards to thedepartment concerned and the time of delivery the objectivegenerally intends to reduce the time of response to critical issuesas postulated by Goal 3. Considering that the emergency unit is oneof the most critical and sensitive areas in any clinic, reducing thetime of response will result in the decline of the overall time ofresponse to critical cases besides reducing the likelihood ofinjuries among healthcare providers – Goal 1.
Thesecond specific objective will be to create daily logs of workplacesafety issues, which will be completed by the end of every shift.Recording of the cases will enable the conduction of quarterlyworkplace safety audits as required by Goal 1. In addition, it willbe possible to identify and investigate particular incidents foranalysis and eventual action, hence the fulfillment of Goal 4.Finally, the logs can be utilized as sources of information that willbe presented in the monthly meetings and briefs as postulated in Goal5.
Oneof the most reliable performance measures when it comes to workplacesafety is the OSHA Recordable Injuries. This performance measuregenerally indicates the occurrence of injuries at the workplace,which is a critical metric in the management of safety. OSHA definesa recordable injury as any work-related fatality, one that causesunconsciousness, can lead to a transfer and restriction of work, anyinjury or illness whose intervention goes beyond first aid or anydiagnosed cases of chronic illnesses, cracked bones or cancer(Osha.gov, 2017). OSHA Recordable Injuries can be evaluated in thefollowing criteria:
Alignment with goals – Although it is based on indicators, recordable injuries are a primary tool that can be used in the development of strategies to reduce the number of injuries as they provide a history and trends. In addition, the recorded number of injuries will feature in the monthly assessments and quarterly audits.
Relationship with health outcomes – When the number of recorded injuries and illnesses is low, it is expected that the quality of care is high, which implies that health outcomes are positive.
Organizational control – The organization will not have much authority in the recording and maintenance of the recordable injuries considering that OSHA provides guidelines concerning the basic requirements and implementation. Nonetheless, the organization will have autonomy in the use of the recorded data and information.
Reliability, validity, and standardization – Generally, OSHA has a standardized approach to recorded injuries, which improves the validity. However, the fact that the records are standardized can reduce their adaptability in specific cases, which lowers reliability.
Generally,the performance measurement baseline comprises the triple constraints– schedule, cost, and scope (French et al., 2013). In the case ofworkplace safety performance management, each of the three componentsshould indicate the desired state of affairs at the end of aspecified time. The performance measurement baseline for the OSHArecorded injuries is rather simple to develop and implement. Based onGoal 1, the number of recorded injuries should decrease by 10%compared to the previous year. It implies that the schedule forperformance measurement is one year. The cost will include everyadditional expenditure incurred in the reduction of workplaceinjuries, which may include recruitment of a specialist in workplacesafety management whose duty will be to coordinate the maintenance ofrecordable injuries, investigation of incidents, and conduction ofaudits. Other costs may be associated to stationary, pamphlets, andany other necessary input. Finally, the scope will not be limited tothe maintenance of the recordable injuries but will also include allthe measures taken in the reduction injuries as identified in thestatement of costs.
Thereare three primary methods for the evaluation of provider quality thatinclude percentage compliance, actual versus expected performance,and performance against a benchmark (Hrsa.gov, 2017). The actualversus expected performance approach to performance evaluation willbe utilized for Quality Health Solutions. Generally, the actualversus expected performance involves the evaluation of the currentstate of affairs with the predetermined goals (Kerr & Hayward,2013). In this regard, the performance of the hospital as indicatedby the identified performance measure at the end of the evaluationperiod will be compared to the baseline, which will give indicationof whether the goals set have been achieved. One of the primaryconsiderations in the adoption of the method is its adaptability andflexibility to the measurement strategy adopted by the healthcarefacility. For instance, the use of quarterly milestones, can beintegrated in the evaluation of the actual and expected performance.Particularly, the decline in the number of recorded injuries at theend of the first quarter can be evaluated with respect to theexpectations by the end of the fourth month.
Theonline Oxford Dictionary defines success as the “accomplishment ofan aim or purpose”. At Quality Heath Solutions, success means theachievement of organizational goals with a specific evaluationperiod. Success can also be determined by the quality of carereceived by the clients as well as the well-being of employees in thefacility. There is a broad range of considerations in thedetermination of the level of success. For instance, the degree ofcoordination of different healthcare activities and initiatives is aprimary consideration as it determines the overall effectiveness andoutcome of intervention. Also, availability of inputs such asmedicines and equipment is a factor in the determination of the levelof success in healthcare. However, the determination of success willnot consider the broad definitions and conditions and, rather, itwill be evaluated in consideration of the context.
Theperformance of the facility will be determined based on the end-pointindicators, such as the number of recordable injuries. It willcritical to eliminate the contributions made by the addition oftechnology, equipment, and medicines in a bid to acquire a morerefined view of the input by other efforts undertaken to achieve thedesired state. Some of the primary efforts to consider will includetraining of employees, meetings and briefings, and the developmentand implementation of short-term strategies. However, it can be quitechallenging to assess the contributions by individual elements in theimprovement of the desired state, which may prompt the use ofstrategies such as approximate string matching.
French,K., Albright, H., Frenzel, J., Incalcaterra, J., Rubio, A., Jones,J., & Feeley, T. (2013). Measuring the value of processimprovement initiatives in a preoperative assessment center usingtime-driven activity-based costing. Healthcare, 1(3-4),136-142. http://dx.doi.org/10.1016/j.hjdsi.2013.07.007
Hrsa.gov.(2017). PerformanceManagement & Measurement. Hrsa.gov.Retrieved 8 January 2017, fromhttps://www.hrsa.gov/quality/toolbox/methodology/performancemanagement/part2.html
Kerr,E. & Hayward, R. (2013). Patient-Centered PerformanceManagement. JAMA, 310(2),137. http://dx.doi.org/10.1001/jama.2013.6828
Kines,P., Andersen, D., Andersen, L., Nielsen, K., & Pedersen, L.(2013). Improving safety in small enterprises through an integratedsafety management intervention. Journalof Safety Research, 44,87-95. http://dx.doi.org/10.1016/j.jsr.2012.08.022
Osha.gov.(2017). OSHAInjury and Illness Recordkeeping and Reporting Requirements |Occupational Safety and Health Administration. Osha.gov.Retrieved 7 January 2017, from https://www.osha.gov/recordkeeping/