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The definition of business excellence is: a state of organizational performance achieved through the successful integration of a variety of operational and strategic elements that enables an organization to become one of the best in its field. Excellence is initially evident when an organization rises above its competitors, and it is usually measured by the ability to sustain a leading or significant market share. The strategic and operational elements contributing to excellence include the organization’s approach to total quality management, quality assurance, quality awards and quality standards, core competency, benchmarking, customer service, the balanced scorecard, and leadership. Taken altogether, these components should produce an organizational approach to the generation, development, and delivery of products and services that is better, cheaper, and smarter than that of the competition. Attempts at becoming an excellent organization have spawned terms such as best practice, best-in-class, and world class manufacturing and are usually associated with a holistic approach to competitive advantage.

So clinical business excellence takes this definition and applies it to clinical settings. Medicology has a centre of excellence in this area. They are already running courses to help the NHS staff develop on both a professional and a personal level. Now they are holding a conference on, yes you guessed it, Clinical Business Excellence. This conference will be held on the 29th June 2010 at Park Crescent Conference Centre. For more details see clinicalbusiness.co.uk.

Morale is one of the most significant factors affecting organisational performance with clear links to many adverse situations:

• High sickness & absence
• High staff turnover
• Poor performance
• Poor clinical outcome
• Low customer satisfaction ratings
• Reduced team effectiveness
• Conflict & obstruction
• Increased tribunals & grievances

Medicology MTI has been developed to address two specific needs:

a robust and sensitive measure of morale
a differential diagnosis of the factors positively or negatively influencing it

It consists of a series of questions around known influencing factors and takes the average person around 10 minutes to complete.

Robust Measure

Medicology MTI introduces two important processes to ensure that the morale measurement returned is both sensitive and representative.

Firstly, it utilises variance to assess morale, i.e. how far above of below neutral the score for a particular factor is for that person and thus avoids the weakness found in many systems that use an arbitrary scale.

Secondly, it asks the respondent to indicate how important a factor is and this is taken into account in the overall calculation. Coupled with variance, this creates an immensely sensitive measure.

Differential Diagnosis

Medicology MTI is designed to provide detailed analysis, reporting and guidance. Your morale report will include analysis by:

• overall score
• individual questions
• different staffing groups or departments

Furthermore, individual questions contribute to section morale scores, to help you identify problems in the following areas:

• Growth & Development
• Leadership & Management
• Personal Factors
• Relationships
• Work (the work itself)
• Workplace (the work environment)

This level of analysis and reporting allows you to not only assess morale in different staff groups but to diagnose any specific problem areas so that interventions may be applied.

Practical Information

Medicology MTI is designed to make your life easy:

• Run morale testing from a few to thousands swiftly and effortlessly
• Define which staff groups are most appropriate to you
• Re-run the survey at intervals (which can be set up automatically e.g. 3 monthly intervals) to assess how it is changing over time
• Bulk upload your staff from Microsoft Excel® or provide them to us and we’ll do it

For more information or to try out this great product for yourself see medicology mti

medicalperception.com from Medicology Ltd allows Trusts, PCTs, SHAs, Government, Pharmaceutical, Medical Equipment & Biotech companies, health service suppliers and more to access, survey and evaluate the mindset of health service staff, simply and cost-effectively. Medicology Ltd is also the leading provider of leadership, management and personal development for health service professionals, especially clinicians, meaning we spend most of our lives inside the heads of clinical staff, understanding how they think, how they evaluate problems, their similarities and differences from each other, their sources of meaning and more. That’s a very, very good place to be when designing meaningful, high quality research.

What can we do?

• Survey health professionals in every medical specialty
• Access the medical mind nationally and internationally
• Evaluate clinical perceptions around drug therapies
• Gauge perceptions and feelings about important issues
• Develop insight into clinical pathways
• Understand how professionals choose products & services
• Develop greater sales force effectiveness
• Evaluate job satisfaction & morale
• Run a series of evaluations over time

This is just a brief set of suggestions, so if you need something not on the list then simply ask.

Why medicalperception.com?

