MGH Assignment

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MGSC6206 Service/Manufacturing Operation Management SEC 03 - Fall 2014 Mass General Hospital: CABG Surgery (A) Case Analysis
1. What are the primary challenges in improving operating processes in a health care environment? In the healthcare environment, improving operating processes is tie to effective cost control if not cost cutting. This is a very crucial undertaking for hospitals and many healthcare organizations. But there are many challenges that come with the process of improving operating processes. First, costs in all aspects of operations and any changes that might be initiated with a hospital poses greater challenges due to the extensive use of financial resources or discretionary spending which might be linked to complicated private, government reimbursements methods. More challenges in improving operating processes have to do with staffing or human resources. As we saw in the case, the success of the implementation of the care path for example, was tie to the “buy in” of all the departments’ staff. This is critical and costly in terms of FTEs (Full time employees). There would be additional staff to train, or specializations which is challenging in a new environment. With the care path implementation requiring change in behaviors, processes and practices, the challenges didn’t lie in this initiative but in convincing staff to adopt it as a more effective way of conducting the CABG. This would require additional resources, change in the cost structure and uniformity of processes. This new approach in a new environment is in itself a challenge because the healthcare environment especially hospital like MGH lacked standardization of many processes. 2. What is a care path? What are its specific features? What does it not do? Care path, also referred to as critical path, is one of the main tools used to manage quality in healthcare using standardization of care processes. It implementation aimed to reduce the variability in clinical practices, costs while improving the outcomes1. Care path promote organized and efficient patient care. At MGH, critical path also known as care path was described as an optimal sequencing of timing of interventions by doctors and nurses for a medical procedure. The care path was designed to minimize delays in healthcare processes while maximizing the quality of care (Wheelwright & Weber, pp 6). Care path, as a program did not introduce new treatment technologies or change how treatment were performed but it features were intended for: Standardization of procedures

Time-line compress
Reduction in variability between individual surgeons

The main features of the care path and how it would improve on the current operation are below:

Current Operation
Care Path
Large variability in how the CABG procedure is performed
Standardizing the operating procedure
Relatively high length of stay and costs as compared to other hospitals Detecting diversions from the care path and alerting caregivers. Producing exception reports for analysis Poor cost accounting and no centralized documentation

Improving record keeping for better patient records and cost analysis Poor communication between parties along the care path
Improving the communication between various parties within the care path system In practice, the care path was applied to manage a process and improve patient care within the hospital. There are some limitations to the care path method. One of the most important limitation was the fact that the care path did not dictate the medical treatment of a given patient (in case of the CABG). But only: Delt with some part or data of the patients as far as medical records. It is limited to build the scenarios for the future, because it is based on optimal or current practices. It implementation depended more so on changing behaviors and processes long-time established in healthcare sector. Time consuming and required a “buy in” for all departments and staff to success...
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