Leading Performance Indicators In St. Thomas’ Hospital London Free Essay


Patients always expect to receive quality treatment whenever they visit a hospital facility and that their health concerns are addressed adequately (Braithwaite, 2018). Healthcare is a predominant factor that significantly impacts a country’s political, social, and economic well-being, hence the need for awareness and knowledge of the key performance indicators and their impact (Garber, 2019). Key performance indicators in hospitals are useful in identifying gaps and barriers affecting the quality of patient services (Rosen et al., 2018). This report provides an in-depth analysis of key performance indicators used to determine the health and safety of St. Thomas Hospital London, specifically in the surgery department. The surgical department was chosen because of its sensitivity and strategic importance when handling patients.

Skilled and quality manpower

The target role of skilled and quality manpower is to analyze the hospital’s capability, particularly its surgical department, in meeting the needs of the patients (Agarwal et al., 2019). The sensitive nature of cases handled in the surgical department requires an adequate staff that is well-trained and able to deal with emergencies that may emerge during the procedure (). St. Thomas’ Hospital London has one of the best-qualified specialized health professionals (Guys and Thomas Hospital, 2022). However, with an increase in patients, the hospital has witnessed a shortage in manpower affecting its rate of operations and quality of services.

However, inadequate staff attendance in the unit has reduced the quality of services, as many patients needing critical care are left unattended. Staff attendance has further influenced the needed cooperation and coordination, leading to inadequate provision of critical services. In this sense, minimal or no risks are discussed in deeper detail to develop effective solutions. Moreover, the lack of coordination and cooperation has led to an insufficient and dysfunctional working environment among the department staff, characterized by increased delays in attending to patients. The hospital management in the surgical department has been heavily criticized for inadequate supervision, support, and mentoring of junior staff and the need to develop an organizational culture that is not only open and practical but also inclusive and integrative (Duan et al., 2021). Even though there are daily handovers, they could be more detailed hence the increased lack of attendance. Moreover, the surgical dashboard ratings provided by the surgical department must be better displayed and recorded, meaning that the management and patients must be better informed on the outcomes and potential risks of surgical processes and procedures.

Supplies and equipment

Agarwal et al. (2019) argue that the availability of supplies and equipment is as important as having qualified personnel in the hospital’s departments, as hospital personnel can only effectively work with adequate availability of supplies and equipment. The unit’s staff effectively and adequately uses the necessary supplies, equipment, and control measures to ensure all stakeholders, including patients, are well protected from infection. The supplies and equipment used in the surgical department have been recorded t be clean and regularly checked for maintenance. To promote optimal hygiene practices, the department ensures that its clinical waste is disposed of as required. Moreover, the department’s clinical records are regularly updated.

Supplies and equipment also influence the department’s technical activities and operations, including appropriately performing surgeries. Supplies and equipment promote surgery precision and achieve positive patient outcomes (Rosen et al., 2018). Availability of adequate personal preventive equipment (P.P.E.) and antibiotics and regular disinfection of surgical rooms increased the success of surgical operations without implications such as the transmission of infections between the health personnel and the patients. Lack of supplies, such as required I.T. tools, has contributed to technical malfunctions in the surgical department with serious consequences on patients’ health. Additionally, the need for more supplies such as drugs and other resources and equipment in the surgical unit is influenced by the government underfunding the facility, jeopardizing patients’ safety and well-being.


The rationale behind analyzing thromboprophylaxis is to determine how surgeons in the surgical department of St. Thomas’ Hospital London can minimize the unit’s mortality rate. Thromboprophylaxis is a strategy that involves using antithrombotic drugs and mechanical methods to promote venous flow from the legs (Horner et al., 2020). According to Spyropoulos and Raskob (2017), thromboprophylaxis is among the top strategies for reducing mortality in patients who undergo surgical processes. However, despite the high benefits of thromboprophylaxis supported by massive evidence from research among surgical patients, the strategy is rarely used. Through interviewing four doctors working in the surgical unit, I confirmed that thromboprophylaxis is one of the least intervention methods used in the unit, especially on patients at risk of venous thromboembolism.

