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Case analysis案例分析
Introduction 介绍
首先，与产品制造不同的是，医院或医疗保健行业由于产品在交换过程中的无形性，应被划分为服务行业。考虑到服务交付过程中涉及许多要完成的步骤，因此医疗服务的性质应基于高水平的服务提供者-接收者交互的设施（Pripley，2013年）。因此，需要灵活而有效的服务设计，而不是精确的生产设计。医疗从业者需要承认，在这项业务中为客户服务不仅是为了治疗患者，而且是为了关心患者的心理状况，并确保一定程度的客户满意度。在这种情况下，希望纪念医院的医护人员显然失败了。
First of all, unlike product manufacturing, a hospital or the healthcare industry should be categorized into the service sector because of the product intangibility in the exchange process. Given that there is great complexity in the service delivering process involving numbers of steps to complete, the nature of healthcare service should be facility based with high level of service provider-receiver interaction (Greasley, 2013). Therefore, instead of a precise production design, a flexible yet effective service design is required. It needs to be acknowledged by healthcare practitioners that serving a customer in this business is not only to treat a patient, but also to care about their psychological conditions and to ensure a certain level of customer satisfaction. In this case, the medical attendants in Hope Memorial Hospital have clearly failed.
在重复用药错误的情况下，尽管个人因缺乏对患者病情的沟通而受到指责，但主要原因还是服务提供过程不完整。这一错误的过程包括职责分配不清、内部互动不充分以及与客户缺乏沟通。首先，当客户意识到药物清单丢失时，他考虑了可能发生的各种错误，但无法确定清单的确切位置。这反映了医院中一个模糊的责任部门，因为应该有一个人负责记录病人过去的用药记录，或者在急诊室中有一个特定的小组负责从救护人员那里接班。第二，护士答应把正确的名单信息传给下一班。然而，第二天早上，病人仍然被注射了错误的药物，这是两年前的一份清单。这清楚地反映了错误的沟通和工作移交过程。要求有明确和严格的规定，所有参与治疗过程的医护人员都应了解一名患者的最新信息。还应提供明确规定的不同班次之间的工作交接标准。由于缺乏客户沟通，问题主要集中在医院的投诉系统，下一部分将对问题进行讨论。除此之外，还应改进设施布局和产品设计，以便不再出现上传信息困难等问题（Chase等人，2004年）。总的来说，尽管个别员工的责任推卸加剧了问题，但不完整的服务流程主要促进了有缺陷的服务交付。为了解决这个问题，需要一个清晰的流程图或服务蓝图，以明确提供物理和机构支持的药物服务一线和后勤办公室的责任（Russell&Tyler，2014年；Olideley，2013年）。In the case of repeated errors in medication use, although individuals are to blame for lacking communication about the patient condition, it is still the incomplete service delivering process that mainly contributes to the dispute. This faulted process includes an unclear duty allocation, insufficient internal interaction and lack of communication with customers. Firstly, when the client realized the medication list missing, he thought about various errors that might occur but could not figure out how exactly the list was left. This reflects a vague responsibility division in the hospital since there should have been a person taking the patient’s past medication record or a particular group in the Emergency Room responsible for taking over from the ambulance crew. Secondly, the nurse promised to pass the information of the correct list to the next shift. Yet the next morning the patient was still injected wrong medicine that was from a list two years ago. This clearly reflects faulted communication and work handover process. Clear and strict regulations are required that an information update about one patient should be made known to all medical attendants involved in the treatment process. A clearly defined standard of work handover between different shifts should also be available. Regarding lack of customer communication, the problem mainly lies in the hospital’s complaint system, of which the problem will be discussed in the next part. Apart from the process, facility layout and product design should also be improved, so that problems such as difficulty in uploading information would not occur anymore (Chase, et, al, 2004). Overall, although individual workers responsibility shirking is exacerbating the problem, the flawed service delivery is mostly facilitated by the incomplete service process. To resolve this problem, a clear process flowchart or service blueprint is needed to clarify responsibility of medication service frontline and back office providing physical and institutional support (Russell & Tylor, 2014; Greasley, 2013).
According to the response from Melanie Torrent, the hospital quality assurance manager, it is highly possible that similar problems would happen again. The indifference to the patient’s well-being and potential danger can be a hidden contributor to severe medical negligence. The repeated confirmation about the patient’s safety currently would not rationalize the malpractice that could have put the patient in danger. This illustrates an incomplete service package where a proper service attitude is in lack (Greasley, 2013). A question of where further complaint should be filed is also important for dealing with hospital malpractice, since the client in this case was clearly not receiving reasonable arrangement from the quality assurance manager. Therefore, a complaint system involving different institutional levels is needed so that mutual control is available to ensure different parties are taking their respective responsibility. In summary, in this case, a more active customer interaction process is needed in order to provide practical resolutions rather than meaningless concerns, otherwise similar problems are likely to happen again.
Conclusion
In conclusion, in the healthcare industry where the volume (ie, number of patients) and level of standardization (ie, regulated operation process) are both high, it is plausible that continuous production is required, meaning the medical practitioners should keep an attitude of caring and responsible and perform in a professional way continuously (Russell & Tylor, 2014). Apart from the proactive role that should be played by the healthcare provider, to fully eliminate similar problems, combined efforts from regulatory entities and business association are also important.
References:
Chase, R.B. Jacobs, F.R. and Aquilano, N. J. (2004) Operation Management for Competitive Advantage. 10th Edition. New York: McGraw Hill.
Greasley, A. (2013). Operations Management, New York: Wiley
Russel, R. S. and Tylor III, B, W (2014) Operations and Supply Chain Management. 8th Edtion. New York: John Wiley & Sons.
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