Continuous Improvement

The imperfectness of organisational processes means there is always room for improvement. The persistent pursuit of efficiency is the foundation of continuous improvement. Any approach adopted by a firm must be not only impactful but also sustainable. The implication of this viewpoint is that the organisation has to be certain of the continuous improvement program’s scope and ensure process alignment (Holtskog, 2013). The scope of continuous improvement refers to the extent of the reach of adopted strategies within the organisational framework. This element can evolve as the organisation changes due to increased efficiency. The main aspects of the scope of continuous improvement are enterprise scope, functional scope, and maturity scope.

The enterprise scope defines the general operational area in which a firm intends to apply continuous improvement tools. An important consideration, in this case, is the contribution of different operational domains to the organisation’s success (Hutchins, 2016). For Encore Care, the most important operational domain is the range of care types. The initial enterprise scope in this regard would be long-term residential care. This offering has the potential to grow significantly in the future which makes it an appropriate place to start the organisation’s continuous improvement journey. The functional scope, on the other hand, involves the firm deciding on whether the continuous improvement will only involve operational aspects or it will incorporate other systems such as support functions (Clark, Silvester, and Knowles, 2013). In the case of a healthcare organisation like Encore Care, the functional scope would involve deciding whether continuous improvement will focus on both the clinical and non-clinical facets of elderly care. Proper decision making is necessary here since there is a risk of sub-optimisation of benefits of continuous improvement in addition to stakeholder confusion. A systemic functional scope for Encore Care would involve processes to improve clinical outcomes by focusing on the quality of care and patient safety in addition to tools optimise non-clinical outcomes such as streamlining resident flow. Lastly, the maturity scope involves considering the future of the company after the consistent application of continuous improvement principles. Encore Care is committed to evolving into a world-class elderly care organisation. The maturity scope would, therefore, involve total organisational alignment on the vision, goals, and expected benefits of the continuous improvement journey.

    The development of continuous improvement largely involves changing the perception of organisational employees hence building a new workplace culture. The involvement of employees throughout the strategising process is therefore necessary. Successful organisations in this context adopt the strategy of small, manageable improvements. Change is therefore gradual, and employees are not overwhelmed by a radical process overhaul. Monitoring improvement and providing timely feedback are also important aspects in the development of continuous improvement. Organisational leaders can determine the success of their strategies and adapt where necessary. Employee motivation is also an important element of the development process. This move would ensure that employees adopt a proactive stance in continuous improvement.

Continuous Improvement vs. Continual Improvement

            Continuous improvement and continual improvement are wrongly used interchangeably despite their inherent differences. The former means that a firm is in a constant state of seeking process improvements. The focus is therefore on both linear and incremental improvements within organisational processes. Continual improvement, on the other hand, refers to process improvement done in stages which are separated by a duration (Radnor, Holweg, and Waring, 2012). The breaks enable the organisation to analyse the improvements and decide what changes could be made to achieve better results. Continual improvement is a broader concept since it consists of both continuous process improvements and discontinuous systemic improvements. The latter ensures that the organisation does not continue trying to improve ineffective strategies. An example of discontinuous improvement is redesigning an entire firm.

            An organisation can achieve continuous improvement through a variety of methods which range from the Deming cycle to process innovation. All methods, however, are classified into two broad approaches: incremental continuous improvement and breakthrough continuous improvement (Sanchez and Blanco, 2014). The first approach involves making small changes to a process with the view of improving it in case of any problems. The rationale behind the incremental approach is the creation of a cheap and fast methodology without reviewing an organisation’s entire operations. The principle of peak efficiency, therefore, forms the basis for incremental improvement since major distractions are avoided. Breakthrough continuous improvement involves making large alterations to a process by reviewing the item in question and making appropriate decisions. This approach is costly and prolonged but results in larger revisions. The breakthrough approach is necessary in the case of processes which need to change significantly to remain relevant to the firm. The principle behind the breakthrough approach is achieving the highest economic return in the short and medium term (Duffy, 2013). The radical changes associated with the approach translate to 50 to 95 percent improvement within a year hence agreeing with the theoretical foundation. The best way to deploy a comprehensive continuous improvement program is to combine both approaches. At Encore Care, such an approach would ensure that the organisation deals with smaller issues as quickly as possible while still catering to larger items.       