Complications of care

Care complications are a common phenomenon that patients tend to experience as an aftermath of surgical procedures, including temporary or lifetime disability or even death (Grocott et al., 2017). Factors such as wrong diagnosis, the condition of the patient and inadequate supplies are some factors that contribute to complications of care in the surgical unit. Research conducted by Agarwal et al. (2019) asserts that there are instances where it is impossible to avoid care complications. For St. Thomas’ Hospital London, complications of care have been caused by a lack of inadequate supplies, reduced staff attendance and mistakes made by the medical staff while addressing patient’s concerns (Care Quality Commission, 2022). Additionally, the hospital has been facing computer meltdowns causing care complications during a recent heat wave. According to the hospital management, the heat wave led to delays in operations, with all departments experiencing cancellations due to the I.T. failure. The Trust’s main duty is to protect the safety of the patients, and the Harm Review indicated increased harm to patients in the hospital. For example, even though no severe harm was caused, one patient could not get a transplant when donor organs had been found during the heat wave period (Guys & St. Thomas, 2023).

Mortality rates

According to Grocott et al. (2017), death is among the dreadful eventualities among patients needing surgical procedures. Moreover, mortalities in the surgical unit may be influenced by factors such as equipment malfunction or human error. St. Thomas’ Hospital’s surgical unit has a mortality rate of 11% (Guys and Thomas, 2022). Inadequate supplies influence the relatively high mortality rate, lack of adequate health personnel, and high staff attendance in the unit.

Recommendations for implementation

The surgical department is responsible for creating a conducive and healthy working environment by ensuring their staff is motivated to increase attendance. S.T. Thomas’ Hospital London’s surgical department should ensure its human resource department hires an adequate number of well-trained and qualified personnel in the surgical department in order to maintain its reputation. The hospital management should provide regular training on hygiene among the unit’s health care providers to create a culture of the high level of hygiene and limit cases of infections during and after surgical procedures. The staff should be motivated through developing strategies such as incentives to increase their performance and reduce staff attendance. The surgical teams should be trained on the effectiveness and efficacy of the thromboprophylaxis intervention method to promote positive outcomes, especially in patients with venous thromboembolism.

Additionally, there is a need for the hospital Trust to develop a strategic plan to ensure effective computer processing, data storage and backup to avoid I.T. failure and malfunctions (Guys & Thomas, 2023). The Trust should also consider writing to the N.H.S. England, alerting them on I.T. failure caused by a change in weather to develop effective mitigations. Moreover, there is a need for adequate provision of hospital supplies and adequate health personnel to reduce the high mortality rate in the surgical unit.


Examining the surgical unit of St. Thomas Hospital London is critical as it deals with sensitive cases in human health care. The key performance indicators discussed in this report explain the unit’s condition in satisfying patients’ needs. There is a need to train the surgical team on the efficacy of using thromboprophylaxis as an intervention for increasing patient outcomes. Generally, the surgical unit indicates a high level of preparedness in addressing patients’ health concerns except for minor issues. However, among other issues, there is a need for adequately trained healthcare providers in the surgical department to assist in reducing medical errors and the high mortality rate.


Agarwal, S., Sripad, P., Johnson, C., Kirk, K., Bellows, B., Ana, J., Blaser, V., Kumar, M.B., Buchholz, K., Casseus, A. and Chen, N., 2019. A conceptual framework for measuring community health workforce performance within primary health care systems. Human resources for health17(1), pp.1-20.

Braithwaite, J. (2018). Changing how we think about healthcare improvement. Bmj, p. 361.

Care Quality Commission. 2022. All inspections:St. Thomas’s Hospital. https://www.cqc.uk/locations/RJ122/reports

Chazapis, M., Gilhooly, D., Smith, A.F., Myles, P.S., Haller, G., Grocott, M.P.W. and Moonesinghe, S.R., 2018. Perioperative structure and process quality and safety indicators: a systematic review. British journal of anaesthesia120(1), pp.51-66.

Grocott, M.P., Plumb, J.O., Edwards, M., Fecher-Jones, I. and Levett, D.Z., 2017. Re-designing the pathway to surgery: better care and added value. Perioperative Medicine6(1), pp.1-7.

Guy’s and St. Thomas. 2023. Review of the Guy’s and St Thomas IT critical Incident. Final Report from the Deputy Chief Executive Officer. January.2023. N.H.S. Foundation Trust. hhtps://www/guysandthomas.nhs.uk/medial/13017/ITcritcial2Bincident2Breview/

Guys and Thomas. 2022. Quality report 2021/2022/ hhtps://www.guysandthomas.nhs.uk/medical/13030/Qualityaccounts20212022

Horner, D., Goodacre, S., Pandor, A., Nokes, T., Keenan, J., Hunt, B., Davis, S., Stevens, J.W. and Hogg, K., 2020. Thromboprophylaxis in lower limb immobilization after injury (TiLLI). Emergency medicine journal37(1), pp.36-41.

