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In part one of her three-part blog series, Dr Mona Stokes, Director of Ziradian Consulting, discusses how to identify areas for investment:

 

On occasion it may seem counter-intuitive to invest further resources into certain services. In some cases it can feel like throwing good money after bad, especially with ever tightening purse strings in the public sector. So how to choose where to invest, and where to stop spending?

It can be much more complex than one might think; identifying areas where investment will produce the greatest returns is extremely challenging. Should you choose departments where the tariff is potentially the greatest, the area that is working at the narrowest margins or simply those that are failing to deliver cost-effective or safe care? The answer is simply none of these. I would simply suggest choosing the area where staff or patient satisfaction surveys reflect the poorer ends of the spectrum.

There has been increasing interest in patient and staff satisfaction. Collecting surveys to assess these levels is not a new concept. Indeed, in General Practice one of the factors contributing to practice payment relates to patient satisfaction. Recognition of the importance of patient satisfaction is increasingly pertinent to acute trusts also. Staff satisfaction levels have been linked to the financial performance of healthcare organisations; where poorly performing trusts have low levels of staff satisfaction and trusts that are financially stable have greater reported levels of satisfaction.

Poor staff or patient satisfaction of a service usually relates to a number of factors. Patient satisfaction indicates that the final product is either ineffective, inappropriate or poorly presented. It may be that the product itself, in this context clinical care, is completely reasonable, but there is something in the way that it is delivered that is suboptimal.

Where patient satisfaction is poor, staff experience is also often low. There is often a reportedly high level of workload or stress, even where activity equals other areas. There is also a lower reported level of self-direction or autonomy. Unsurprisingly there may well be higher levels of staff sickness in these areas and poor staff retention.

These 'soft' signs are clear indicators of a service that is struggling to maintain a cohesive pleasant working atmosphere. Patient care is ultimately affected and so this is where I would focus my attention.

To address these shortfalls a comprehensive package of changes must ensue. These must take staff with them and preferably be driven, led and managed in an integrated and empowering fashion. Staff engagement is critical to effecting an improvement that will ultimately lead to a happier, healthier workplace.

 

If you have any comments or questions about this blog post please email info@zircadian.com