INTRODUCTION
The customers or clients in any kind of business are the lifeblood of the organization. These people give the organization a reason to exist and a direction to follow. Thus, the provision of quality products or services for the customers is a vital focus of any business endeavor. The concept of quality takes a different essence in the service industry. According to the American Society for Quality (2007) the impact of the service industry depends upon the quality of personal interaction between service personnel and their clients.
Definition of the Problem
This analytical report is an attempt to assess the effectiveness of the proposed plans for addressing the problem of skill inadequacy among the staff that results to poor service quality at GreenLife Old People’s Home and to identify other possible methods. The report looks at four specific plans namely staff reinforcement training, preference for recruiting mature and experienced employees, designation of a “key” worker among the service staff, and arrangement of recreational activities for personnel, residents and their families in light of the existing literature on improvement of quality service in nursing care to determine congruence and to identify other alternatives to the issues faced by GreenLife.
Background Information
GreenLife Old People’s Home has been providing nursing care services for the aged since 2004. Specifically, GreenLife offers personal care such as assisting the aged residents in bathing, showering, getting up in the morning, going about daily activities, and going to bed at night; preparing and serving meals, accompanying the residents to the hospital for consultations and check ups, aiding in taking prescriptions when they are sick, and organizing outings for their leisure and recreation needs. Lately, GreenLife has been receiving consistent complaints from residents and their families on the quality of staff service that they are experiencing. Most of the clients and their families perceive that the staff lack adequate skills in providing nursing care which is the cause of some form of negligence of duty. Feeding and bathing are often delayed while one resident suffered an injury in the wash room and was not known until the next day. Another complaint is the long waiting time for residents to receive assistance from the nursing home personnel. The Administrative Executive of GreenLife is concerned about these issues since they may lead to loss of organizational credibility, trust from the clients and other more serious consequences. Accordingly, the Administrative Executive proposed four measures to address the issues facing the organization. The first plan is staff reinforcement training which aims to impart the necessary skills and knowledge regarding nursing care service based on the guidelines of the social welfare department. Secondly, GreenLife seeks to improve their recruitment strategy by hiring and placing experienced individuals in providing care for the aged and recognizing their needs, and employing more people to meet increasing number of residents. Thirdly, there is a need to select a key worker from among the existing manpower who will be responsible for training and oversight of the care workers’ performance as well as assist in communication and management of the workforce. Finally, recreational activities are deemed necessary to give opportunity for employees, residents and their families to interact and build stronger relationships.
Limitations of the Study
The discussions provided in this report are mostly based on the Proposal and Progress Report on Improving Staff Care Quality of GreenLife Old People’s Home. The report revolves around the information contained in the two documents and on the existing literature about service quality in nursing homes. First, the report attempts to find any congruence and gaps between the four proposed plans for improving service quality and available literature on the topic. Second, the report seeks to identify other methods of improving quality service from the available literature.
Overview of the Report/Scope of the Inquiry
The report presents first the existing challenges facing GreenLife Old People’s Home and the proposed measures to address these issues. Afterwards, the report finds available literature on improving service quality in nursing care services to relate the applicability of the plans. The report then finds other methods of improving service quality in nursing care before formulating conclusions and recommendations regarding the improvement of quality of service at GreenLife Old People’s Home.
