Support Planning for Geriatric Health Conditions

Discussion Paper on Quality Service and Impacts on Poor Service Quality in terms of reputation, Accountabilities of private and public sector and Stakeholders

Written by:

Eva Michelle S. Baculi
Shela Mae Sabanpan
Gynievel Ondasan
Epifanio Jr. Montajes
Elangkovan Balakrishnan

INTRODUCTION

Kindly Residential Care Rest Home had experienced problems regarding the quality of care of its services, in so doing, as a Geriatric Healthcare Specialist; I am tasked to organize a group of caregivers in order to produce a paper that discusses Quality Management Approaches and Techniques. Such research work will be disseminated to all health staff so that it will be implemented and eventually will improve the services of the rest home in serving our geriatric clients.

As we all know, New Zealand, like all other countries, faces the same challenge in the rapid increase in the ageing population. With this, health sector is greatly affected as it provides greater services to varieties of conditions, such as arthritis, heart disease, and even dementia, thereby health facilities, such as hospitals and rest homes have also increase their workload. Being in the health sector, it is our vital role to ensure that all our clients are given the best quality care. But then, how do we define quality service? What will be the impact if we give poor quality service in the organization with regards to reputation? What will happen to the stakeholders? And lastly, what are private and public accountabilities with regards to poor quality service? As mentioned above, it is then necessary to answer these questions to have better clarity on what it means to give quality care so that we, ourselves, could give the best quality service to those people suffering from dementia and other geriatric conditions.

What is Quality Service?

Service quality is viewed as “the degree and direction of discrepancy of the client’s perception and expectations and are influenced by five gaps” (Parasuraman et al, 1985):

Tangibles as seen on the facilities, equipment, health care workers and some communication materials such as patient’s folders, prescription forms and requests forms
Reliability or the hospital’s ability to perform the promised service accurately and dependably.
Responsiveness or health care workers willingness to aid the patient and give prompt service
Assurance or the competency, knowledge and courtesy of the health care workers and their ability to inspire patient’s trust and confidence towards the hospital services
Empathy or the caring, undivided attention given to patients by the health care workers.

Therefore, the quality of health care depends upon on the how the patient perceives. Patient perception of quality ranges from their desired health outcome, relationship with health care workers, health care workers qualifications and performances and healthcare access and choice.

To provide service quality among the clients the aim of the organization must be achieved while service performance and client’s satisfaction must be met. As we talk about service quality in health care there are many questions that would pop-up in our minds. Everyone deserves a good service quality especially in a healthcare setting or any residential care where mentally impaired clients are being taken care of. Sometimes understanding the opposite concept of good service quality will enhance your knowledge to do well on the services you provide to your clients. Especially if you are a healthcare provider, you must do your very best to provide the proper care that your client needs.

Poor service quality has a big impact towards any organization. It is because it could affect the internal and external aspects of your business. Client satisfaction must be a priority at all times. Giving poor quality service to clients could pull any business or organization down. It could negatively impact the stakeholders and shareholders because they are the ones who would be affected by poor service quality. For example in the hospital or any home care, if the doctors, nurses and other medical teams who are involved in the care are showing poor quality service to the clients, it could affect not just the hospital and the employees themselves but the organization as a whole.

IMPACTS OF POOR SERVICE QUALITY IN TERMS OF REPUTATION:

The reputation of any business or organization will be affected if poor service quality is practice. Reputation is how your organization is being perceived through the eyes and judgment of your clients, suppliers, employees and other parties that are included in your organization. An organization engages in various activities such as rendering proper quality care, responding to the needs not just to the clients but also to the significant others and their families, attending to queries and complaints if there is any in an appropriate approach, and by taking any feedback or concerns in a positive way. Through these things a strong reputation can be built by the organization which could attract and retain our clients. The organization’s reputation is the biggest and most important determining factor in the long term success of your efforts. Your reputation is recreated each day with each client that you are taking care of. In reality, however, you are not only dealing with the organization’s reputation in general but also other considerations that arise from the minds of the clients or to significant others who deal with you during the organization’s activities. Therefore, reputation is very much important because this is a key factor that determines the trust and confidence that clients will have on us. We must keep in mind that our clients will talk about us about the services we give them. If we provide poor service quality they can negatively influence the public’s perception on what our company is all about through word of mouth.