Staff Involvement in Continuous Improvement

            Employees are a major stakeholder in the continuous improvement journey since they are tasked with the implementation of proposed changes. Measurement of processes the first step in continuous improvement since it explains organisational performance. Employees must be involved from this point since the measures help them understand processes and their roles in the firm better (Kaplan et al., 2010). If staff members are given the responsibility to manage the measures, they gain ownership of the continuous improvement process. The direct implication of this is increased employee commitment to organisational initiatives. Change management becomes easier, and they help drive the process by providing feedback that is particularly important in continuous improvement. Employee involvement also provides the opportunity for the generation of better ideas. At Encore Care, nurses and healthcare assistants interact directly and constantly with residents and as such understand the weaknesses of the organisation’s processes. If they are involved significantly, process improvement ideas will be based on informed perspectives. Top managers cannot make effective improvement ideas on their own since they will base their thinking on past experiences and their perception (McLean and Antony, 2014). The issue of increased productivity is also relevant when it comes to employee involvement in process improvement. The perception of ownership of the continuous improvement journey leads to the improvement of overall morale (Jurburg et al., 2017). Observable parameters such as decreased absenteeism and decreased employee turnover lead to increased productivity. These benefits are essential to the continuous improvement agenda since changes will be made faster and more effectively. Employee involvement is also beneficial to the performance appraisal process which is a critical success factor in the success of a continuous improvement program. Involving the staff in this context means that every individual understands how they are performing relative to set improvement targets. With employees on board, it is easier to recognise unanticipated deficiencies and formulate corrective measures to foster process improvement.   

Development of a Quality Strategy

The Scope of Quality

            Quality is a concept that traverses all organisational functions and operations. In the healthcare sector, quality is key to organisational success since there is no place for compromise as would be the case in other sectors. At Encore Care, the scope of quality pertains aspects such as patient safety, effectiveness, timeliness, and quality of life at the facilities. A broad scope ensures that all organisational functions share a common feature of quality. The modern organisation is geared towards providing quality products to its customers; a paradigm that has necessitated the development of quality as a field of study.

            Quality management is a discipline that involves monitoring all processes and outputs to ensure they are fit for purpose and uphold the desired level of excellence (Goetsch and Davis, 2014). The concept is based on the idea that an organisation’s long-term success is the result of consistent customer satisfaction. Quality management is a broad field that consists of the following components: quality planning, quality assurance, quality control, and quality improvement. Quality assurance involves a set of activities that ensure that process implementation produces products or services that meet stakeholder requirements consistently. The concept is process-oriented and involves ensuring that employees have appropriate knowledge and skills to fulfil their responsibilities competently (Amaral and Rosa, 2010). To ensure that quality assurance is effective, it must be independent. Examples of quality assurance activities are internal and third-party audits. Quality control, on the other hand, involves a planned inspection of products or services to ensure that they meet minimum expectations of quality (Mitra, 2012). Unlike quality assurance, this component is oriented towards a firm’s products or services. Effective quality control is characterised by the strict control of product or service specifications. Quality improvement refers to efforts taken by the organisation to increase the efficiency of actions and procedures. The process utilises information derived from quality assurance and quality control. Initiatives such as continuous improvement and 5S are examples of quality improvement programmes.   

Approaches to Quality Management

            The approach that an organisation pursues quality management is based on an evaluation of the type of business, staff, and customers. One of the most common approaches in this regard is the creation of the ultimate TQM environment. This approach involves enhancing employee cohesion throughout the organisation. The management should shift the focus from statistical achievements to individual contribution (O’Neill, Sohal, and Teng, 2016). The organisation, in this case, aims to offer quality products rather than looking to provide cheap or quickly-produced ones. The approach is based on the principle of customer focus in which case it always tries to meet and exceed customer expectations. The second approach to quality management is the use of Pareto charts. Visualising causes and effects can help the management understand underlying problems better. This approach is based on Pareto’s principle that “80 percent of an organisation’s defects comes from 20 percent of the organisation’s problems” (Mongin, 2016). The Pareto chart forms the basis for strategy formulation to enhance the monitoring of processes and outputs. The third approach used by organisations is using ISO standards. To achieve the certification, a firm must train employees to be consistent in performing job duties to ensure predictable outcomes (Levine and Toffel, 2010). The standardisation of processes can result in significant achievements with regard to quality management. The underlying principle of this approach is a focus on processes. Streamlined processes are widely beneficial since they reduce costs, eliminate waste, and boost continuous improvement.

