ABSTRACT
This chapter reviews a management consultancy intervention at a wing of a hospital (referred to hereafter as ‘Northern Hospital’, or ‘NH’) where the consultants were engaged to execute a performance improvement project to train the general public how to behave more responsibly in a hospital with regard to hospital-acquired infections (HAI) such as MRSA.iThe Northern Strategic HealthAuthority (NSHA) commissioned the work because NH had among the highest rates of infection in the region, falling far short of Department of Health (DoH) targets regarding HAI.The chapter’s contribution to service operations management and the study of healthcare is to consider the implications of piecemeal improvement programmes and reflect on whether a more studied approach towards operational performance objectives, developing an operation strategy,might result in behavioural and performance stepchange improvement. The work belongs within an existing body of research on performance improve-
ment in healthcare,much of which discusses the application of tools and techniques deriving from the Toyota Production System (TPS) collectively known as lean (Krafcik, 1988). A brief comparison is made between the case and other research before reflecting on service delivery and performance within the UK’s National Health Service (NHS).Consideration is given as to whether the use of an operation strategy, another manufacturing-derived approach, could help the NHS have greater success in achieving its objective of using resources to best effect to deliver improved patient care (NHS Plan, 2000).Typically, an operations strategy provides the broader conceptualisation of service delivery and ‘value’ creating organisational knowledge and enabling planning to reconcile market requirements and resources (Slack and Lewis, 2011).The purpose of this chapter is to reflect on that reconciliation, or its absence, in the NHS in conjunction with the concept of ‘patient value’, a key priority area for health policy (Currie et al., 2008) and a driver of the consulting intervention described. Healthcare is perhaps the most personal and important service people experience.
It is also a service people need but do not necessarily want (Berry and Bendapudi, 2007). Patient perceptions of safety and care are what make up the ‘patient
experience’, something that transcends a purely medical perspective. Unlike other services where demand increases supply, in healthcare supply increases demand.More physicians or hospital beds in a given region translate into more medical services rendered on a per capita basis without necessarily improving the overall health status of that population group (ibid.). Service quality is an approach to achieving better health outcomes, with both
quality and value determined by the beneficiary, and has become an important corporate strategy for healthcare organisations.Groonroos (2007) suggests there are two distinct components to quality, the technical aspect, or what is provided, and the functional aspect, or how the service is provided. It is the functional aspect that patients perceive and receive.Patient satisfaction therefore demands consideration of both the service concept and the customer characteristic (Anderson et al., 2008).