Kilbourne, A.M., Beck, K., Spaeth‐Rublee, B., Ramanuj, P., O’Brien, R.W., Tomoyasu, N. and Pincus, H.A., 2018. Measuring and improving the quality of mental health care: a global perspective. World psychiatry17(1), pp.30-38.

Rosen, M.A., DiazGranados, D., Dietz, A.S., Benishek, L.E., Thompson, D., Pronovost, P.J. and Weaver, S.J., 2018. Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist73(4), p.433.

Spyropoulos, A.C. and Raskob, G.E., 2017. New paradigms in venous thromboprophylaxis of medically ill patients. Thrombosis and haemostasis117(09), pp.1662-1670.

Lean Supply Chain At A Local Business Assignment Essay Example

I interviewed the “Supplies managing director of McDonald’s company.”

McDonald’s is one of the most recognizable brands in the world, with a long and fascinating history (Cassidy et al.2021). The company was founded in 1940 by brothers Richard and Maurice McDonald in San Bernardino, California. Originally, the brothers operated a drive-in restaurant called “McDonald’s Bar-B-Q,” but they soon realized that hamburgers were their most popular menu item (Cassidy et al.2021). In 1948, they redesigned their restaurant to focus exclusively on hamburgers, fries, and milkshakes and introduced a new concept: fast food.

Today, McDonald’s has more than 39,000 locations in over 100 countries. The company’s menu has evolved over the years to offer customers r a wide range of products and services. The company is best known for its burgers, fries, and milkshakes, which are popular worldwide. However, McDonald’s also offers a variety of other items on its menu, including salads, wraps, breakfast items, and desserts (Cassidy et al., 2021).

One of McDonald’s most popular products is its Big Mac burger, a menu staple since 1968. The Big Mac consists of two beef patties, a special sauce, lettuce, cheese, pickles, and onions on a sesame seed bun. Other popular burgers on the menu include the Quarter Pounder with Cheese, the Double Cheeseburger, and the Filet-O-Fish.

In addition to its burgers, McDonald’s also offers a variety of side items, such as French fries, apple slices, and mozzarella sticks. The company has also recently introduced plant-based options, such as the McPlant burger, to cater to customers looking for vegetarian or vegan options.

Breakfast items are also popular for McDonald’s customers, with options such as Egg McMuffin, breakfast burritos, and oatmeal on the menu. The company has also started offering all-day breakfast in some locations, allowing customers to enjoy breakfast items anytime. McDonald’s also offers a range of services to its customers, including drive-thru, delivery, and mobile ordering.

The company’s success can be attributed to its efficient and effective supply chain management practices. From my comprehensive interview with the supplies chain managing director, here are some ways in which McDonald’s integrates a lean supply chain in their operations:

Commitment to zero defects:

According to the supply chain Managing director, McDonald’s is committed to delivering high-quality and consistent products to its customers, reflected in its rigorous quality control system. The company’s quality control measures include a comprehensive supplier approval process, regular product testing, and on-site inspections to ensure that all food products meet the company’s strict standards. In addition, McDonald’s uses advanced technologies to monitor and analyze its supply chain performanceallowingws the company to identify and address quality issues in real-time.

The director stated that the company’s quality control system has helped to eliminate defects and waste in the supply chain “through continuous monitoring and improvement, we have been able to drive down the number of defects in our supply chain, which has resulted in cost savings and improved customer satisfaction.” This shows that McDonald’s commitment to zero defects has not only improved the quality of its products but also helped the company to reduce waste and costs in its supply chain.

Frequent shipment of small lot sizes according to strict quality, delivery, and performance standards:

The director also confirmed that; McDonald’s has implemented a just-in-time (JIT) system to receive frequent shipments of small lot sizes from its suppliers. This system helps reduce inventory and waste while ensuring that the company always has fresh ingredients. The JIT system is supported by a sophisticated logistics network that ensures that supplies are delivered to restaurants quickly and efficiently. It works closely with them to establish clear expectations and guidelines to ensure that suppliers meet the company’s strict quality, delivery, and performance standards. The company also provides training and support to help suppliers meet these standards. For example, McDonald’s offers a Supplier Performance Index (SPI) that measures suppliers’ quality, delivery, and service performance. The SPI is used to identify improvement opportunities and to recognize suppliers that perform well.