COLLECTED DATA
Quality of care in nursing homes and nursing care services as reported by Peak and Sinclair (2002) comes in three categories: structure, process, and outcome. Structure refers to attributes of the facility, equipment, material resources, manpower, organizational structure, and methods of reimbursement. Process involves the actual practice of hands-on patient care while outcome includes the impacts of care provided to the patient and patient satisfaction resulting from that care (p. 75). Nursing care services are required to establish commitment to consistent staff development relative to gerontological nursing that encompasses all the knowledge and skills in the care of the chronically ill and disabled aged people such as care planning, resident assessment, compassion for the old, and commitment to caring. Staff development and in-service training should be mandatory for all employees to ensure that they can maintain and enhance their skills and expertise in care provision (Louwe and Kramer 2002, p. 38; Wunderlich and Kohler 2001). The proposed staff reinforcement training for implementation in GreenLife is supported by the literature. The purpose of the training is to reiterate to the staff of the old people’s home the necessary skills and knowledge that they should possess to ensure quality of service to the residents. However, GreenLife should strictly implement the training to involve all the staff. Due to the heavy workload of the staff, only 8 of the 17 were able to participate in the training. There is a need to strictly require all the staff to attend the training to guarantee that the entire workforce is getting uniform knowledge and skills in their practice of care giving. Secondly, quality care provision requires a sufficiently-skilled and diverse workforce to ensure that aged residents receive a wide array of services for their various needs. Manpower requirements in nursing homes include different professionals such as nurses, therapists, social workers, dietitians, pharmacists, dentists, food servers, housekeepers, and so forth (Wunderlich and Kohler 2001). Thus, quality service cannot only be achieved by recruiting mature and experienced personnel. Although people with thorough academic and practical training in care giving for the old can render efficient service since they already know what they should do, quality service still calls for diverse skills among its manpower. GreenLife should be able to establish recruitment procedures that would enable it to identify and employ highly-trained and experienced workers not only in care giving but also in therapy, social welfare and counseling and even the basic duties of housekeeping and food serving. Furthermore, quality in nursing care services can be achieved through leadership which provides the organizational focus. Leaders should be able to communicate their visions through their actions, set aside time to get to know their employees, solicit staff participation in decision making and problem solving, appreciate good employee performance and render coaching, and assist the employees in understanding the essence of service excellence in care provision (Wojciechowski, Gesell and Williams 2003). The selection of a “key” employee in GreenLife addresses the leadership requirement critical in achieving improved quality of service. The responsibilities of the key employee such as provision of training, supervision, assistance in team communication, and management of team are parallel to what the literature says about leadership in nursing care services. The key employee or the leader should be committed to service excellence and quality performance, be able to impart this commitment to the other staff, and guide the employees’ motivations and efforts towards the fulfillment of quality service. Finally, nursing home residents, family members, and employees are the three groups of stakeholders in a nursing care service setting that determine the parameters of quality service and resident satisfaction (Peak and Sinclair 2002, p. 75). These stakeholders engage in constant interaction as care services are provided by the staff, received by the residents, and evaluated by the residents and their families. Employees should be able to gain the trust and participation of the residents and members of their family to ensure that all the necessary procedures in care provision are adhered to. Also, any dissatisfaction with a service provided by a care worker would impact the reputation of the nursing home. The last proposed plan which is to arrange recreational activities for residents, family members, and employees can make interaction, open communication, deeper understanding of one another, and development of a stronger relationship possible.
The issues in GreenLife can be addressed through an innovative approach in enhancing service quality in nursing care service settings called the Wellspring Model. This model integrates resident-centered care concepts, personnel empowerment, and clinical training modules that target the broader context of service quality. Through this model, nursing care workers are provided training in best practices on subjects like nutrition, feeding, pain management, palliative care, and leadership. GreenLIfe can benefit from this module because it would enable the employees to supplement their knowledge in various aspects of care giving that can guide their performance. In addition, the Wellspring model advises nursing homes to give their manpower the freedom to determine the proper ways of performing their jobs and formulating work-related decisions. GreenLife employees can have the autonomy to manage their duties and detect any challenges in the performance of their tasks. Finally, this model teaches the ways to accumulate clinical information from residents including prevalence of unrestrained episodes, number of falls, weight loss, and so forth, and then use these data to assess staff performance and quality of care provision. Through this model, GreenLife’s manpower would gain access to the best practices in care provision from various sources across the country that can enrich their knowledge base and practice (The Wellspring Model 2005).
