Health Services and Facilities Planning - Coursework Example

? Health Services and Facilities Planning Table of Contents Executive Summary 3 Health Plan Discussion and Analysis 3 Sydney South West – Community Health Strategic Plan 2007-2012 3 Positive Aspects of the Plan 4 Plan Gaps 5 Looking at the Plan Process Stakeholders 6 Gauging Organizational Commitment 6 Gauging the Indicators for Evaluation and Performance 7 Conclusion 8 Recommendations 8 References 10 Executive Summary The Sydney South West Area Health Service strategic health plan from 2007 to 2012 is strategically sound on paper, with an adequate planning horizon, and strategic objectives and measurable targets tied to a set of priority clinical areas. It reflects deep experience and engagement with its constituents, and has room to grow. On the other hand, areas such as plan monitoring seem lacking. Planning for unseen contingencies can also be improved and further substantiated. The review of the literature suggests that a good plan also includes a sound financial plan integrated into the key objectives and goals, to increase the chances of the strategy succeeding. Health Plan Discussion and Analysis Sydney South West Area Health Service has a mandate to provide public health services to their assigned area of responsibility, a parcel of Australia that is socially, ethnologically, culturally and economically diverse, reflecting the complex needs of its constituents. Part of the response to this mandate is the document detailing its strategic community health plan for the planning period from 2007 to 2012, the focus of this paper's critique and analysis (Sydney South West Area Health Service [SSWAHS], 2007). Sydney South West – Community Health Strategic Plan 2007-2012 As the plan document states, the SSWAHS has a mandate to provide health care services to its assigned area of responsibility, and the plan is in response to that, and also to a more inclusive plan from state of New South Wales to provide such services and ensure adequate health care for the state in a plan document stretching through 2010. The SSWAHS plan is noteworthy for being thorough in covering vital aspects of a good plan, including a set of clear objectives; a health vision for the area extending beyond the planning period ending in 2012, looking through to 2016; health care delivery plans that are tied to so-called clinical priorities, embodied in a “Core Clinical Business Framework”; as well as a defined action plan (SSWAHS, 2007, pp. 2-3). Positive Aspects of the Plan It is noteworthy that this plan has a longer time horizon than other comparable plans in the state, as compared to the strategic health plan for the North Coast region of New South Wales, where the time horizon is shorter at three year (North Coast Area Health Service, 2007). Moreover, SSWAHS at least on paper has a strategic plan that looks beyond the planning period's 2012 end, to at least 2016, another plus SSWAHS, 2007). The SSWAHS plan also fares well in terms of planning horizon in to the state's immunization program, for instance, which has a three-year horizon from 2008-2011 (NSW Department of Health, 2007). The SSWAHS also benefits from the way the priority clinical areas have been culled from data on the field with regard to what the key health concerns for the geography are, with emphasis on those clinical areas that are problematic for a large part of the population, including sexual health, and health concerns associated with an area dense with people from different cultures and ethnicities (SSWAHS, 2007, pp. 5-6). It is also noteworthy that the SSWAHS plan, by reinforcing the idea that clinical areas need to be prioritized to maximize the impact of spending and resources of the group, mirror the idea presented in a later document on strategic health and research directions for the state, moving past 2012 (NSW Ministry of Health, 2011). The notion that priority areas need to be ranked is a sound strategic idea, reflected likewise in other health plans of note in Australia and elsewhere. This bodes well for the practicability and the potential success of the plan and its strategies (NSW Department of Health, 2010; Sydney Local Health District, 2012; NSW Ministry of Health, 2012a; NSW Ministry of Health, 2012b). Plan Gaps Looking at the SSWAHS plan, there are immediate concerns relating to how the financial aspect of the plan melds with the other key aspects of it, such as those relating to the addressing of health concerns within the priority clinical areas. Looking at the document in total, there is scant mention with regard to funding and the financial aspects of the strategy. This is a clue with regard to what can be construed as a relative lack of rigor in the planning and crafting of the strategy itself. Where will the money come from? How will it be allocated and used? Who will have process ownership of the financial aspects of the plan? The assumption is that the area manager, working with the accountants and financial managers, will take care of these details. On the other hand, in the absence of concrete financial details as to how the strategy is to be funded, one is left with a general picture of the strategy failing to live up to its promises, because the funding components are vague, or non-existing. On the other hand, a review of the literature reveals that good strategy papers for public health planning address financial and funding issues as fundamental to good planning. As an example, a strategy review paper prepared by the health ministry of the state of NSW details the financial aspects of the strategy in a substantial early part consisting of nine pages out of the document’s 43 pages. The SSWAHS document, in contrast, only has one mention each of funding and financial (SSWAHS, 2007; (NSW Department of Health, 2010; Sydney Local Health District, 2012; NSW Ministry of Health, 2012a; NSW Ministry of Health, 2012b; New Mexico Department of Health, 2008; National Parks Service, 2011; National Prevention Council, 2011; US Department of Health & Human Services, 2010; Iowa Department of Public Health, 2012). Looking at the Plan Process Stakeholders There is adequate representation of key stakeholders in the process of health care strategy planning and formulation reflected in the SSWAHS