            Encore Care is committed to providing quality healthcare services and has invested heavily in technology to help meet quality needs. The use of technology at the firms mainly revolves around workflow processes. The organisation’s use of QMS Wrapper enables department heads to coordinate, control, and direct various tasks at the workplace. As a nursing manager, I am tasked with quality measurement and reporting. The use of the software lessens the workload associated with monitoring activities and helps track the progress of quality initiatives.   

Development of Quality Management Principles

            Quality management principles were developed over the last three decades to represent factors which influence the achievement of quality (Heras-Saizarbitoria and Boiral, 2013). The principles are the theoretical foundation of ISO 9001. The customer focus principle is the epicentre of quality management. The commitment to meet and exceed customer expectations perfectly summarises what every organisation should aspire. The principle of leadership alludes to the fact that organisational commitment is necessary for effective quality management. This principle inspired the development of the involvement of people principle. By working together, stakeholders enhance an organisation’s capability to create and deliver value (Fotopoulos, Psomas, and Vouzas, 2010). The development of the current process approach involved the merging of two principles: the process approach and the systems approach. The principle emphasises that the standardisation of processes increases efficiency; a sentiment that was influenced by the evolution of manufacturing philosophy. The merged component of systems approach in this principle recognises the notion that the interaction of organisational elements influences behaviour. Continuous improvement also played a significant role in the development of quality management principles. The improvement principle maintains that a focus on improvement contributes to organisational success. The emphasis on evidence-based decision making also proves that quality management is an evolving field that reacts to developments regarding fields such as manufacturing and analytics. The use of data analysis techniques is now commonplace in organisations, and it plays a significant role in decision-making. The final principle in this context is the mutual benefits relationships principle. This statement is more of an emphasis on good practice. The quality management principles all share the commonality of being practical. Management professionals around the world can use the principles as a guide when looking to implement a quality management program. The regular editing of the principles ensures that the field of quality management is always based on recent research and developments.    

Quality Standards at Encore Care Homes

The quality strategy for Encore Care Homes is an approach which aims prioritising quality in all operational activities. The organisation has a quality strategy, whose ultimate aim is to deliver care of the highest quality to residents and continuously look to improve on various aspects of operational activities. Encore Care perceives residents as partners in their care. The staff listen to their feedback and act to improve on issues they notice. The quality strategy encompasses the following: caring and compassionate staff; effective collaboration between all stakeholders; a safe and hygienic care environment; clear communication; clinical excellence; and continuity of care (Poksinska, 2010). All activities at the organisation’s homes strive to achieve the standards highlighted in the quality strategy. To ensure progress and maintenance of the quality standards, there is a quality measurement framework. The framework has quality outcome indicators that show progress towards the standards of the quality strategy. The indicators include care experience, end of life care, personal outcomes, resource use, employee engagement, and self-assessed general health. The interpretation of individual indicators enables the organisation to mark out areas that would need improvement. The organisation can, therefore, formulate relevant policies to help improve the quality of services. The systematic framework has helped Encore Care improve a variety of aspects of elderly care and as such improve as an institution. The organisation uses technological resources to ensure the implementation of the quality strategy. QMS Wrapper, the preferred software at Encore Care, is comprehensive and flexible thus enabling us to personalise measuring tools for the clinical and non-clinical outcomes. The system has been in operation for more than a year, and the results have been impressive. By monitoring the progress of the quality improvement programme, the management has been able to institute small changes hence optimising outcomes and ensuring proper follow-up.

