Wordcount (Excluding appendices): 1516 {draw:frame} Jan Cervenka HC-BUS-F Group B 2009 – 2010 Table of Contents Introduction This report was commissioned by Doctors Campbell and Stewart and compiled by Jan Cervenka of Total Administrative and Organisational Solutions (TAOS). It was compiled in order to examine the organisational issues and problems of Cairnwell Health Centre. The organisation risks losing additional funding for the next five years if the problems are not solved. The main issues are low staff morale; high levels of stress-related absenteeism and a lack of appropriate IT.
This report aims to examine these issues in detail and make recommendations for change. The organisation is Cairnwell Health Centre, which is located in the middle of the Hamewith housing estate in Fraserhead. It is headed up in partnership by doctors Campbell and Stewart. They employ a number of staff: a Practice Manager, two receptionists, two typists, an archivist and nursing staff. The capacity of the Centre is about 1000 patients. The report was to be submitted by 5 October 2009. Methods of Investigation Questionnaires were distributed to patients on 5th September Results were collected on 10th September.
Staff questionnaires were distributed on 5th September 2009. Results were collected on 10th September 2009. Observation of the surgery was held on 11th September. Costing for new IT system was researched with Hewlett & Packard on 15th September 2009. Doctors Stewart and Campbell were interviewed on 20th September Findings Patient Questionnaires (Appendix 1) Of the one thousand copies of Patient Questionnaires, which were distributed among patients, there were eight hundred and seventy six replies. The outcome was debatable, as you can see in PATIENT QUESTIONNAIRE OUTCOME (Appendix 2). Staff questionnaire (Appendix 3)
Ten copies of the Staff Questionnaire out of fifteen copies were handed back to staff. The outcome of the Staff Questionnaire was more definite (Appendix 4). All members of staff felt uncomfortable within their occupation. All of them thought that the approach of the Practice Manager and leading doctors was not satisfactory. Members of nursing staff stated that they felt they are forced to work overtime very often. The typists and receptionists also pointed out that IT equipment is out of date. Their complaints were mainly addressed to the stability of hardware and to theage of software applications.
Sometimes, they were unexpectedly unable to type in or find out personal data of patients, this causes long delays. Staff also think that that IT equipment does not let them work as well as they can. The majority of staff members would also welcome more training, because they sometimes can not deal with problems they face every day. They do not know, for example, how to deal with rude or elderly patients properly. Observation The main issues, which were extracted from both Patient and Staff Questionnaires, were affirmed by the observation of the surgery. The observation was held in the reception area, waiting area and staff area.
It was noticed, that queues at the reception were undesirably long. Approximate waiting time was between 15-20 minutes. The receptionists were unpleasant and frustrated. It was found that this was caused by the computer, which stopped working suddenly. One of the receptionists tried to calm down waiting customers, but not successfully. The Practice Manager started shouting at the receptionist instead of helping her. They often did not answer telephone calls. Research into IT solutions It was found that the IT systems of the surgery were out of date and thus, very slow and unstable.
Sometimes, it was impossible to type in personal information of the patients, because memory storage of the computers was full. In some cases, it was also impossible to find out personal data of patients due to system failures. Problems with IT equipment lead to increasing stress levels of staff. During an appointment with an advisor of Hewlett & Packard, costing of IT equipment refurbishment was discussed. Interview with Doctors (Appendix 5) Both Doctors are ready to undertake appropriate changes in order to improve patient services rapidly. Conclusion
It was found that the problems that the Surgery faces are serious and need to be solved as soon as possible. All members of staff do not feel comfortable within their occupation. They are not satisfied with the managerial staff of the Surgery. They are also not satisfied with the IT equipment. This leads to one of the biggest issues of the Centre – IT equipment. Both hardware are software are outdated. Problems with the IT is a major influence on stress-related absenteeisem. It was found that the doctors realise that the service provided to patients is not the best.
They are ready to undertake appropriate changes to improve levels of provided service. Doctors Stewart and Campbell should consider the following recommendations in order to improve the efficiency of the Surgery. Recommendations To improve levels of the service provided to patients TAOS recommends following solutions. Staff meetings Meetings between the managerial staff, the leading doctors and the lower staff should be carried out regularly and communication between all members of staff should be improved. Occasionally, staff reports should be compiled. Relationships between members of staff Teambuilding
Appropriate building courses should help to improve responsibility and behaviour at work of every member of staff. Refreshment facilities improvement IT systems improvement Training of Staff All members of staff should be trained in order to learn how to deal with patients and possible problems properly. Fosters Seminars and Communications Company (http://www. fosterseminars. com) can provide training courses for healthcare staff. For further information see Appendix 9. Appendices Appendix 1 PATIENT QUESTIONNAIRE Dear patients, _We would like to take this opportunity to ask you to fill in this short survey.
