Report_Cairnwell_Health_Centre

INTRODUCTION This report was commissioned by Doctors Stewart and Campbell and compiled by Petra Kosova of Total Administrative and Organisational Solutions (TAOS). The aims of the report were to identify the administrative problems and recommend changes. Cairnwell Health Centre is located in the middle of Fraserhead. The capacity of the Centre is 1,000 patients. It is headed up in partnership by Doctors Stewart and Campbell who employ several staff members including a Practice Manager, two receptionist/clerical assistants, an archivist, two typist and nursing staff. The Health Centre has been inspected by representatives of the Buchan NHS Trust. During inspection these issues were found: ➢ Low staff morale ➢ High levels of stress-related absenteeism ➢ A lack of appropriate IT ➢ High levels of patient dissatisfaction with appointment system and attitude of staff The Health Centre needs to secure funding for next five years but firstly is required to resolve problems of low morale, absenteeism and administration inefficiency. This report was to be submitted by 5th October 2009. METHODS OF INVESTIGATION 1. An interview was carried out with Doctor Campbell on the 28th August, 2009 2. An observation of the reception area was carried out on the 31st August, 2009 3. A patient questionnaire was handed out on the 4th September, 2009 4. A staff Questionnaire was handed out to staff and answered anonymously on 5th September, 2009 5. An IT system was evaluted on 7th September, 2009 6. A meeting with staff was carried out on 8th September, 2009 FINDINGS 1. On 28th August an interview with Doctor Campbell was carried out. Doctor Campbell answered on the questions which were about the main problems of the Health Centre such as low staff morale, discussing where faults happen, skills of staff and improving of the IT system. (See Appendix 1) 2. On 31st August, an observation of the reception was carried out. These issues were found: ➢ The receptionist was often away from her desk. ➢ A telephone was ringing for a long time without an answer. ➢ During the morning there was a queue of patients. ➢ Patients were not served in satisfactory time. ➢ The appointment system and attitudes of staff led to high levels of patient dissatisfaction. 3. Patient questionnaire was handed out on 4th September (see Appendix 2). In the patient questionnaire were six questions. From 600 patients filled the questionnaire 556 with followings results: ➢ From 556 patients, 143 were not satisfied with the appointment system. ➢ Over 69 % of patients were not comfortable with the attitude of staff. ➢ 501 patients answered that the medical equipment was effective. (See Appendix 3, Diagram with results) 4. The staff questionnaire was handed out on 5th of September. (See Appendix 4). In the questionnaire types of question were included which could help to remedy staff troubles. The questionnaire was designed to be anonymous. This was to encourage people to be honest in how they answered. ➢ Only 20 % of staff was satisfied with their job. ➢ 40 % of staff had 50 and more days off last year. ➢ 7 members of staff from 10 felt under pressure in the workplace. (See Appendix 5, Diagram with results) 5. On 7th September the IT system was evaluated. The following issues were found: ➢ Hardware and software were outdated such as monitors, matrix printers and security system. ➢ Security system was not upgraded and it could lead to data lost or misuse of private patients’ records. ➢ Old monitors CRT´s (cathode ray tube) could cause problems like headaches and problems with eyes. Pictures were of poor quality and glimmered. ➢ Matrix printers were old and not economically viable. Printers were consuming a great deal of energy plus wasted colours. 6. On 8th September was carried out the meeting with staff. The following points were prioritised: ➢ Low staff morale. ➢ Stress-related absenteeism. ➢ Patients’ dissatisfaction with attitude of staff. These problems were discussed with staff. Every member of staff agreed with changing attitudes to patients’ and a reduction in stress-related absenteeism. CONCLUSION During dates 28th August, 2009 to 8th September, an interview with Doctor Campbell was carried out where the main problems were discussed. An observation of the reception area was carried out, patient and staff questionnaires were distributed too. The IT system was evaluated and finally a meeting with staff was carried out. Some significant problems were highlighted during the visit to Cairnwell Health Centre: ➢ Low staff morale ➢ High levels of stress-related absenteeism caused by lack of communication between members of staff ➢ A lack of appropriate IT ➢ High levels of patient dissatisfaction with appointment system and attitude of staff RECOMMENDATION Doctors Stewart and Campbell should consider the following recommendation in order to improve the efficiency of the surgery. Team building ➢ Hiring a professional company TeamBondign with the experience to manage the team building component of the Surgery. ➢ This company will help to the staff manage their job, staff will be more satisfied, more creative, healthier, more motivated, more flexible and better able to meet job demands. ➢ Course Effective Communication will offered teaching. Effective Communication will be taught to staff members. ➢ Increased appreciation of each other within the team. ➢ An understanding of the strengths and weaknesses of the communication styles of the group ➢ www.teambonding.co.uk IT SYSTEM (hardware and software) First