Improving a healthcare facility can be a question of applying the right strategic management model. These models have been shown to work if implemented well, but they might need some readjustment to be applied in a healthcare context. The first model to consider is Management by Objectives, which has been implemented effectively throughout various businesses. When it works well, it increases employees’ motivation and allows them to participate in goal setting while monitoring their performance and administering correctives. It is also easy to implement, as most of its tenets are likely to be applied already. However, its major flaw is that the objectives in the system are usually very quantitative. Holding nurses and doctors to KPI-like standards, already swamped and stressed specialists may be robbed of their professional discretion.
Another possible solution lies with Total Quality Management, a management strategy that prioritizes customer satisfaction and directs all efforts to attain it. In particular, the EFQM model is a variation on Total Quality Management that divides healthcare operations into five enabler criteria and outcomes into four results criteria (Van Schoten et al., 2016). Thus, approaching a healthcare facility with these criteria in mind, definite improvements can be made to enablers, and they have been shown to produce positive outcomes. Its significant upsides are proven effectiveness and robust assessment tools that help keep track of the enablers and outcomes. The downside of the model is that it tracks performance holistically and is oriented at processes, and a healthcare context may not lend itself well to that without significant alteration.
The third popular strategic management model is Six Sigma, which, at its core, is aimed at eliminating errors to improve the final service. It has been shown to produce good results with high awareness and involvement from top management (Antony et al., 2018). The tools provided by Six Sigma are aimed at collecting data, creating strategies, and tracking progress, as reducing flaws requires accurate information. The upside of using it is that healthcare is exceptionally vulnerable to error and flawed procedures, eliminating which has the potential to improve its quality significantly. The downside of Six Sigma is that it has little application beyond eliminating flaws, and some adverse outcomes might not be a result of an error.
It is safe to say that Management by Objectives should be discarded from the possible solutions. Firstly, it has likely already been implemented in a facility in some form, and secondly, broadening its implementation makes a healthcare facility too stiff. When choosing between the remaining Total Quality Management and Six Sigma, the correct choice seems to be integrating both. Six Sigma could improve many processes and flaws known at a micro-level, such as departments, wings, or wards. They should be the healthcare facility’s local-level error prevention tool, that local leaders should help implement. EFQM could be the facility’s holistic performance tracking and quality improvement solution that counts lower-level Six Sigma as one of its methods for such. Aiming only at meeting targets or improving processes could prove ineffective. However, when supplemented with Six Sigma’s focus and error prevention methodology, it could detect possible improvement areas in minute and non-obvious details.
The strengths of that approach include its reliance on proven methodology and a double-pronged approach to both improving care and reducing medical error. It also considers non-obvious parts of daily operations that could serve to increase the quality of care or the wellbeing of workers. Its main weakness is its complexity and its need to deeply analyze every stakeholder among the staff, as well as involve everyone in performing two programs at once. Workers are usually busy, and budgets are usually low, so implementing this mixed model may be prohibitively expensive and time-consuming. The opportunities it gives is a marked improvement in the quality of care, which is an extremely effective marketing message. The threats come from the model’s complexity, as budgets are provided from elsewhere, and experiments with strategic management may halt performance.
References
Antony, J., Palsuk, P., Gupta, S., Mishra, D., & Barach, P. (2018). Six Sigma in healthcare: a systematic review of the literature. International Journal of Quality & Reliability Management, 35(5), 1075–1092.
Van Schoten, S., de Blok, C., Spreeuwenberg, P., Groenewegen, P., & Wagner, C. (2016). The EFQM Model as a framework for total quality management in healthcare. International Journal of Operations & Production Management, 36(8), 901–922.