ACCOUNTABILITIES OF THE PUBLIC SECTOR:

PUBLIC SECTOR

The declining quality of service of Kindly Residential Care Rest Home led to a negative impact that resulted to a liability to the public sectors accountability and the results are the following:

Low client patronage. Because of the poor quality service, client’s family members opt to avail services of other health facilities instead of Kindly Rest Home.

Jeopardize the Rest Homes reputation. Public perception would be sour due to the above mentioned infarction, and it will taint the reputation of the health services of New Zealand. Some might think or generalize the idea that other health facilities in the area have similar problems. That is why, the District Health Board have continuously monitoring the services of all its health institutions to ensure that standardized health practices will be adhered.

Increase in staff turn-out. Since patronage of the public will be minimized of the Kindly Residential Care Rest Home, low income earning of the rest home will affect the increases in wages/ other benefits to the employees. As a result, employees will opt to transfer to other work to seek a much better wage offer and equally, recruitment will be affected considering that Kindly rest home can no longer afford to pay additional workers.

Loss of profit. With few client patronage and tainted reputation, obviously, will result to decrease in profit, not to mention that the facilities operational funding allocation will be greatly affected.

Under scrutiny of government health organization. As mentioned earlier, the District Health Board ensures that health facilities under its jurisdiction will adhere according to the standardized health practices formulated by the board. Any health institution that will violate health standards set will be sanctioned by the DHB. Possible measures will be imposed such as fines, withdrawal of public funding support, closures, reprimand and other government actions.

Leads to poor services. Poor quality of care will result to accidents due to equipment malfunction such as defective bed side rails and wheelchairs and legal actions against facility personnel will be made as a result of such negligence. Another is possibility of infection outbreak resulted from lack of disinfection materials or even poor hygiene practices and finally, contamination will affect not just to other residents, visiting family member and also to home staff.

ACCOUNTABILITIES OF THE PRIVATE SECTOR:

It is always expected that if the management is poor the quality of service to be rendered is also poor. In New Zealand there are private sectors who are also handling the health care of patients with dementia and the other common geriatric diseases. If this private sectors are not well-prepared to assist these patients, there will be a great impact on the kind of institutions they have and because of poor service quality, the patients will be affected so much. The medical staff of these private sectors should attend training on health care program. So as to widen their knowledge, skills and attitudes on the health care program. The government should not permit private sectors to start giving assistance to patients with dementia and other common geriatric diseases if not ready because they are adding more problems to the patient and to the health care program in general. It is advisable that all the medical staff of this private sector should be well informed of all the best practices in the health care program. The New Zealanders also want their country to have the best health care program. The patients need special care and attention, likewise, it is needed for this home care private sector to know well the cause and effect of the ailment of this individual patient, so the management will be able to give them the proper assistance needed, thus, giving the patient the feeling of belongingness and acceptance. That is they are accepted as individual in the society where they live. These patients with dementia will not feel insecure because of their illness or personality, but instead, have that feeling of joy and happiness. So this kind of behavior will be enjoyed by the patient with dementia if the medical staff in private sectors are well trained and are ready to assist patients with dementia and other common geriatric diseases.

There is really a need for a thorough screening of medical staff for private sectors so as to avoid poor service to their clients. These dementia patients need to be understood so it is the management to make adjustments so as to understand each other. They need a loving assistance so as to give them a comfortable life despite of their ailment. The better quality of service the better will be the result. You will lessen the stress of the patient and helping the individual a wholesome member of the community. The New Zealanders are health conscious. Therefore, private sectors should work hand in hand with the health care program of the government. There is a need for the private sectors to establish the best practice quality management health care for the benefit of the individual with dementia and other common geriatric diseases.

STAKEHOLDERS:

Stakeholders are individuals or group of individuals who are afflicted by or can control a company or product throughout its life. Without the continuing participation of these stakeholders, it would find it difficult for a company to get through, because a company and the stakeholders are mutually co-dependent. Their involvements are vital in company’s expression of values, execute its mission, establish strategies and enhance relationships continuously. Also, they are also important for involvement in performance-based sense. If the company establishes long term relationships with these stakeholders, it runs smoothly and has a better chance of earning profits, can increase production and harvest the word-of mouth benefits. However the stakes are high once a company establishes the long-term relationship with them. In this section, we will categorize these stakeholders into two:

Internal Stake Holders:

These internal stakeholders include

Clients

Clients are categorized as the consumers and patients. Since they are the final user and the payer of the health care system, they become the most valuable stakeholder; thereby, they also must be participative in their own care. They have to be informed about their illness, the kind of medical treatment and as well, be accountable of their health. They also have the right to voice out any concerns of the company.

