Strategic Leadership and Future Delivery Healthcare Business Plan

Strategic Leadership and Future Delivery Models

The issue of life expectancy at birth is a relatively novel one. Before the 19th century for instance, the United Kingdom -- the country with the longest time-series of measured life expectancy -- had not measured this variable at all. It is nevertheless estimated that the life expectancy at birth was between 30 and 40 years -- today, it is around 80 (Roser, 2016). Within the United States, it is of 79 years; in Japan it is of 84 and Monaco (the highest expectation in the world) is of 89 years (Central Intelligence Agency, 2016). There are still countries with lower life expectancies, but the people in all countries across the globe are expected to life at least 49 years, with Chad having this lowest expectancy of life at the time of birth, followed by Guinea-Bissau and Afghanistan with 50 and Namibia and Somalia with 51 (Central Intelligence Agency, 2016).

In all aspects nevertheless, the life expectancy has increased significantly over the past two centuries, and this trend is observed in both developed as well as under-developed regions of the globe and it is a result of a multitude of forces, such as increased living standards, increased access to health care, improved population education, better technologies and so on. And in this new global setting, the patients become more and more demanding and expect higher quality medical services. In response to this growing demand of today's society, the HCAHPS has been created as a standardized method of collecting and measuring information regarding the patient experience in hospitals (Centers for Medicare and Medicaid Services, 2016). Based on the findings, the patients can analyze hospitals, compare them and choose to seek medical attention at the facility they find most suitable for their needs. In terms of the medical care providers, these can use the HCAHPS surveys to analyze the means in which their patients view them, to compare themselves with other hospitals and sector averages and, based on their findings, to develop new methods by which to improve their services of medical care. This is therefore the scope of this project, to assess the current state of the Los Angeles Community Hospital and to propose methods of improvement within the facility.

A. Los Angeles Community Hospital HCAHPS scores

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national standardized set of assessments collected from recent patients and targeting eleven specific quality issues. The current project assesses the HCAHPS data for the Los Angeles Community Hospital in an effort to improve the quality of the medical act as this is provided to those patients with fewer resources available. The institution's most recent HCAHPS data (as of May 2016) is presented below:

Quality issue

Always

Usually

Sometimes / Never

1.

Patients who reported that their nurses communicated well

57%

22%

21%

2.

Patients who reported that their doctors communicated well

62%

17%

21%

3.

Patients who reported that they received helps as soon as they wanted

44%

28%

28%

4.

Patients who reported that their pain was well controlled

52%

27%

21%

5.

Patients who reported that staff explained about medicines before giving it to them

44%

20%

36%

6.

Patients who reported that their room and bathroom were clean

48%

24%

28%

7.

Patients who reported that the area around their room was quiet at night

28%

29%

43%

8.

Patients who reported that they were given information about what to do during their recovery at home

Yes

73%

No

27%

9.

Patients who understood their care when they left the hospital

Strongly agree

32%

Agree

50%

Disagree/strongly disagree

18%

10.

Patients who gave their hospital a rating on a scale from 0 (lowest) to 10 (highest)

9 or 10

42%

7 or 8

27%

6 or lower

31%

11.

Patients who reported they would recommend the hospital

Yes, definitely

38%

Probably

30%

Probably/definitely not

32

At an overall look, the Los Angeles Community Hospital reveals a series of patient dissatisfactions, such a high percentage of its patients (32 per cent) stating that they would not recommend this hospital or nearly a third of its patients having rated it 6 or lower. A better view of the HCAHPS scores for the LA Community Hospital will be created throughout the following section, as the survey results are compared with those in the state, the country and two other hospitals in the region.

B. Analysis of the HCAHPS scores

1. Comparison with the state and national averages

Always

Usually

Sometimes / Never

1.

Patients who reported that their nurses communicated well

Los Angeles Community Hospital

57%

22%

21%

California average

75%

19%

6%

National average

80%

16%

4%

2.

