SWOT Analysis

Process Improvement Scenario

You are an internal organizational change facilitator in the operational excellence (OE) department of Universal Health System (UHS). UHS is a major healthcare organization headquartered in Washington with hospitals and clinics in three other states. Community Hospital was acquired three years ago and UHS provides corporate services, such as human resources and billing. The rest of the operational services are managed by Community Hospital and include facilities, housekeeping, laundry and food services. UHS has sent you out to help Community Hospital manage change in their process improvement projects.

The risk

Food services has been identified as an area needs to be improved. A survey has been conducted by UHS leadership and there are specific areas of improvements:

·       Long wait times for food preparation and delivery. This affects the cafeteria and the patient meal deliveries.

·       The layout of the kitchen and cleaning area is outdated and inefficient.

·       Productivity standards are the lowest scores in UHS.

The current state

Community Hospital has been a county hospital for the last 40 years. Due to poor performance, safety warnings, low quality and loss of revenues, the county sold Community Hospital to UHS. Many of the business staff employees were laid off or transferred to the corporate office. Most of the staff who remained have been employed for over 10 years. Some departments like surgical services, the emergency department and nutrition services have had a turnover in staff and implemented some state of art methods. Other departments like facilities, laundry and food services, have had low turnover and maintain the same procedures.

The CM Challenge
A Process Improvement consultant from UHS worked with the staff and identified three opportunities for improvement.

·       Layout of the kitchen and dishwashing area

·       Change job duties and tasks to reduce customer wait time and improve delivery to patient room

·       Make changes to menu to provide better meals to staff and patients

The work to make changes to the kitchen will be performed by the facilities department and any electronic devices will by managed by IT, otherwise the rest of the work will be performed by the available food service staff. The staff was involved in the decisions to update the kitchen and the dishwashing area. Two experts from corporate HR were onsite for two weeks for interviews to make recommendation for staffing and productivity improvements.

The culture of Change Management (CM) promotes inclusion and consensus and attempts to let each hospital act independently. Process Improvement relies on established lean methods and has been working with many other member hospitals to improve processes, with mixed results. The Process Improvement Expert has been working with food services for the last three months to analyze some of the issues and determining root causes. She will be working with the team to plan out the improvement.

The process owner for the improvements is a new manager in the food services department that has been there six months. He is enthusiastic and positive and wants to make the cafeteria a great place to have a meal. Not all his ideas have been welcomed by the staff.

Most of the staff has been there for over ten years and three have been there over twenty years. This means that some of the food staff makes more money than some of the nurses on the floor. The department director also manages housekeeping services and has been working at Community Hospital for nearly thirty years and has been talking about retiring in a few years.

There have been very few changes in this department and some of the staff has been requesting a “face lift” and claims the menu items have not changed since the 90s. There does not seem to be a sense of urgency, even when there is a line of customers. The department director has been getting pressure from UHS regarding productivity and she says this is because the staff is paid at a higher rate than any other food service staff in the organization.

Additional consideration for process improvement

·       Any improvements that require money need a capital request for budget. Many of the programs at Community Hospital are stalled because the capital budgeting process at UHS is difficult and requires approval from a governance committee.

·       The customers for the cafeteria are Community Hospital employees, hospital patient family members and some patients. Patients received their meals from food services after a consultation with a nutritionist.

·       It is rumored that UHS is not doing well financially and that there are efforts to reduce costs and improve productivity through the hospitals in the systems. OE’s role is to make changes that improve the bottom line and all process improvement projects are required to report the actual cost savings at the end of the year.