There are very compelling reasons to use medicalperception.com

• Highly cost-effective for the highest quality research
• Rapid deployment time
• Professional outward appearance
• Ability to retain and re-run research studies, gaining insight into trends over time
• Build in the ability to control for different psychologies
• Highly trusted, competent team
• Enormous degree of medical insight available in study design

Experts are warning that poor communication between hospital staff and with their patients is far too common and deeply damaging. According to the findings of a confidential review patients left out of the loop and staff clocking on and off without a handover was commonplace. Change in the hospital team structure over recent years has seen individual clinicians become “transient acquaintances during a patient’s illness rather than having responsibility for continuity of care”, says the NCEPOD report. It found a co-ordinated handover of patients between night and day staff only occurred in a quarter of the teams. In 13.5% of cases lack of communication compromised continuity of patient care.

In just over half (53%) of cases there was an apparent lack of input from senior doctors “leading to delays in giving patients timely and appropriate care”, report author and surgeon Ian Martin said. And 30% of the patients were not seen by a consultant within the recommended 12 hours after admission. In a fifth of patients who were not expected to survive on admission there was no evidence of any discussion between the health care team and either the patient or relatives on treatment limitation. Many “do not attempt resuscitation” orders were signed by very junior trainee doctors. NCEPOD chairman Professor Tom Treasure said the report vividly revealed the challenge medical teams face in making the transition between saving life and allowing natural death. “It should be ensured that patients achieve the best quality of life until they die. Effective team working and communication with patients, relatives and carers are fundamental to getting this right.”

Director of the Patients Association, Katherine Murphy, said: “These findings run the risk of undermining basic confidence in the NHS. Some of the examples are shocking. “NCEPOD is the nearest the NHS has to airline ‘near miss reporting’. Its findings must be acted upon, or problems will continue to plague vulnerable patients and their families.” John Black, president of the Royal College of Surgeons, said doctors had long been concerned that the loss of team working in hospitals had fuelled the risk of poor communication, and sub-standard patient care. He said the implementation of a 48-hour working week under the European Working Time Directive almost certainly meant that the problem had got worse since the latest study was carried out. Professor Black said the only way to address the problem was to opt out of the directive.

A Department of Health spokesperson said measures had been introduced to improve care – including an end of life strategy – since the report’s survey was carried out. “We are putting in place an extensive programme of health and social care training to support end of life care provision, including pilot projects to support the development of communication skills. He added that evidence from hospitals already implementing a 48-hour week showed a drop in mortality and no evidence of harm to patients. “Working together with the local NHS and the Royal Colleges we have set up a rigorous quality assurance process to give us an accurate picture of how EWTD is being implemented and so we can provide support where it is needed.”

Experts are warning that the cost of treating the growing number of people drinking heavily threatens to cripple NHS hospitals. If the trend continues the burden will be unsustainable with a quarter of England’s population consuming hazardous amounts, alcohol addiction already costs the NHS more than £2.7 billion a year.

The report claims that hospital care alone cannot solve the problem, but increasing out-of-hospital provision could be more cost effective. This would include GPs screening and counselling their patients on alcohol misuse. Trials suggest that brief advice from a GP, or practice nurse, leads to one in eight people reducing their drinking to within sensible levels. This, says the report, compares well with smoking cessation, where only one in 20 change their behaviour, changing the way alcohol-related services are delivered could save hospitals 1,000 bed days and Primary Care Trusts up to £650,000 a year, experts estimate.

Professor Ian Gilmore, president of the Royal College of Physicians, said: “The nation’s growing addiction to alcohol is putting an immense strain on health services, especially in hospitals, costing the NHS over £2.7 billion each year.” And this sum has doubled in under five years. “This burden is no longer sustainable,” he said. “The role of the NHS should not just be about treating the consequences of alcohol related-harm but also about active prevention, early intervention, and working in partnership with services in local communities to raise awareness of alcohol-related harm.”

Steve Barnett, the chief executive of the NHS Confederation, said: “We hope this report helps to outline the scale of the problems facing the NHS and acts as a warning that if we carry on drinking in the way that we are currently, the bar bill will be paid in worse health and a health system struggling to cope.”

Two thirds of PCTs have adopted reducing alcohol-related hospital admissions as a local priority for the first time. “The department is providing Primary Care Trusts with the support, tools and incentives to deliver alcohol services in their own areas effectively according to local needs.”

