Archive for category: Healthcare

Healthcare operations – summative report

CASE: Nancoota Regional Hospital (NRH) situated in regional NSW is a 300-bed tertiary hospital serving a growing population of 50,000 people across a landmass of 21,000 square kilometres. In addition to acute care, NRH provides services including comprehensive primary care, acute care, aged care, community, and home-based health services. To support the functioning of the hospital, there is a facilities management service that provides round the clock non-clinical services such as cleaning, ward support, maintenance and engineering services, energy and utility management and food services.

While NRH has grown in the past many years adding specialist mental health services, trauma services, and speciality acute services including nephrology, oncology, cardiology, and telehealth services to its portfolio of tertiary services, the hospital has had several ongoing issues. One of the key issues has been health care workforce shortages, like many regional and rural hospitals, which has compounded in recent years. The other issues relate to siloed operational management in many departments with them running their scheduling, workforce management and IT systems in isolation from the rest of the hospital and healthcare services. Further patient flow and care models as utilised in the emergency department and inpatient wards led to frequent bed blocks and shortages. In addition, there were frequent cancellations of elective surgeries to accommodate immediate or emergency surgeries. Finally, a culture of top-down management has led to poorly consulted decision making and inadequate progress with many clinical and non-clinical projects designed to improve patient flow.

The hospital board commissions a review panel comprising of operational, clinical, HR and policy experts to assess the problems plaguing the hospital and make practical recommendations to the board to consider. You have been appointed as the chair of the panel considering your expertise in Business Process Management (BPM) and wide experience in healthcare operations.

At the time of the constitution of the panel, the COVID-19 pandemic emerges in Australia and strikes NRH. The issues compound the problems in NRH that arise immediately due to the pandemic. NRH has significant challenges in its capacity to handle the surging patient volume, redesigning its care models to cater to a different profile of patients and demand, and organising necessary PPE for all its staff. It becomes inevitable for NRH to change the way it operates.

The immediacy of the panel to convene and provide relevant recommendations is obvious. As the chair, while recognising the need to address the immediate problems, you also consider the need to fix chronic and structural issues that have exacerbated the current crisis.

Your task

In your deliberations with the panel members, you consider six elements to develop recommendations. The elements include strategic alignment, governance, BPM methods, IT, people and culture.

Your task is to present a report outlining immediate, short term and long-term solutions to address the issues facing NRH while ensuring the hospital services are viable in the long term and a people-oriented culture is enshrined.

Refer to the ‘Hospital Operational Management in Emergencies/Crisis’ resource to formulate your strategy and recommendations.

Format

Your report should include/address the following:

• a background section where you review the literature to set a context
• a justification of why you have selected specific frameworks and/or tools to address the problem and why you have excluded others
• a description of the solution that your analysis indicates
• an outline of the key elements required for the approach you would take to implement your recommended solution.