CONCLUSION
Summary of Findings
Improving staff competence and service quality can be achieved through staff development trainings, recruitment of skilled and diverse workforce, leadership, and strong relationships between employees, residents and family members. Staff training can help the employees gain knowledge and competence relative to caring for the old, appropriate working behaviors and attitudes, and specific skills in responding to the needs of the aged residents. Matured and experienced personnel are also found out to be crucial to improving the quality of service in nursing home settings. Workers who are highly-trained, both academically and practically, know the appropriate skills, knowledge, and attitudes in care provision for the aged. However, the literature states that the nursing home setting needs various professionals that can deliver specific services such as nursing care, therapy, social work interventions like counseling, food service, housekeeping, pharmacy, and diet and nutrition techniques. Thus, it is advisable that a nursing home seeking to improve service quality should not only hire experienced workers but also workers from different professions. Furthermore, the preference for a key employee is also necessary for improving nursing home service quality because the key employee performs leadership duties that give the organization focus and direction. Finally, recreational activities would provide the stakeholders the chance to share and discuss issues and possible solutions in a collaborative manner and develop a stronger relationship. An innovative model known as Wellspring Model encompasses the abovementioned issues in one structured approach providing training on specific nursing care theories, staff empowerment and management of relevant clinical data.
Overall Interpretation of Findings
The proposed plans for improvement of staff competence and quality of service at GreenLife are consistent with the existing literature. Staff training and development proven to equip care service providers with important skills and knowledge about care giving can help GreenLife address the lack of competence of its manpower. Training can enhance the ability of the staff to handle their duties so that the residents would not suffer longer waiting times and delays in care provision. Experienced and diverse workforce would enable GreenLife to enjoy the benefits of having a workforce that can deliver varied services for the diverse needs of the aged residents. Leadership also provides GreenLife the ability to oversee staff performance, facilitate communication and sharing of ideas, and ensure that all efforts are geared towards satisfaction and benefit of the residents. Also, recreational activities provide a venue for GreenLife’s employees, residents and their families to tackle issues and solutions to address these issues, and establish working relationship with one another. The Wellspring Model is proven to be effective in fulfilling these objectives. The model provides training modules on important clinical care concepts and employee empowerment that can help GreenLife’s personnel to learn relevant ideas in clinical care and give them more liberty to manage their service delivery.
Recommendation
GreenLife should be able to implement the plans in a consistent manner and with sufficient monitoring mechanisms to ensure that everyone is committed to the objectives. There is also an underlying problem with heavy workloads that jeopardize the duration and quality of service that the staff can render to residents. GreenLife must be able to recruit specifically-trained people for every responsibility in the organization so that the employees’ duties would be more structured and they would be given extra time to engage in internal staff development initiatives.
REFERENCES
Improving the Quality of Nursing Home Care: The Wellspring Model 2005, The
Commonwealth Fund, viewed 12 March 2007,
Louwe, H and Kramer, A 2002, Self-Help Guide for Assessing and Improving Nursing Home Quality Issues Related to Optimizing Your Work Force,
Home School of Nursing at the University of Minnesota, viewed
12 March 2007,
StaffGuide093002v1.pdf>.
Quality in Service 2007, American Society for Quality, viewed 12 March 2007,
Peak, T and Sinclair, S 2002, ‘Using Customer Satisfaction Surveys to Improve Quality of Care in Nursing Homes,’ Health and Social Work, vol. 27,
no. 1, p. 75.
Wojciechowski, S Gesell, S and Williams, A 2003, What Drives Customer
Satisfaction in Nursing Homes?, Press Ganey Associates, Inc., viewed
12 March 2007,
readings_findings/satadv/article .php?article_id=7>.
Wunderlich, G and Kohler, P 2001, Improving the Quality of Long Term Care:
Strengthening the Caregiving Work Force, The National Academies Press Home Page, viewed 12 March 2007,
No comments:
Post a Comment