Background

Blanche Davis had just completed her third year as Director of Quality at Laralex Hospital, a medium-sized not-for-profit facility located in a growing region of the Southeastern United States. Laralex Hospital, a member of the Southeast Medical Care Group, offers a wide range of services to patients who typically belong to one of the three major managed care providers in the area. The 260-bed facility includes numerous departments such as maternity, emergency, cardiac care, diagnostic testing, and medical imaging. Blanche’s primary responsibility was maintaining the Hospital’s accreditation status, which the Board of Directors considers critical to long range viability. In order to maintain accreditation, the hospital must submit to audits (both through written documentation and on-site visits) designed to evaluate its operations against recognized best practices. The hospital must also provide the agency with periodic updates, including routine ongoing performance data. Flexibility exists relative to the procedures used at individual hospitals to evaluate performance. Many hospitals use external performance benchmarking systems. These systems are administered by independent organizations that collect data from participating hospitals, then place each facility into a peer group of similar facilities, so that a fair comparison may be performed. The organization used by Laralex Hospital charges $8,000 per year for their service. In addition, Laralex employs other benchmarking organizations, such as an organization that analyzes data from patient satisfaction surveys. 

Study the case study document. Work with your team to address the issues as indicated below

Your case study analysis will prepare Blanche with explanations that she can present to her management at the next staff meeting. In preparation for this meeting, you will write a report as if you were Blanche.

Blanche’s focus will be on highlight problems with the current system and convincing hospital management to allow her to explore the implementation of a new process-oriented approach. Throughout, she will need to use words that Hazel (and other similar-minded managers) would understand, and terms that make sense within a health care facility. That is, she should avoid generic phrasing (e.g., process, defect, or nonconformance) and focus on applications at Laralex Hospital. The report should address the following issues, using examples and/or analogies as illustrations. It should be concise, clear and complete. Because the reader of the report will not be aware of the questions below, she should not simply repeat the questions when developing your report (the report should flow nicely while addressing these issues).

1. Explain what is wrong with using percentiles to compare hospitals. Give an example (not the tomato example from the case) that illustrates why percentiles are ineffective.

2. Show the run charts and statistically evaluate each run chart using runs rules (an Excel file with the data is provided); interpret each run chart for the outcomes analyzed in the case.

3. Explain the use of run charts – their purpose, what they can and cannot do, how they are constructed, the meaning of the runs rules, and the method of interpretation.

4. Give an example of how a fishbone diagram can be used at the hospital – be specific by showing a fishbone diagram with at least 10 entries.

5. Give an example of how a scatterplot can be used at the hospital – be specific by showing labeling X and Y axes and showing what some potential data might look like.

6. Give an example of how a Pareto chart can be used at the hospital – be specific by showing a Pareto chart that might occur in one of the hospital with at least 8 bars.