Contents

Understand how to identify and meet stakeholder needs in service delivery. 2

1.1 Identify stakeholder groups and their expectations for service delivery. 2

1.2 Assess the impact of poor service quality for the organization and stakeholders. 3

1.3 Explain how quality standards are set and monitored. 4

2. Understand how to manage quality of service delivery. 5

2.1 Analyze the concepts of quality and quality standards in relation to service delivery. 5

2.2 Evaluate approaches to quality management in service delivery. 6

2.2 Setting of quality standards and monitoring them.. 9

LO3 Promoting continuous improvement in service delivery. 11

3.1 Analyze the concept of continuous improvement in service delivery. 11

Research: 11

Service improvement 12

Referrer and patient choice. 12

Resource management 12

Accountability: 12

3.2 Need for continuous improvement and change implementation. 12

Reference. 14

Understand how to identify and meet stakeholder needs in service delivery

1.1 Identify stakeholder groups and their expectations for service delivery

Those who are interested in the performance and decisions taken and their evidence are called stakeholders of the healthcare system. In the healthcare system, patients are the external customers. Nurses, doctors, therapists, pharmacists, technicians and support staff, researchers and social workers form the latter group. External stakeholders provide input to the system such as patients, suppliers, patients, and funding agencies. The internal customers are internal stakeholders. Key stakeholders are those who can pass laws such as health missions and block officers. Hospital governing bodies and NGOs are public stakeholders (Bower, 2005).

Stakeholders of an organization have varying expectations and perceptions. However, perceptions depend on the quality of service delivered. If the perception of the customers is met, then they are satisfied, and vice versa.  External customers want proper behavior, treatment, good service and responsibility on part of the hospital authority, timeliness, safe environment, proper passing of information, etc. Internal stakeholders want roper remuneration and on time. Funding agencies want quick returns on their investments, suppliers want goods relationship with the system so that they can partner for a long time, health missions expect the system to abide by the rules laid down by the government and governing bodies of hospitals expect proper performance from the employees. If the system caters to all of these needs s of the stakeholders they will be able to satisfy the latter (Parasuraman, et al 1985).

In order to be aware of the expectations of the stakeholders there has to be a strong and communicative management system that takes the burden of solving the problems. Difference in opinions can be mitigated by face to face conversations with the stakeholders. This way each side will learn about the requirements and problems of the other. Only discussing the barriers will never solve the problems, the barriers have to be addressed by implementing the solutions. The first thing to be done is identify the issues and the people who are tied to them. Even after solutions are implemented, problems remain. For this there has to be more research to understand the glitches of the system. Different issues such as political, communication, change management may come up. After this, expectations of each category of stakeholders are to be addressed (Bower, 2005).

1.2 Assess the impact of poor service quality for the organization and stakeholders

The organization has to wash hands of its reputation as customers lose trust from them thinking the management to be opaque. Healthcare providers and national economy is adversely affected by poor service. When a hospital performs badly, it will be in the bad books through word of mouth and the income will gradually decrease. Poor service such as bad conditions, lack of cleanliness, no information, long waiting hours, lack of punctuality, bad behavior are some of the examples that affect hospitals adversely (Parasuraman, et al 1985).

Every organization has certain aims and wants to meet the strategic objectives. If the service is poor and the hospital loses out on customers, then they will not be able to meet those aims. If the management does not take proper initiatives to solve the issues rising out of poor service, the aims of the hospitals will fall through. If this happens, the hospital will suffer losses and will have to take extra initiatives and incur extra costs for enhanced training of personnel and advertising that the organization is refurbishing. They will have to face the media and speak out that things are in a controlled state in the present scenario. (Bower, 2005).

The organization is answerable to its stakeholders. Shareholders, government, patients, etc are all affected by bad quality of service delivery. External customers face a lot of problems as stakeholders when an organization involved in healthcare cannot deliver proper service. They’re rises a common slogan that the organization is only for the rich and the system is very complicated so ath6 common man is never in the loop. Moreover, if a hospital fails to attend and render adequate service to a patient, he or she may die, may suffer more or may even s[read a certain disease while staying unattended or poorly attended. For example, if a TB is patient is left untreated for a long time, not only will he suffer, he or she will also be a carrier for the germ of the disease and several others will be attacked. When one employee in a hospital performs badly, the pressure of performance falls on others. Because of this, they may suffer from lack of confidence and delve into depression (Parasuraman, et al 1985).

1.3 Explain how quality standards are set and monitored

Meeting the requirements and demands of stakeholders is a very important action. For this, the first thing to be done is find out the priority areas, actions to be taken and the ways of verifying them. Many a time, it has been seen that a hospital has a set of standards to meet but, the employees are not bothered to meet them since there is no control on their operations. Hence, monitoring becomes significant for achieving desired results. Separate units should be set up for contagious diseases, for patients of different age groups, and other specialist services that would facilitate patients. Staffs should be properly trained, research options should be vast to ensure proper service and collaborate with other stakeholder groups like government, NGOs, administrative body of hospital. Average waiting period should be decreased. (Bower, 2005).

