Tag: measuring quality

OM in the News: Have a Fear of Flying? Don’t Read Today’s Post

Airlines’ hiring binge has suddenly thrust many pilots behind the controls of different, bigger planes than they are used to flying, reports The Wall Street Journal (Nov. 8, 2023). That rapid advancement is fueling anxieties over whether pilots’ newness to certain aircraft could lead to serious incidents and accidents.

The union for Southwest’s pilots believes the airline’s initial training program needs a bigger revamp. Major carriers have added nearly 10,000 pilots to their ranks this year.

Pilot newness to airplanes’ make and model is among the factors officials have looked at since air travel’s fast, and often strained bounce back from the pandemic. This aspect of “juniority” has emerged in the aftermath of some serious problems over the last two years, leading pilots, airline officials and safety experts to scrutinize the experience level of the people in the cockpit.

With travel demand soaring, pilots are moving up through the ranks faster than before. Major carriers are pulling pilots from regional carriers more quickly, with pilots used to smaller airliners advancing to bigger planes, needing to learn new procedures, controls and quirks. Airlines that hurried pilots out the door during the height of the pandemic had to quickly pivot when demand surged back. Carriers have added 23,000 pilots to their ranks the past two years, dramatically higher than decade long averages.

There is precedent for concern. The U.S. Transportation Department found a correlation between accidents and pilot experience with aircraft type. Analyzing 322 airline accidents, the office found fewer accidents involving pilots who had more time flying the aircraft make and model.

The industrywide battle for pilots has jolted the methodical pilot career progress. Regional carriers are struggling to hold on to pilots for more than a few years.  About 8,000 regional pilots are expected to move on to bigger airlines this year—44% of that workforce. Before the pandemic, regional pilot turnover was 10% to 20%.

“The pace of hiring and the resulting turnover is unprecedented. I do have a concern over the experience in seat,” said the CEO of one carrier. Some pilots are able to move from smaller planes to bigger ones or to upgrade from first officer to captain years faster than the decade-long waits they sometimes faced in the past. The chairman of the United pilots’ union said the airline’s internal monitoring systems have turned up issues that appear to be correlated with the amount of time pilots have spent in their seats.

Classroom discussion questions:

  1. What tools in Chapter 6 of your Heizer/Render/Munson text could be used to analyze this potential problem?
  2. What would quality guru Philip Crosby say about the issue? (see page 217)

OM in the News: A New View of TQM in Hospitals

The atrium of the Henry Ford West Bloomfield Hospital
The atrium of the Henry Ford West Bloomfield Hospital

At the Henry Ford West Bloomfield Hospital outside Detroit, patients arrive to uniformed valets and professional greeters. Wi-Fi is free and patient meals are served on demand 24 hours a day. Members of the spa staff give in-room massages and other treatments.

While clinical care is the focus of any medical center, hospitals have many incentives to move toward hotel-inspired features, services and staff training. And competing on the amenities is all the more important because there is so little reliable comparative data on hospitals’ medical outcomes. “In the absence of hard data on cancer treatment or surgery success, patients may look to the quality of the hospital’s environment,” writes The New York Times (Aug.2, 2016).

In 2009, a 24-hour room service at Henry Ford West Bloomfield was introduced instead of set meal schedules. Similarly, patients at the more than 50 Henry Ford Medical outpatient centers in the region can choose the time and location of many tests, procedures and appointments using an online system modeled on airline reservation portals. When it was introduced in 2014, cancellation and no-show rates dropped immediately.

At Henry Ford West Bloomfield, scores from federally mandated surveys show that the evolving features at the hospital have helped to improve its customer satisfaction ratings and make patients more likely to recommend the hospital to others. Length of stay and readmission rates have also decreased, which allows more beds to open up and the hospital to treat more patients. Indeed, a study by Deloitte found that hospitals with higher patient experience ratings were generally more profitable than those with lower scores. “Hospitals want to create a loyal customer base,” says an industry expert.

Classroom discussion questions:

  1. Referring to the Global Company Profile featuring Arnold Palmer Hospital (see Ch. 6), what techniques does Arnold Palmer use that are not noted in the Henry Ford article?
  2. Why is it hard to measure hospital quality?

OM in the News: The Dangers in Measuring Hospital Quality

nurseOne of our definitions of quality in Chapter 6 is user based: “quality lies in the eyes of the beholder.” The Atlantic’s article (April 17, 2015), titled “The Problem With Satisfied Patients,” states though, that a misguided attempt to improve healthcare has led some hospitals to focus on making people happy, rather than making them well. When healthcare is at its best, hospitals are 4-star hotels, and nurses, personal butlers at the ready—at least, that’s how many hospitals seem to interpret the government mandate by the Department of Health and Human Services. DHHS announced that 30% of hospitals’ Medicare reimbursement would be based on patient satisfaction survey scores. The goal: transparency and accountability, which would improve healthcare.

But a recent study revealed that patients who reported being most satisfied with their doctors actually had higher healthcare and prescription costs and were more likely to be hospitalized than patients who were not as satisfied. Worse, the most satisfied patients were significantly more likely to die in the next 4 years. As one MD said: “Patients can be very satisfied and dead an hour later.”

The concept of “patient experience” has characterized patients as customers and nurses as automatons. Some hospital job postings advertise that they are looking for nurses with “good customer-service skills” as their first qualification. By treating patients like customers, hospitals accept the cultural notion that the customer is always right. But hospitals, too, can offer poor care and still get high patient-satisfaction ratings. A study of poor performing hospitals found that 2/3 of them scored higher than the national average on the key patient question; “YES, they would definitely recommend the hospital.”

Research has shown that hiring more nurses is the true key to patient satisfaction. Higher staffing of nurses has been linked to fewer patient deaths and improved quality of health. Failure-to-rescue rates drop. Patients are less likely to die or to get readmitted to the hospital. Their hospital stay is shorter and their likelihood of being the victim of a fatigue-related error is lower.

Classroom discussion questions:
1. What are the definitions of quality (see Chapter 6) and how do they relate to hospitals?

2. What are the flaws, if any,  in surveying patients to measure hospital quality?