Organizational Behavior Management in Healthcare

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Table of Contents

Evaluating Consultant Workshops in Human Services
Enhancing Patient Flow in Emergency Departments
References

Evaluating Consultant Workshops in Human Services

APA Formatted Reference: Gravina, N., & Austin, J. (2018). An evaluation of the consultant workshop model in a human service setting. Journal of organizational behavior management, 38(2-3), 244-257.

Purpose of the Study: The goal of this study was to document and assess a consultant-workshop approach that Organizational Behavior Management specialists routinely use.
Participants: Thirteen senior therapists (STs), who oversaw a team of 6 to 8 instructor therapists in the company, attended the training two and a half years before this review. At this assessment, 9 of the STs that finished the program were still working at the agency, and six consented to take part in the evaluation. The center director required participation in the first program, and it was entirely voluntary to take part in this survey.
Setting: The research was conducted in a government-funded organization in Canada that administers behavioral services to people diagnosed with autism. The group served about three hundred people at the time of this research, with another five hundred on the standby list. Workshop training meetings were held with tables, chairs, a projector, and a whiteboard in the institution’s training center.
Dependent Variable and Measurement: Senior therapists’ (ST) initiatives are provided as the main data source for this evaluation. The data collected for the projects differed based on the purpose of the project performed by each ST. The choice of dependent variables for STs’ projects was according to their needs and interests. There was no specific information on the clients or employees in any of the data provided.
Assessment and Findings: Certain project elements remained in situ at the follow-up, and minimal data suggested that performance improvements were retained or extended. The findings are used to make proposals about how to improve the workshop structure.
Independent Variable: The independent variable in the study was the level to which autism had impacted the client.
Experimental Design: The projects of all seven trained administrators were finished. Three studies employed A–B designs, whereas the remaining four used complicated experimental designs that yielded positive results. However, no data on maintenance or generalization was collected in any of these cases, so that no conclusions can be formed regarding the possibility of this consulting strategy producing long-term and broad changes in the organization.
Results: Some senior therapists were not working with the institution when this program was conducted, therefore, information was not available for all projects. After the sessions, three activities for which follow-up data was accessible, preserved at least a couple of the intervention aspects.
Interesting Point of Discussion: According to outcomes of this evaluation, the program significantly taught senior therapists in a social services organization that were previously familiar with behavior therapy to execute the plan their quality management initiatives. The projects were a success, implying that the skilled workshop approach may assist supervisors in completing performance enhancement initiatives.

Enhancing Patient Flow in Emergency Departments

APA Formatted Reference: Kelley, D. P., & Gravina, N. (2018). Every minute counts: Using process improvement and performance feedback to improve patient flow in an emergency department. Journal of organizational behavior management, 38(2-3), 234-243.

Purpose of the Study: Longer emergency department appointments are linked to various negative outcomes for patients, including decreased patient satisfaction and higher expenses. Although hospital staff has no control over certain factors that determine the duration of emergency department visits, there are some changes to enhance performance. This project aims to decrease the emergency department’s door-to-discharge duration in a hospital with about 150 beds in the southeastern United States.
Participants: The participants in the study were staff members including nurses and physicians, despite no efforts to elucidate involvement.
Setting: This research took place in the emergency department of a 150-bed capacity hospital in a mid-sized town in the southeastern United States.
Dependent Variable and Measurement: The major dependent variable in this investigation was the average time from when a patient arrived at the emergency room to the first laboratory or radiological test was ordered (door-to-order). In addition, the estimated duration from the moment a patient reached the emergency room until they were discharged was recorded as a secondary measure (door-to-discharge). The Allscripts Clinical Performance Management System, which is used to track patients while in the hospital, was used to determine this. When patients came to the ER, a clerk entered their data in the system, and then emergency department staff modified the patient record, and the client was discharged.
Assessment and Findings: The hospital wanted to shorten the time for a patient to get from the entrance to discharge. Narrowing the scope of the investigation focused on a door-to-order sub-system that took longer than expected. The hospital gathered benchmarking information from high-performing emergency departments, which indicated that this time might be as little as ten minutes. The emergency department director selected an acceptable objective of 20 minutes based on comparison data and existing performance.
Independent Variable: The number of patients receiving services at any period was the study’s independent variable.
Experimental Design: An ABC design was used to evaluate the interventions. Due to the emergency department’s restrictions, a stronger design was not possible, and it would have been challenging to reverse the process modification after implementation.
Results: The shortest time of door to order was 36.2 minutes, while the estimated timeframe from door to discharge was 182.6 minutes over three months. The minimum duration from door to order was 28.7 minutes three months following the process adjustment, a reduction of 7.5 minutes. From door to discharge, the average time was reduced by 20.1 minutes to 162.5 minutes. The expected time from door-to-order was reduced to 22.1 minutes, encompassing the daily input measures, a reduction of 6.6 minutes from the preceding phase and 14.1 minutes from base point. From door to discharge, the time needed decreased to 159.6 minutes, a 2.9-minute difference over the previous phase and a 23-minute reduction over baseline.
Interesting Point of Discussion: This relatively modest process modification and assessment intervention was linked to a significant reduction in the time it took for patients to receive their first laboratory or radiological tests after arriving at the emergency department. Although the process adjustment was disclosed to all nurses, it was not embraced by all, so the provision of daily feedback encouraged acceptance of the new procedure. As a result, process transformation interventions may still require behavioral change interventions to be successful. This finding is significant because some process improvement practitioners may lack experience with behavior change strategies, which might restrict the effectiveness of process improvement initiatives.