Family Members

Family members are often said to be partners, joining forces with the health care staff in ensuring the best health care needs of the client/patient. They have the right to question any misdemeanors or wrong choice of treatments and even medications that are prescribed to the patients. It has become a common knowledge that many of this establishment face lawsuit mainly because of miscommunication between the family and the establishment. This can be reduced and corrected by giving the right information, discuss better recommendations to the patients and inform of the establishment’s policy rules and regulations. This will give a better understanding to both parties concerned and there will be a connection between them to work together for the benefit of the patient admitted there.

Care providers

Who knows the patients suffering dementia better than the care providers? Hence, the importance of the care giver is of vital importance to the patients and more so to the establishment. Nurses, aides, medical staffs, dietitians, pharmacist are all part of the category. Each and every employee takes their positions seriously as any cause of carelessness would affect the lives of the patients. It is not only essential to attain good quality care givers but they must also be protected by the establishment. There are many numerations that can be given to the care providers as incentives to take their job more seriously and also give them the aspiration that they can depend on the establishment if any crisis arises. The establishment can also furnish the care providers with better trainings and information on how to deal with the dementia patients at every level and treat the Geriatric patients with using the latest skills and equipment’s to make the treatment less stressful for the patient.

External Stakeholders:

Medical equipment supplier

Medical equipment suppliers may seem insignificant but indirectly they hold a major stronghold in the establishment. Medical equipment comes in all shape, size and functions and is one of the factors the patients depend on heavily. In this case, medical supplier has to be prompt in delivering their stock according to their records. Any equipment malfunctions must be reported immediately to the suppliers to be replaced or repaired so there will not be any disruption to the patient’s physiotherapy or exercises. It is also their role to explain the benefits of equipment and how it will benefit them in the long run. Any new products in the markets are introduced to the Health care and proper and detailed information must be given to the patients and also the therapists

Food supplier

Food is equally important factor in this establishment as it is a basic human necessity. Not only that, patients need their food on time so they can consume their medication on time therefore, the food chain cannot be broken or interrupted in any time or else dire consequences will happen. If the food supplier is not a reliable one or produces poor in quality or not in the dietary list should be terminated and a reliable one should be tendered in immediately. The establishment should check the timing and quality (freshness) of the food items at all times. This also means it has to be under the Food Act.

Care Home Building maintenance supplier

The building material supplier is also one of the many major factors that need constant reviewing. Especially in the Kindly Residential Rest Care home it is vital that all building structure is secure, safe and durable in any case of natural disasters. Safety of the patients must be the first priority. Many criteria must be given attention to, including proper and good lightings at the home, hand rails for support, and many more. Injuries and damaged grounds of the building will bring a questionable reason to the safety of the patients as well as the establishment. It is advisable always to keep in check of building maintenance and cleanliness at all times. Other stakeholders like the patient’s families are sure to note of this.

D.H.B ( District Health Board )

Every Health care facility is automatically registered under the District Health Board which is a requirement bonded by the Government to ensure the delivery of quality health care services. This procedure is done so that any legal complaint against the Home can be done through the District Health Board. The Kindly Residential Rest Care home is for the benefit of the elderly patients, patients going through Dementia and Alzheimer and other Generics illness. So the environment and the premises must always be in good conditions and abiding all the rules and regulations that will encourage more patronage to the health care. If any faults are filed against the care home, warning letters will be issued by the D.H.B. to make the changes according to the rules and regulations. If the warning letters are neglected, the D.H.B. has the right to cancel the license to run the rest home care. This will affect the entire Rest Home business and image in the health care business will be tarnished.

CONCLUSION:

In today’s world where there is an outgrowing number of ageing population and the advances in sciences that increases the life expectancy of people, the demand of health care increases. Therefore, there is a need for continuous improvement so as to satisfy the ever-increasing market. To be able to do this, it needs good quality management. If a certain organization exhibits poor quality management, it can lead to negative impacts affecting both the internal and the external aspects of the business. The company’s reputation is damaged and many would be greatly affected, the clients, the employee, caregivers, employees and worse, its existence. To avoid this from happening, it is then important that we render good service particularly to the clients, family members. Not only that, we should also need to work as a team that can lead to a long lasting improvements. We should also ensure that we adhere to the policies and procedures. With this, the result would be good quality, efficiency and profitability.