Our company, Total Administrative and Organisational Solutions, is compiling a report about the surgery that you attend. Then, we can make reccomendations to improve the service provided to you. _ _Thank you for your help. _ _(Instructions: Choose an answer that you feel is right by ticking it)_ The attitude of nursing staff is: Poor Satisfactory Good Excellent The waiting times at reception are: Satisfactory Unacceptable The attitude of receptionist towards patients is: Poor Satisfactory Good Excellent The cleanliness of premises of the Centre is: Unacceptable Satisfactory
Good Excellent Is there anything else that you think we should know about? Appendx 2 PATIENT QUESTIONNAIRE OUTCOME _Of the one thousand copies, eight hundred and seventy six replies were received. _ The attitude of nursing staff is: {draw:frame} The waiting times at reception are: {draw:frame} The attitude of receptionist towards patients is: {draw:frame} The cleanliness of premises of the Centre is: {draw:frame} In the comment section, patients wrote further feelings about surgery, which were not covered in prior questions.
The majority of the patients are not satisfied with the approach of the receptionist. Many of patients also pointed out, that the equipment of the surgery is very good. They are satisfied with magazines, which are up to date. Appendix 3 STAFF QUESTIONNAIRE _Thank you for your help. _ _(Instructions: Choose an answer that you feel is right by ticking it)_ How do you feel about your job? Very satisfied Satisfied Dissatisfied Very dissatisfied How do you feel about the managerial staff? Very satisfied Satisfied Dissatisfied Very dissatisfied
How do feel about your working hours? Satisfied Dissatisfied Very dissatisfied. Would you welcome more training? Yes, I would No, I would not Appendix 4 STAFF QUESTIONNAIRE OUTCOME _Out of 15 copies of the questionnaire, 10 replies were received. _ How do you feel within your occupation? {draw:frame} How do you feel about the managerial staff? {draw:frame} How do feel about your working hours? {draw:frame} Would you welcome more training? {draw:frame} In the comment section, staff members wrote down further feelings about their occupation.
All of them pointed out the very poor IT equipment. This is discussed in the Findings section. INTERVIEW WITH DOCTORS STEWART AND CAMPBELL Summary of the interview Examples of questions *How do you feel about the service* which is provided to patients? Dr. Stewart I realis_e, that the service is not the best and I know, that we must improve it as soon as possible. Otherwise, we can lose funding for upcoming years. It would by mandatory for us. _ Dr. Campbell _I agree wit Dr. Stewart. I would like to tell you that we are trying to improve it, but we have not been successful so far.
That is the reason why we hired TAOS – to help us. _ What do you think about high levels of stress-related absenteeism? Dr. Stewart I think, that the problem is caused by everyone. Not only by us and management. Still, I think, that the staff should work harder. Dr. Campbell _I realise, that the Practice Manager is often too demanding. Sometimes, he shouts at the staff without any reason. I think, that he should attend a training course. _ Appendix 6 Overview of the company Team building events for corporate clients…
We also provide central London Team Building activities, for example our London Treasure hunt which can be undertaken on foot and public transport, and our River Thames Rib Experience is a real show stopper. Appendix 7 To get more information about the RefresU Company, it is needed to make an appointment with a manager of this company. It is needed to fill in a contact form on their website. Contact adress: RefreshU Unit 18A Lenham Storage Ham Lane, Lenham, Maidstone, Kent ME17 2LH Phone number: 1234567891 Appendix 8 _ {draw:frame} _ Health solutions » AMBER on HP systems » Contracts management » Electronic Health Records Hospital information systems » Medical archiving solution » Medical image management and PACS » Printing & Imaging Appendix 9 _~WE CARE~ A Guide to Patient Sensitivity _SM Dealing with the Challenging Patient_ SM_ _Documentation in the Clinic SM_ Work is Not Just a Daycare Program for Adults_ SM_ Dealing with Employee Management and Workplace Issues_ SM_ Mediating Disputes in the Workplace_ SM_ Reducing Conflict & Improving Communication_ SM_ Violence in the Workplace_ SM_ _Legal Issues and the Nurse Manager SM_ Avoiding the Malpractice Blues_ SM_ Get Fired Up, Not Burned Out_ SM_ {draw:frame}
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