Renovation of structure, technological customer service for 24×7, safety and security, constant availability of fresh food for patient and family, affordable service, etc should be undertaken for patients. Vaccination for staff against contagious diseases, proper living and working conditions for staff, quality control panel for service, for proper staff involvement and performance. IF staffs don not get motivated they will not be able to perform properly. If customers in an organization are not satisfied, the organization will in no way obtain its objectives.

As stakeholders the administrative body also needs to be approached. They should be informed about everything going on in the institution. The annual reports should be submitted to the shareholders and directors. If in the annual meeting any one is absent, then he or she has the right to cast a proxy vote as per the choice of the shareholder.  Hence, the hospital management like other organizations should delineate the various duties and responsibilities it has towards its stakeholders and monitor them efficiently (Parasuraman, et al 1985).

A hospital should set up standards for reaching its aims and objectives of serving the customers and stakeholders. This will help them in reaching their strategic goals. Marketing strategy, price strategy, etc will then be efficiently covered. All the information regarding service delivery should be maintained so that the performance of each and every employee can be later evaluated for promotions and incentives (Bower, 2005).

2. Understand how to manage quality of service delivery

2.1 Analyze the concepts of quality and quality standards in relation to service delivery

Quality in a layman’s words is the degree at which excellence can be measured.

In service delivery, the difference between expectations and performance is called service quality.

An organization which has high service quality always meets the requirements of the stakeholder and also stays competitive in the market. Service quality is directly proportional to economic stability and competitiveness. Customers create perceptions on their own from advertisements, past events and word of mouth and try to compare the perception with expectation. If the service perceived is less than the expectation then means that the service delivery as not of good quality (Parasuraman, et al 1985).

Factors like needs, publicity and recommendations influence the expectation of stakeholders. Both increase and decrease in service quality depends upon the gap between perceived quality and expected quality. In North Carolina, Parasuraman, Zeithaml and Berry devised the GAP model which mentions the factors which should be maintained while delivering high quality. In RATER the five determinants are tangibles, responsiveness, service assurance, empathy and reliability (Bower, 2005).

Business methods that are meant to obtain quality policy and objectives is called Quality management system or QMS. It helps in understanding what customers want and require. Policies, framework, resources and methods that are needed to implement management of quality comprise the system (Parasuraman, et al 1985).

The most vastly used QMS rule is the ISO 9000 (International Organization for Standardization) series. The FDA( Food and Drug Association in USA) and IIP.

ISO is a voluntary authority in which the member countries have a representative each and they have vast authority on quality and standard. To reach ISO standards, an organization has to meet the steps of Proposal, Preparatory, Committee, Enquiry, Approval and Publication. It operated in 164 nations in 2013 (Bower, 2005).

Formed in 1991, IIP or Investors in People in UK is a devise used to improve businesses and protect investors’ integrity. Though it originated in UK several other nations have been licensed by the Investors in People International. It was responsible for managing the policies, quality assurance, promotion and development of the, of fund contributors and investors. The group operates in over 70 countries all over the world in 30 languages (Parasuraman, et al 1985).

2.2 Evaluate approaches to quality management in service delivery

There are several theories as well as approaches to quality management that are illustrated in the following section. The first of this approach is the total quality management theory that is illustrated below:

                                                Figure 1 : 6 C’s of TQM

Total Quality management is an approach for long term success by the help of customer satisfaction. The participation of all the employees are needed for the success of total quality management. As seen from the above diagram total quality management comprises of six C’s that are enumerated below:

Customer focus: It is the customer who, in any industry, determines the success as well as failure of an organization. Hence to this effect quality of the products/ services is enhanced. In this regard the various organization undertake many measures like employee training, installing new equipments, tools as well as new designing process so as to uphold customer focus in their approach (Bower, 2005)

Control: Control is inherent for any business or organization that seeks to maintain quality in its functioning. Hence the management of the organization needs to implement a control system that will look into the aspect of controlling the activities of the organization for managing the quality.

Commitment – Commitment is another necessary factor in order to extract quality in the operations. In this regard the managers have to be pro active in exalting the employees so as to make them committed to attain commitment.

Culture – culture of various organization differ that makes it difficult for the management to attain excellence unless a superior work culture has been cultivated. In this regard an integrated system is crucial to continually ameliorate the services and products.

Continuous improvement – As stated above the aspect of improvement is not an abrupt process. It should be continuous in nature so that the quality of the product/ services is maintained throughout the functioning of the entity.

Cooperation – cooperation plays a vital factor in devising the successful endeavor of any organization. Communication plays a vital part in ensuring that cooperation is present among all the echelons of an organization. Cooperation plays a large part in boosting morale as well as motivating the employees.