Collaborative buyer-seller relationships:

He further informed me that; McDonald’s, the fast-food giant, has established a reputation for developing robust buyer-seller relationships with its suppliers. These relationships are characterized by close collaboration, where the company works hand in hand with its suppliers to identify opportunities for continuous improvement, reduce costs, and increase efficiency. McDonald’s understands that working closely with its suppliers is critical to maintaining its competitive edge in the industry. As such, the company has invested heavily in building long-term relationships with its suppliers, resulting in a high degree of trust and cooperation between the two parties. The collaborative approach employed by McDonald’s ensures that both the company and its suppliers benefit from the relationship. The suppliers benefit from a stable and predictable source of revenue, while McDonald’s benefits from a reliable supply of high-quality products at competitive prices. The company’s commitment to collaboration has also led to a culture of innovation and experimentation, where both parties are constantly seeking new and better ways to enhance their respective businesses.

Regular production schedules sent to suppliers regularly:

Per the director, McDonald’s provides suppliers with stable production schedules to help them plan their production and reduce waste. By providing these schedules, McDonald’s allows suppliers to plan their production more effectively, reducing the likelihood of stockouts, delays, and other disruptions that could negatively impact the supply chain. Additionally, this helps suppliers to optimize their production processes and minimize waste, which is critical for maintaining profitability in today’s competitive business environment.

Besides, the business provides stable production schedules, which also benefit the company by enabling it to maintain high control over its supply chain. By knowing when and how much of each product it will receive, McDonald’s can plan its operations more effectively, ensuring it has the necessary resources, staff, and equipment to handle the incoming shipments. This, in turn, helps the company reduce costs and improve efficiency, which is essential for staying competitive in the fast-food industry.

Sharing of electronic information between supply chain members:

As per the director’s reply, McDonald’s leverages technology to share electronic information with its suppliers, including vital data on sales, inventory levels, and production schedules. This approach allows for better communication and coordination between supply chain members, leading to an efficient and effective supply chain. The use of technology enables McDonald’s to provide suppliers with real-time information on changes in demand, enabling them to adjust their production schedules accordingly. Moreover, sharing electronic information helps to reduce the likelihood of stockouts and delays, ensuring that McDonald’s can meet customer demand. Additionally, this approach allows the company to gain valuable insights into its supply chain operations, which it can use to optimize processes, reduce costs, and improve efficiency.

Shipping needs:

Per the director’s reply, McDonald’s works closely with its logistics partners to manage its shipping needs. To transport its products from suppliers to its restaurants, the company employs a variety of transportation modes, including trucks, ships, and planes. This enables the company to respond quickly to changes in demand, ensuring that its restaurants have the products they need to serve customers. The use of different transportation modes also helps to minimize shipping costs and reduce the environmental impact of its supply chain operations. Moreover, McDonald’s works with its logistics partners to optimize its shipping routes and schedules, ensuring that deliveries are made promptly and efficiently. This approach enables the company to maintain a reliable and efficient supply chain, ensuring its restaurants have the necessary products to meet customer demand. Overallmanagingof shipping needs is a critical aspect of McDonald’s supply chain strategy, which helps the company maintain its position as a leader in the fast-food industry.

Overall, McDonald’s has a well-designed and efficient supply chain that integrates lean principles to minimize waste, improve quality, and enhance efficiency, which agrees with the argument in the course text.


Cassidy, O., Shin, H. W., Song, E., Jiang, E., Harri, R., Cano, C., … & Bragg, M. (2021). Comparing McDonald’s food marketing practices on official Instagram accounts across 15 countries. BMJ Nutrition, Prevention & Health4(2), 510.

Monczka, R. M., Handfield, R. B., Giunipero, L. C., & Patterson, J. L. (2021). Chapters 1 and 2. In Purchasing & supply chain management (7th ed.). Cengage.

Air Travel Liberalization University Essay Example

Lykotrafiti, A. (2015). Liberalization of international civil aviation–charting the legal flight path. Transport Policy43, 85-95.

This article examines the legal frameworks that have led to the liberalization of international civil aviation. The essay examines liberalization’s effects on the aviation sector and identifies this trend’s potential upsides and downsides. While increased competition and reduced consumer prices are positive outcomes of liberalization, the author contends that it can also lead to a race to the bottom regarding safety standards and worker rights. The paper concludes that regulation is necessary to maintain safety and sustainability and that liberalization should be addressed carefully.

This is a credible source as it has been published in Transport Policy, a peer-reviewed publication, and written by a recognized authority on aviation law. The author thoroughly introduces the subject, citing supporting laws, regulations, and case studies.