The NHS under the spotlight again! This is because they are being accused of not doing enough to protect staff from a daily barrage of punches, slaps and kicks. In the last 3 years there has ony been a 0.5% increase in sanctions against offenders, this is despite a promise of “zero tolerance” approach.

Some cases that have made it to court got dropped as it was deemed “not to be of public interest”. Surely the medical staff have the same rights as everyone else to go to work and do their job without fear of being attacked. Instead that basic right has been denied. The medical professionals are under enough strain as it is with the potential collapse of the institute that provides them with a job and the fact the NHS is stretched so much that there isn’t enough staff.

More should be done to protect those that provide such a valuable service, saving lives.

Given the current economic climate this is an important and timely conference, designed specifically to help address the challenge facing healthcare teams and organisations as they strive to manage costs in a period of growing financial famine. Whilst commencing with the drivers of financial change, the programme addresses the full breadth of issues surrounding achieving meaningful cost improvement without compromising clinical quality. Cost improvement will only be achieved with the hearts, minds and practical engagement of the clinical workforce itself and so this receives special attention in a practical, hard hitting but positive programme.

Medicology Conferences are designed to enable the widest possible audience to gain insight into and solutions
to the core issues facing healthcare professionals today, by providing a cost-effective and accessible platform for information migration, experience sharing, collaboration and knowledge management. Conference topics are identified utilising the following criteria:

• There is a pressing need to resolve challenges in that area
• A wider audience needs access to important insight
• The topic area warrants wider discussion
• The issue in question has significant impact on healthcare success

We are particularly committed to bringing knowledge, insight, strategies & skills to frontline healthcare
professionals, who often face the challenge of implementing major initiatives or resolving key challenges at the operational coalface. Doctors, Nurses, Allied and Business Professionals at all levels of the organisation need access to the insight brought to Medicology Conferences. Widely Accessible to the Right People
Clinical and other frontline staff often find it difficult to access the insight necessary to succeed and thrive in the modern environment because many healthcare conferences are organised, publicised and priced in a manner that precludes them from attending when in fact it is they who really need access to the insight. Medicology conferences are designed to address this very issue by:
• Carefully managing costs to ensure the lowest possible cost of attendance
• Utilising lower cost but high quality venues to ensure the right capacity at the right price
• Ensuring the widest possible publicity to the right people

To book onto this amazing conference Cost Improvement Conference

In an attempt to transform services and improve value for money a lot of healthcare organisations have turned to Lean as the basis of their improvement efforts. It is not a new concept in fact its origins can be traced back to the 15th Century when the Venetian Navy introduced a ‘flow line’ for the production of war ships. Most people though would trace its history from its implementation within Toyota where is acquired the name of the ‘Toyota Production System’ and this became ‘Lean’ in the book ‘Lean Thinking’ that was published in 1996.

However, whilst the history of Lean in manufacturing is well established, it has only been over the last five or so years that Lean has found its way into the healthcare sector. The initial focus of Lean in healthcare was very ‘point’ focused, such as fixing low level problems in a pathology lab or dealing with theatre capacity. When organisations realised that such a low level approach was unlikely to lead to changes that lasted, the focus changed to ‘end to end’ clinical pathways, but in the early days this meant from the start point till the end point for a patient within a single organisation.
Amnis Courses

As Lean has matured, more people have started to experiment with pan-health economy Lean and this is where Lean moves from being a tactical tool to a strategic approach. It is still early days for the larger projects but there are already signs of success that significantly outweigh the many problems any form of transformation activity within the healthcare sector will experience.

In particular, because Lean consultants generally use a lot of jargon and even today use a lot of manufacturing related examples, it can be very off-putting for front-line healthcare staff. Even more damaging though is when Lean is used as a punishment because a team are under-performing or where the leadership team have hidden motives.

Lean can also experience problems after implementation if the focus is not on turning the changes in the process that have been achieved (such as new referral process) into a change in behaviour (which is achieved when people no longer realise that the process is ‘new’). With a lot of the early adopters of Lean focusing on the exciting parts of Lean, such as ‘Rapid Improvement Events’, the aspects of successful programmes that really make the difference have been forgotten, such as making sure that the Lean programme aligns with the organisational objectives, engaging frontline staff and dealing with any problems that arise along the way through some form of ‘Continuous Improvement’ process.

