The purpose of this assignment is to create a project charter with a work breakdown structure.Select one case study in Chapter 8 of the textbook from the following options: Case Study: NurseManager or

Case Study

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Case Study

1. Problem Outlined in Case Study

The case study's stated problem is around a full-service health plan's insufficient capacity to offer outstanding customer service (Quigley et al., 2007). The customer experience ratings, obtained through the CAHPS survey, indicated that the health plan's customer service needed improvement. Further reports from the Member Services Department and member surveys confirmed these findings. The plan recognized the need to improve customer service to meet the current needs of its members and support the growing demands.

1. Discussion of Project Goals

The project goals were to improve customer service and address the underlying causes of the poor customer experience. The health plan aimed to develop a comprehensive quality improvement intervention that would result in significant improvements in customer service ratings and meet the needs of its members. This initiative aimed to:

Improve Customer Service Measures: The organization aims to enhance its customer service measures by implementing industry standards (Quigley et al., 2007). These standards will serve as a benchmark for evaluating the performance of the customer service department.

Demonstrate Customer Service Improvements: The organization sets a goal to showcase improvements in customer service over two consecutive quarters in 1999. This objective is particularly important in preparation for the upcoming NCQA accreditation cycle, demonstrating the organization's commitment to delivering excellent customer service.

Increase Positive Customer Feedback: With a heightened focus on customer service and improvements in telephone service, the organization anticipates an increase in positive customer feedback. This improvement will be measured through Member Services surveys and CAHPS surveys, reflecting the satisfaction and perception of customers (Quigley et al., 2007).

Redesign Career Path Incentives: The director of the Member Services Department has devised a plan to redesign career path incentives. The purpose of this initiative is to attract and retain qualified service representatives, ensuring a skilled workforce capable of delivering high-quality customer service.

1. Role of Project Manager in Planning

The project manager is responsible for overseeing, coordinating making sure that the project goals are properly established in all phases of planning, and that a well-defined plan is developed to achieve those objectives (Quigley et al., 2007). The project manager played a crucial role in the planning phase of the quality improvement intervention. The project manager developed a comprehensive action plan based on the findings from Step 1 and Step 2 of the quality improvement process. They set performance targets, established goals for improvement, and outlined specific actions to address the identified challenges.

1. Role of Project Manager in Organizing

The project manager organizes the project team, assigning roles and responsibilities to team members based on their skills and expertise. In the organizing phase, the project manager was responsible for ensuring that the necessary resources and personnel were allocated effectively. The project manager organized the implementation of the action plan, ensuring that resources, staffing, and training were aligned to support the (Quigley et al., 2007). They created new management positions, redesigned training procedures, and established a dedicated data analyst role to facilitate reporting and analysis.

1. Role of Project Manager in Budgeting

The project manager had a role in budgeting by collaborating with finance and administrative departments to develop a budget for the quality improvement intervention. They identified the resources required for implementing the intervention strategies and worked to optimize resource allocation. The project manager monitored the budget throughout the project and made adjustments as needed to ensure financial sustainability.

1. Role of Project Manager in Monitoring Progress

The function of the project manager was quite important in terms of keeping track of how far along the quality improvement intervention had gotten. They established mechanisms to track the implementation of intervention strategies and monitored key performance indicators related to customer service. The project manager continuously monitored the performance measures and compared them to the established goals (Quigley et al., 2007). They worked with the Service Improvement Committee, Quality Improvement Committee, and Board of Directors to assess progress, analyze results, and amend the action plan as required. The project manager ensured that the goals were being met, identified areas for improvement, and took necessary actions to maintain and enhance the improvements achieved.

1. Role of Project Manager in Managing Reports and Documentation

The project manager was responsible for managing reports related to customer service performance, member surveys, and compliance. They delivered annual performance reports to the relevant committees and board, provided Member Services annual reports, and developed new quality improvement projects(Quigley et al., 2007). They maintained records of performance measures, analyzed data trends, and documented the actions taken to address specific issues.

1. Role of Project Manager in Health Care Quality and Safety Initiatives

The project manager focused on improving customer service, enhancing patient satisfaction, and ensuring efficient handling of member calls. The project manager facilitated collaboration and knowledge sharing between different departments to promote a culture of continuous improvement (Quigley et al., 2007). The project manager collaborated with vendors, stakeholders, and staff to develop and implement strategies that would address areas of concern and improve the overall health care quality and safety. The project manager also addressed issues related to staff retention and career development to create a positive and safe work environment.

1. Conclusion

In conclusion, the case study highlights the quality improvement intervention implemented by a full-service health plan to address its poor customer service capabilities. Through task coordination, budget setting, progress monitoring, and management of reports and documentation, the project manager played a critical role in establishing policies better outcome of this intervention. Through their efforts, the health plan aimed to achieve significant improvements in customer service and member satisfaction, as measured by performance targets and customer surveys. By implementing organizational changes, enhancing training procedures, and increasing staffing levels, the health plan sought to transform its Member Services Department into a more efficient and effective customer service function.

References

Quigley, D. D., Farley, D., & Wiseman, S. H. (2007). Improving performance for health plan customer service: a case study of a successful CAHPS quality improvement intervention. RAND. https://www.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/reports-and-case-studies/ExecSummcaseplancustsvce-RAND7607.pdf