Deming’s 14 points on total quality management is a set of management practices that helps organizations to increase quality by focusing on total quality management. These points are mentioned below:

1. To develop steadiness of the production process to augment quality of services and products
2. Adopt the new doctrine of change.
3. Abhorring dependence on inspection to attain quality.
4. Putting stress on working with a single supplier so that total cost maybe reduced.
5. Constant improvement of planning, production and service.
6. Facilitating training programs for increasing job efficiency.
7. Implementing leadership.
8. Mitigating fear factor.
9. Facilitating interaction within the workforce.
10. Removing deadlines and targets for the employees.
11. Removing any quantitative allocations and goals for the employees and the management.
12. Doing away with the annual grading system and recognition on an individual basis.
13. Devising innovative training and self improvement program for everybody.
14. Involving all the people within the organization to achieve goals and targets (Bower, 2005).

2.2 Setting of quality standards and monitoring them

As illustrated in the above sections each and every organization has its own set of culture and ethics. Hence implementing quality standards will vary from organization to organization. In this effect some generic measures may be followed:

1. The management identifies and decides to implement TQM as one of its strategies.
2. The management of the organization analyses the current practices, present level of customer satisfaction and quality management within the organization.
3. The management team then central standards and principles that are to be employed and communicates them.
4. A centralized master plan of TQM is developed on the basis above three steps.
5. Different teams and groups are formed for improving processes and practices.
6. Managers participate personally in the quality management through means of planning, training, counseling and other methods.
7. The progress of the process management is evaluated and changes are evaluated on a regular basis.
8. Feedbacks from all level of the employees are elicited and system of reward and recognition is established.

Another tool for maintaining quality and standard is by implementing ISO 9000 standards. ISO 9000 is a series of standards or values which classify, create and sustain a quality assurance system for different industries. All over the world numerous companies and organizations have implemented it to ensure quality and standardization of their services and products. The setting up of ISO 9000 is very well established by the following diagram:

Developing theories for analyzing individual interactions so that the organization may develop may also be illustrated by group theory as illustrated below:

Basic Group theory formed by Bruce Tuckman is quite relevant to build strategies for team work and optimizing service quality and delivery. The theory has five components which are described as follows:

1. Forming – In this stage personal relations have the feature of dependence. The members of a group look for dependence from the group leaders. In this they look for guidance and instructions from the leaders for performance. The leaders need to be assertive as well as helpful to the group so that the employees get a concise view of what has to be done as well the means to achieve them (Bower, 2005).
2. Storming – As the name suggests storming relates to the inner conflicts within a group. The group members work towards the attainment of the organizational goals and in the process there will be conflicts within the organization.
3. Norming – The norming phase means that the interpersonal relations are elicited by cohesion among the group. In this phase the group members take cognizance of the fact that the ideas and the experiences of the other members in the group. The group members take active part in sharing their ideas and experiences for the betterment of the organization.
4. Performing – This is a stage that is very difficult to arrive at. In the performance stage the employees and workers are essentially divided into groups and sections for the enhancement of the goals. The division of the employees also enhances the performances of the organization. The overall goal is productivity through problem solving and work.
5. Adjourning – This final stage includes terminations of the task after its final conclusions. To facilitate the termination process effective interventions are needed from the managers and the leaders so that any type of crisis can be averted (Parasuraman and Berry, 1985).

LO3 Promoting continuous improvement in service delivery

3.1 Analyze the concept of continuous improvement in service delivery

“Measurement” implies objective assessment, but does not really include judgment of values or quality; that may be added by the people who are responsible to present and interpret the improvement.

Measurement is essential to the concept of quality improvement. There can be many targets and many stakeholders; these may be observed as the cluster of values and aims behind performance measurement, in the following areas as:

Research:  Data on the structure, activities and effectiveness can be put to use to study the link between organization and performance, and to make it viable on planning and system development.

Service improvement: The providers and the Purchasers can balance the performance within and among hospital employees to stimulate and measure a change.

Referrer and patient choice:  The referrers and the patients can use information like waiting times, outcomes and patient experiences while selecting a provider.

Resource management:  The providers and the Purchasers need data on performance, costs and volume of activity so as to decide on the appropriate use of resources.

Accountability: The public and the politicians often demand more transparency, protection and accountability related to performance

3.2 Need for continuous improvement and change implementation

Fluidity in the functioning of a business venture and increasing need to adapt it to the current trends in the market give rise to change Management. For continuous improvement an organization needs to be flexible so that it may incorporate changes within its ranks and files. Initially, changes bring apprehensions in the minds of those who are directly involved with it with regards to the effect which they anticipate to be brought on by this change. This is a critical period for all the level of staff in the organization to work through it collectively towards desired goals.

The different strategic intervention techniques may be human process interventions, techno- structural interventions, human resources management intervention as well as some theories like contingency theories, autocratic and participative style as well as pro active and reactive theories. The value of using these strategic techniques is for individual as well organizational development. A proper intervention strategy is of utmost importance in context to the successful endeavors of an organization. It eliminates the risks that arise as a result of the complexity of the modern day business needs. The effects of strategic interventions is such that it increases the function ability of these factors in an organization- Efficiency, effectiveness, equity as well as its sustainability (Parasuraman and Berry, 1985).

Reference

Bower A. (2005) The Diffusion and Value of Healthcare Information Technology Santa Monica, CA: RAND

Parasuraman, Zeithaml and Berry (1985), GAP Model