Patients who reported that their doctors communicated well

Los Angeles Community Hospital

62%

17%

21%

California average

78%

16%

6%

National average

82%

14%

4%

3.

Patients who reported that they received helps as soon as they wanted

Los Angeles Community Hospital

44%

28%

28%

California average

62%

26%

12%

National average

68%

23%

9%

4.

Patients who reported that their pain was well controlled

Los Angeles Community Hospital

52%

27%

21%

California average

69%

23%

8%

National average

71%

22%

7%

5.

Patients who reported that staff explained about medicines before giving it to them

Los Angeles Community Hospital

44%

20%

36%

California average

61%

19%

20%

National average

65%

17%

18%

6.

Patients who reported that their room and bathroom were clean

Los Angeles Community Hospital

48%

24%

28%

California average

70%

20%

10%

National average

74%

18%

8%

7.

Patients who reported that the area around their room was quiet at night

Los Angeles Community Hospital

28%

29%

43%

California average

51%

33%

16%

National average

62%

29%

9%

8.

Patients who reported that they were given information about what to do during their recovery at home

Yes

No

Los Angeles Community Hospital

73%

27%

California average

85%

15%

National average

86%

14%

9.

Patients who understood their care when they left the hospital

Strongly agree

Agree

Disagree/strongly disagree

Los Angeles Community Hospital

32%

50%

18%

California average

49%

44%

7%

National average

52%

43%

5%

10.

Patients who gave their hospital a rating on a scale from 0 (lowest) to 10 (highest)

9 or 10

7 or 8

6 or lower

Los Angeles Community Hospital

42%

27%

31%

California average

68%

22%

10%

National average

71%

21%

8%

11.

Patients who reported they would recommend the hospital

Yes, definitely

Probably

Probably/definitely not Los Angeles Community Hospital

38%

30%

32%

California average

69%

24%

7%

National average

71%

24%

5%

In short, the comparison of the Los Angeles Community Hospital with the averages in the country and the state reveal the following:

LA Community Hospital has weaker nurse communication skills, well below the state and national averages

Doctor communication at the LA Community Hospital is also weaker than the doctor-patient communications at other hospitals in the state and the country

The response time when patients need help is significantly lower at LA Community Hospital

Pain management was also decreased at the LA Community Hospital

Patient information regarding the administered medicine is also lower at the LACH (Los Angeles Community Hospital)

Room and bathroom cleanliness were significantly lower at the LACH than the national and state averages

Patients at LACH reported higher levels of noise than other patients; for instance, while 43 per cent of LACH patients stated that their rooms were quiet only sometimes or even never, at the national level, only 9 per cent of the patients had this problem

Fewer LACH patients stated that they were given information upon their leaving the hospital and fewer of them actually understood what they had to do when they left the hospital

Lower hospital rating by the patients; while at the national level, only 8 per cent of the patients rate their hospitals 6 or lower, the LACH was rated 6 or lower by 31 per cent of its patients. Also, while at the national level, only 5 per cent of the patients stated they would not return to the same hospital, the patients at LACH who stated they would not return accounted for 32 per cent of the responses.

2. Score comparison with Cedar's Sinai Medical Center and the Good Samaritan Hospital

Always

Usually

Sometimes / Never

1.

Patients who reported that their nurses communicated well

Los Angeles Community Hospital

57%

22%

21%

Cedars-Sinai

75%

20%

5%

Good Samaritan

73%

21%

6%

2.

Patients who reported that their doctors communicated well

Los Angeles Community Hospital

62%

17%

21%

Cedars-Sinai

78%

16%

6%

Good Samaritan

80%

16%

14%

3.

Patients who reported that they received helps as soon as they wanted

Los Angeles Community Hospital

44%

28%

28%

Cedars-Sinai

62%

29%

9%

Good Samaritan

60%

27%

13%

4.

Patients who reported that their pain was well controlled

Los Angeles Community Hospital

52%

27%

21%

Cedars-Sinai

70%

23%

7%

Good Samaritan

69%

24%

7%

5.

Patients who reported that staff explained about medicines before giving it…