Development of a Quality Management Strategy

The Value of Knowledge Management

            An overload of data within organisations has characterised the dawn of the information age. This phenomenon has made knowledge management increase in popularity and importance (Dalkir, 2013). The first reason for this is that knowledge management facilitates decision-making in the organisational set-up. A proper knowledge management system helps executives filter data, share information, and improve their decision-making capabilities. With many information centres throughout an organisation, it is important to access information when one needs it. The aggregation and organisation of information by a knowledge management system ensure that all decision-makers are fully informed (Lopez-Nicolas and Meroño-Cerdán, 2011). Secondly, knowledge management transforms organisational culture by making learning routine. Staff members can continuously assess themselves and look for new ways to improve. An organisation can leverage this to streamline operations and improve processes. Thirdly, knowledge management enhances innovation within an organisation. The access to knowledge encourages the free flow of ideas. This paradigm shift can evolve into an organisation’s competitive advantage. A variety of technologies have been created to facilitate knowledge management. The technologies include artificial intelligence provisions to help run functions such as case-based reasoning systems, simulations, databases, expert systems, and video conferencing. The use of technology, in this case, is based on a proper understanding of the flow of knowledge within the organisation and the capacity to manage information flow. The popularity of wikis and blogs in recent years has also infiltrated the world of knowledge management. The incorporation of such technologies has enhanced the sharing of knowledge among peers at the workplace hence contributing to knowledge management. The use of technology in knowledge management has also expanded the scope of learning from beyond the organisation’s physical confines (Jennex, Smolnik, and Croasdell, 2012). One can access information in the workplace database from anywhere as long as they have appropriate credentials. This enhanced flexibility has made learning easier and desirable to employees.     

Knowledge Management Approaches

            Knowledge management approaches are based on the various types of knowledge in an organisational setting: tacit knowledge management, explicit knowledge management, and blended knowledge management (Hislop, Bosua, and Helms, 2018). Tacit knowledge is commonly referred to as know-how and alludes to the intuitive knowledge that is largely based on an individual’s experience (Ribeiro, 2013). The nature of this form makes it hard to communicate. In the organisational setting, tacit knowledge is highly valued since it can lead to significant breakthroughs. Tacit knowledge management depends on individuals as knowledge carriers since the type of knowledge is hard to codify. The advantages of this approach are that it is simple to approach and implement. However, its dependence on individuals is a major disadvantage since once the individuals leave the company loses significant knowledge. Another consideration is that one cannot be sure of the knowledge such individuals hold. Explicit knowledge, on the other hand, refers to formalised and codified knowledge. The knowledge can be disseminated through documents and operating procedures. Since it is easy to identify, store, and retrieve, this type of knowledge is handled easily by technology-based systems. This explanation is an advantage of an explicit knowledge management system. The approach is, however, disadvantageous since information can grow obsolete if not refreshed regularly. In addition, the approach is devoid of creativity and cannot inspire change in an organisation. Blended knowledge management involves the transmission of knowledge through a networking site. The openness of the system facilitates the building of communities of practice thus leading to enhanced information discovery and delivery (Yeh, Yeh, and Chen, 2012). A blended knowledge management system also allows the interaction of learners through webcasts. The approach creates a two-way learning experience since employees can discuss ideas, ask questions, and share information. The blended knowledge management approach has a variety of advantages that include access to information at all times, it is social and enjoyable, and access to experts. However, it can result in employees spending work time on the networking site.

Frameworks and Dimensions of Knowledge Management

            Knowledge works within different levels in an organisational framework. This understanding gives rise to the concept of dimensions of knowledge management which include personal, team, organisational, and inter-organisational (Mills and Smith, 2011). The personal dimension is at the bottom of the hierarchy and is based on the belief that by improving the personal ability of employees to retrieve, apply, and share knowledge will automatically improve outcomes in the other dimensions. An important driver for this dimension is the growing need to tackle information overload better. Knowledge management at this level has been greatly enhanced by the popularity of smartphones and web-based tools. The team dimension, on the other hand, is based on the realisation that workplace teams are knowledge engines of the organisation. The dimension is based on the share model with the transfer of knowledge between team members being relatively fast due to collaboration (Liao and Wu, 2010). The organisational dimension of knowledge management is concerned with strategy formulation and investment in supporting infrastructure. At this level, leaders must identify knowledge assets and set relevant objectives to maintain and build on the assets. Tools associated with this level of knowledge management include knowledge portals, blogs, and community tools. The inter-organisational dimension refers to knowledge networks and partnerships between organisations. Such deals are common in educational establishments where organisations partner to develop new knowledge.

            Besides the dimensions and approaches to knowledge management, there are different strategies used by firms to capture knowledge. The main strategies, in this context, are push and pull strategies. The push strategy focuses on encouraging employees to contribute to the knowledge management system by seeking out knowledge. This approach fosters creativity and innovation within an organisation due to the proactive stance taken by employees (Shih et al., 2012). The pull strategy, on the other hand, involves employees in need of knowledge requesting for it from those who possess it. The strategy is static and does not spur the development of new ideas in the organisation.

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