eBusiness Solution With over twenty five years experience in delivering and supporting business systems, this company can provide the right financial, sales and marketing, or operations and fulfilment IT system for Cairnwell Health Centre. As a leading Microsoft Gold Certified Partner, the Centre can be confident that our highly qualified and experienced team will provide a high quality, cost effective solution that will. This is unique in Scotland being the only Microsoft Gold partner accredited to offer three of Microsoft's main Business Solutions and having the in-house capability to develop extensions, integrate and provide the server infrastructure with on-going support and a complete service. Their products span the complete range from Business Solutions to Server Solutions and Development and Integration Solutions.  They include Microsoft Dynamics AX,  Microsoft Dynamics GP, Microsoft Dynamics CRM, Citrix, Microsoft Exchange Server 2007, Microsoft Sharepoint Portal, Microsoft Biztalk Server and Microsoft.net. All can be tailored too meet the needs of a busy surgery. www.firstebusiness.co.uk PATIENT RECORD ECLINITEK - Patient Record Management Solution Electronic Medical Record Software is necessary to ensure the medical practitioner can maintain its operations in an organized and well-coordinated manner. These solutions save time and run the operations using the best mechanisms against liabilities. eClinitek is a user-friendly system of managing patient details & clinical records. It features easy to use Patient searches on various parameters. Doctors can maintain a daily diary, medication history, allergies etc within the system. Various system reports have been provided to ensure information & controls are easily accesable. This Electronic Medical Record System is used to manage and maintain electronic medical records, patient information, prescriptions, lab reports etc. The system is especially helpful in organizing and keeping patient records up-to-date. Patient names, records of treatment and medicine given records are well maintained. ECLINITEK Features: ➢ User Friendly ➢ Security Logins ➢ Patient Card ➢ Patient Searches ➢ Rx Daily Examination Diary ➢ Rx Medication History ➢ Allergies ➢ CT Scan / X-ray / Biopsy APENDICES Appendix 1 An interview with Doctor Campbell 1. What are the main problems with surgery' Firstly, we will try to solve problems with low staff morale and reduce high levels of stress-related absenteeism because if staff are happy, patients are happy as well. Secondly, I would like to satisfy our customers – patients, so will organise an appointment system. And thirdly, we will improve the IT system. 2. Why do they have minimum of low staff morale in this job' A good solution might be to hire more members of staff but at the moment it is not possible because we do not have enough money. 3. Are they working under pressure' Yes, it is a big surgery. 4. Does every member of staff have adequate skills and experience' We are trying to improve skills of staff through courses because we can be certificated and it can raise the standard of our services. 5. Do you have any idea how to improve the IT system' We need computers with an operating system for every office staff. After that we plan to re-write patients cards from handwritten to digitall. Appendix 2 Patient questionnaire A patient questionnaire was distributed to patients on 3rd September, 2009 1. Are you satisfied with the appointment system' ← Yes ← No ← Don’t know 2. Are you satisfied with our services' ← Yes ← No ← Don’t know 3. Do you have adequate information on your health and do you understand it' ← Yes ← No ← Don’t know 4. Are you satisfied with the attitude of staff' ← Yes ← No ← Don’t know 5. Do you think the medical equipment is effective' ← Yes ← No ← Don’t know 6. Are you satisfied with overall service' ← Yes ← No ← Don’t know Thank you for your time to fill out our questionnaire. Appendix 3 [pic] Appendix 4 Staff questionnaire A staff questionnaire was distributed to staff on 4th September, 2009 1. Are you satisfied with your job' ← Yes ← No ← Don’t know 2. How many days off have you had on the last year' ← 1 - 15 ← 16 - 50 ← 50 and more 3. Do you have a problem working as a team with your colleagues ' ← Yes ← No ← Don’t know 4. Why do you think the staff have low morale' Where is the main problem' ← Unsatisfactory management ← Low salaries ← No teamwork, collective ← Don’t know 5. Would you like to change anything' ← Yes ← Salaries ← Uniforms ← Work environment and equipment ← Time working ← Job description ← Anything else ← No ← Don’t know 6. Do you feel under pressure in the workplace' ← Yes ← No ← Don’t know Thank you for your time to fill out our questionnaire. Appendix 5 Results of staff questionnaire Appendix 6 LCD Monitors Technologies to control the output image so that the difference between dark and bright points has always been on the highest level. F-Engine: Special chip implemented in the LG monitors, improving image quality by controlling brightness, contrast and colour fidelity. Also looks after noise removal, due to the way video signal from your computer to monitor. Model: W2043T, LG Sync Range Horizontal Frequency 30 ~ 83 kHz Vertical Frequency 56 ~ 75 Hz Input signal Type of video signal analogy / digital Panel TN 16:9 Size (inch) 20 Resolution (pixel) 1600x900 Angle 176/160 Pixel Pitch (mm) 0.24825 Contrast 30 000:1 Illuminate 300 cd/m2 Response Time 5ms Supported colours 16.7M colours Video Input PC , D-Sub, DVI-D Power Consumption On 38 W Hibernate