Healthcare organisations are already experiencing many of the problems that manufacturers have had to deal with for several decades, namely how to turn great ‘brown paper’ plans into real changes and then how to make those changes stick. It may not be surprising to realise that up to 75% of Lean programmes will never deliver long-term change, instead consisting of a series of exciting (yet ultimately wasteful) Rapid Improvement Events, and that is the same in healthcare as it is in manufacturing.

The choices for healthcare organisations going Lean is either to do it properly and ensure that the changes stick, which can be very demanding of management time, or trying a few isolated projects where the benefits ultimately drift away.

The key to success is to ensure that you adopt an approach to Lean that is flexible for your organisation and not rigidly imposed by a management consultancy to suit them and also to develop the internal capability of your staff as quickly as possible so that they can take the reins for your improvement programme. Ensuring all of this works is where the leadership team need to ensure that the targets they set for their Lean projects will deliver the organisational objectives and that everyone, from the boardroom to the wards, understands what needs to be done, why and by when.

This article was taken from Training Bulletin and is run by a company called amnis if you wish to get more details on this follow this link Accelerated Lean Skills Programme.

Health Secretary Andy Burnham has announced plans to scrap GP catchment areas in England within a year. It follows a claim that ministers want to introduce greater choice into the family doctor system, as they believe that it will drive up standards. The government has trying to get more from GPs ever since their pay rocketed with the introduction of a new contract in 2004. It started with GPs staying open for longer but the idea of ending catchment areas was on the cards before Gordon Brown became prime minister. Lord Darzi mentioned the idea when he revealed his review of the health service in 2008. At the moment catchment areas vary in size; in rural areas doctors see patients up to 40 miles away whilst city-based doctors often only see patients up t0 a 2 mile radius

Patient choice is already a well established right in hospital care with people entitled to choose from any hospital in the country for treatment. Mr Burnham states: “I want the best to be available to everyone, not according to where they live. Too often people’s choice of GP practice is unnecessarily limited by practice boundaries, so, with the profession, I want to open up real choice in primary care.” He also argues that people’s choice of a GP should be based on their own needs – not by lines on a map

Some think that if the Conservatives win the next election they aim to make GP practices become practice based commissioners. This would mean that the majority of their commissioning functions would be carried through federations of GP practices that operate as consortiums. This proposal would mean a reduction in the commissioning role of PCTs in some areas.
Under the Tories:

• The merger of PCTs would be welcomed but not forced
• All GP practices would be expected to become practice based commissioners
• Trusts would be expected to negotiate prices for acute care at a rate under the PbR price
• The Conservatives would welcome such mergers as part of an organic process but stress they would be voluntary. They hope to encourage more GPs to take up commissioning by turning the currently indicative budgets into real cash budgets.

Shadow Secretary of State for Health, Andrew Lansley states that it would give practices real opportunities to save and reinvest. It would also give them control over contracts and how patients are treated. Lansley stresses that any underspends would remain for the use for patient care, not profits. Health project leader at the Social Market Foundation think tank, David Furness, said the implications of an enhanced role for practice based commissioning were “much more significant than has been [previously] discussed”.

When asked if the Conservatives wanted to see more such mergers such as those in London, the response was: “It would be perfectly reasonable to aggregate, but it will be up to them [PCTs] to decide. It would be done on an organic bottom-up way if [they] choose to do so.”

Within the NHS, sources who have been asked to advise the Conservatives on the development of their health policy, said they thought the party would ideally like to see strategic health authorities and PCTs merged to create maybe 40 strategic commissioning bodies, organised around city regions. It is thought that this would rectify the problem that PCTs are perceived as being “too small” to be able to negotiate good value from large acute hospitals.

However, a spokesman for the Conservatives denied that the party were planning to merge SHAs and PCTs, saying that it was “very clear that’s not what we are planning”. He does also add that they do foresee SHAs moving their focus away from providers as more become foundation trusts. However Tory leader David Cameron and Mr Lansley have pledged they will not subject the NHS to another round of structural reorganisation.