The QEH challenge
The call for improvements in all aspects of the operations at the workplace has become more the norm than the exception to the rule. There are increasing demands being imposed on both management and employees.
These demands come as a result of the new expectations that include the provision of quality service, higher levels of productivity and the demonstration of efficiency and accountability. This provides a perfect stage for evaluating the performance of individual public and private organisations.
Recently the board of management of the Queen Elizabeth Hospital took the bold step to go to the public to account for its stewardship and to provide the opportunity for a critique of the work at the institution.
Press reports on the discussions at this open forum highlighted the need for improvements in the hospital collection of payments for services provided, additional financial resources to improve the services that the hospital currently offers, and to enable it to offer additional services. The turnaround time of patients presenting themselves at the Accident and Emergency Department was also a topic for discussion. These issues are not new, and can be likened to a recurring decimal.
The matter of financing is hardly one that the public can resolve in such a forum. The management team at the QEH and its cadre of professional consultants, inclusive of financial planner, investment and procurement experts, amongst others, have to come up with the workable solutions. Unfortunately, they may have the difficulty of manoeuvring around the politicians who in projecting their own agenda, might have other ideas.
In taking a comprehensive look at the workings of the hospital, it is understandable why financing remains the focal point. It goes without saying that finances are critical to the operations of the institution. There is the contention that efficiency and productivity within the institution are equally as important, given that it has a responsibility to meet the needs and expectations of patients and the public at large.
In the scheme of things, it appears that there is some deficiency in the latter areas. If these are in fact areas of concern to the authorities, then there is need to find immediate, medium and long term solutions to these challenges. With all the best will in the world, there can be no quick fix to remedy these deficiencies.
To conjure up such would be to ignore the fact that the process of a cultural shift weighs heavily in effecting change. This change is underpinned by a vision shared by management and staff, which is predicated on image building, the removal of dubious perceptions and the promotion of attitude change.
There is no magic formula to achieving this. It has to start with the identification of basic standards, and the creation of a work environment and culture that will encourage and motivate the staff to perform at its optimum, and to take pride in displaying the highest level of professional in all areas of work. If this is achieved, it can serve as an effective marketing tool in attracting greater philanthropic support.
In the US and Canada, it is the norm to have major organisations and private interest adopt a ward or some facility at the hospital. There is no reason why this should not be more rigorously pursued than seems presently to be the case.
It is about time that such high profile organisations as Sandy Lane Hotel, the Goddard’s Group of Companies, COW Williams Construction and the Insurance Corporation of Barbados, just to identify a few, are invited to support a programme or adopt a ward or department of the hospital. For example, the landscaping of the grounds of the hospital can fall to an organisation that commits to a five year agreement.
In attempting to remedy the problem of financial shortfalls, it may be wise to address and improve on those areas in which the hospital is deficient. In this regard, the cutting out of wastage and a implementing a proactive maintenance programme should be amongst the priorities measures introduced. A sound procurement policy would help to ensure that suitable and appropriate supplies and equipment are obtained.
The possibility exists that a poor staffing numbers contribute to some of the inefficiencies that exists. There is the anticipated counter argument that an increase in staff will create greater financial stress. Given the current economic circumstances, this is understandable. However, if the hospital is to be seen as efficient and capable of delivering quality and timely services, then it places itself in a better position to attract support from those who have it to give.
It can only deliver quality and timely services if it has the requisite human resources and systems in place. Should the QEH positions itself to be marketed as the regional premier institution of choice, it will stand to benefit from higher levels of patient referrals from across the region. The revenue which stands to be earned can inevitably change the bottom-line.
Nothing will change by simply rehashing the same problems over and over again. Management must therefore accept the challenge to devise a plan that will enable the institution to make the kind of investments that will in the short and medium term, allow it to cash in on improved financial returns.
The hospital is a business operation which, like all others, will have to make hard business decisions, albeit after careful thought to ensure that patient care and support are not compromised. The challenge is for the board of management, chief executive officer and the team of executive directors to come up with a plan to secure additional funding support, to that provided by Government.
* Dennis De Peiza is a Labour Management Consultant with Regional Management Services Inc.
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