This resource will significantly aid my research because it provides a clear understanding of the legal and policy foundations for air service liberalization.

Seetanah, B., Sannassee, R. V., Teeroovengadum, V., & Nunkoo, R. (2019). Air access liberalization, marketing promotion, and tourism development. International Journal of Tourism Research21(1), 76-86.

The article examines how the liberalization of airline travel has affected tourism growth in Mauritius. Data was gathered from tourists and tour guides in this study, using a mixed-methods technique. The findings show that easing restrictions on air travel positively affects the growth of the tourism industry and that advertising campaigns effectively attract more visitors. The study also indicated that nations with higher-income economies were more impacted by air access liberalization than countries with lower-income economies.

This is a credible source since it was published in a worldwide journal, International Tourism Research, a peer-reviewed academic journal. Each author has strong ties to a prestigious academic or research institution. By analyzing air access liberalization in Mauritius, the study offers lessons that can be applied to other countries.

This article is helpful for my project since it shows that the liberalization of air travel positively affects the tourism industry. My research question, as is the moderating effect of commercial promotion, is addressed. My research is strengthened by its attention to a small island developing state with its challenges and opportunities.

Abate, M. (2022). Aviation in Africa: Can liberalization help the sector take off? World Bank Blogs. Retrieved March 20, 2023, from https://blogs.worldbank.org/transport/aviation-africa-can-liberalization-help-sector-take

In this blog, Abate discusses the possible advantages of deregulating African airlines. The article explains how liberalization may enhance competition, decrease prices, and open up new routes, all of which may make air travel more accessible and cheap for African people. The author addresses the difficulties of adopting liberalization in an African setting and offers solutions to these problems.

The source is credible, written by a world Bank transportation economist and published on their official blog. Relevant and current data are presented. This article is helpful in my research because it presents a case study of the impacts liberalization could have in a particular location and addresses the difficulties of putting liberalization into practice hence using it will not harm my credibility.

Adverse effects of Air Travel liberalization

Schipper, Y., & Rietveld, P. (2018). Economic and environmental effects of airline deregulation. In Networks in transport and communications (pp. 325-343). Routledge.

The article examines airline liberalization’s global economic and environmental impacts by comparing and contrasting research conducted in various countries such as the United States and Europe. More competition, lower pricing, and changes to the employment landscape are some of the economic effects of deregulation examined in this article.

This is a credible source as the authors are affiliated with the Free University Amsterdam, a well-known and respected University. Routledge, a dependable publisher in academia, published the chapter. The analysis was based on a thorough examination of relevant literature and studies.

This article is helpful for my final project because it thoroughly examines the environmental and economic effects of airline deregulation. It gives me a firm grounding for my studies and can point me toward new avenues to explore. Since it is an authoritative academic source that offers a fair assessment of all sides of the issue, it will be good for my credibility. It will aid me in comprehending the possible outcomes of liberalizing airline services.

Button, K., & Pels, E. (2010). International air transport: the impact of globalization on activity levels. Globalization, transport and the environment, 81.

This article examines how airline liberalization has influenced the industry’s expansion. It also analyzes the effects of liberalization on airlines’ effectiveness, productivity, and profitability, along with their effects on the demand for air transport services. The authors argue that the liberalization of airline services has resulted in adverse environmental effects such as increased gas emissions and noise pollution.

This article is credible as it is a publication in a scholarly journal with a strict peer review process, and the authors are widely recognized experts on aviation economics. This article helps us understand how airline liberalization affects the environment. This article will significantly help my final project because it shows how airline liberalization has affected the industry and the environment.

European Parliament. (2022, February 28). Air Transport: Market Rules. Fact Sheets on the European Union. https://www.europarl.europa.eu/factsheets/en/sheet/131/air-transport-market-rules.

This fact sheet provides an overview of the European Union’s policy on the liberalization of air travel services. The document acknowledges that liberalization can enhance competition and lower prices, but it also has the potential to lower service quality, safety, and security. Competition might encourage airlines to skimp on maintenance and training, raising safety issues. Increased competition may cause a decline in service quality and customer satisfaction as airlines to prioritize cost reduction over passenger satisfaction. Cheaper airfares may also encourage more people to travel, which can harm the environment.

This source is credible since the European Parliament published it. This article is helpful for my project because it gives a general overview of the adverse effects of the European Union’s liberalization of the airline industry, and hence if included in my project, it will not harm my credibility.