document. For one, the prioritizing of critical clinical areas for engagement by the plan takes into consideration the ethnically and socially varied constitution of its service area and population. There is also ample representation to the plan from the planners and administrators too. The extent of the engagement of each of the stakeholders, on the other hand, seems not clear from the document. For instance, there seems to be little actual research input from the community with regard to the clinical areas of priority, and in the absence of concrete figures and inputs, the paper gives the impression of relying too much on motherhood statements and generalized forecasts. The available literature, on the other hand, tells us that a good strategic plan engages stakeholders, and are rigorous when it comes to providing details with regard to the level of engagement, data relating to those, and generally reflects rigor in the culling of the evidence and research relating to this and other aspects of the strategy plan (Bryson, 1988; Spiegel and Alving, 2005; Gibson and Farah, 2012; Vancouver Island Health Authority, 2009; Sambo, Bakeera, Kirigia, & Diarra-Nama, 2009). Gauging Organizational Commitment It is worth noting that the organization itself has only been around since 2005, as reflected in the plan, but given its government mandate, and its being a direct tributary of the state of NSW's general health strategies and programs, one can make the assumption that it has to, by law, demonstrate a keen commitment to public health in general, and in particular aligning itself with the general goals and strategies of the state. Looking at the strategy plan, moreover, there are considerable efforts at substantiating the different strategic goals with a plan, including details on who to engage, and what to do, and how those engagements tie up to the general strategies being discussed. This attempt at detail speaks to a certain level of commitment from the organization to follow through on the plan. On the other hand, again dissecting the plan from the context of how other organizations have come up with their own strategic health plans, one can see that the level of detail pales in comparison to others, and in total this lack of details can be construed as the organization paying lip service to a plan, without no concrete ideas in mind as to how to actually implement it throughout the planning period. For instance, looking at the state plans and comparing them with the strategies outlined in the SSWAHS plan, the difference in details as to how to finance the plans is glaring and large. The lack of details in the latter is telling (SSWAHS, 2007; (NSW Department of Health, 2010; Sydney Local Health District, 2012; NSW Ministry of Health, 2012a; NSW Ministry of Health, 2012b). Gauging the Indicators for Evaluation and Performance In the absence of actual metrics, it is hard to imagine that the plan will be able to measure performance and evaluate success or failure, as the plan currently stands. References to the plan being tweaked as it is implemented through the planning period are promising but vague. Sampling the literature, one sees that good planning includes the provision of measurable parameters for gauging performance and success or failure of the venture (SSWAHS, 2007; Bryson, 1988; Spiegel and Alving, 2005; Gibson and Farah, 2012; Vancouver Island Health Authority, 2009; Sambo, Bakeera, Kirigia, & Diarra-Nama, 2009). Conclusion The SSWAHS document looks good initially, until it is compared to others, and until it is scrutinized in comparison to best practices, the plans put forward by the state of NSW (out of which the SSWAHS draws its mandate and direction), and the general literature on planning and health care planning. The lack of details on the financial and funding aspects of the plan, for instance, can be construed as a lack of rigor on the part of the planners and administrators, when it came to thinking through the implications of the plan on the organization's and the state's finances. The similar lack of rigor is reflected in the lack of adequate details with regard to measuring and evaluating performance (SSWAHS, 2007; Bryson, 1988; Spiegel and Alving, 2005; Gibson and Farah, 2012; Vancouver Island Health Authority, 2009; Sambo, Bakeera, Kirigia, & Diarra-Nama, 2009; (NSW Department of Health, 2010; Sydney Local Health District, 2012; NSW Ministry of Health, 2012a; NSW Ministry of Health, 2012b). Recommendations This analysis shows that the SSWAHS strategy document can benefit from the drafters looking at the state planning documents and other similar plans from other organizations in Australia and elsewhere, as well as from the scholarly literature. This is by way of culling best practices with regard to drafting such strategy documents, and to be able to improve the rigor of the presentation and the planning itself. Financials need to be substantiated, as well as metrics for performance evaluation, among others (SSWAHS, 2007; Bryson, 1988; Spiegel and Alving, 2005; Gibson and Farah, 2012; Vancouver Island Health Authority, 2009; Sambo, Bakeera, Kirigia, & Diarra-Nama, 2009; (NSW Department of Health, 2010; Sydney Local Health District, 2012; NSW Ministry of Health, 2012a; NSW Ministry of Health, 2012b). References Bryson, J. (1988). A Strategic Planning Process for Public and Non-Profit Organizations. Long Range Planning 21 (1). Retrieved from http://docushare.usc.edu/docushare/dsweb/Get/Document-8775/bryson%2B-%2Bstrategic%2Bplanning%2Bfor%2Bnon-profits.pdf Gibson, J. & Farah, Z. (2012). Environmental Risks to Public Health in the United Arab Emirates: A Quantitative Assessment and Strategic Plan. Environmental Health Perspectives 120(5). Retrieved from http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.1104064 Iowa Department of Public Health. (2012). 2012 Strategic Plan: Health & Long-Term Care Access. Division of Health Promotion & Chronic Disease Prevention. Retrieved from http://www.idph.state.ia.us/adper/common/pdf/legis/2011_hlt_access.pdf National Parks Service. (2011). Strategic Action Plan. US Department of the Interior. Retrieved from http://www.nps.gov/public_health/hp/hphp/press/1012-955-WASO.pdf National Prevention Council. (2011). National Prevention Strategy. Office of the Surgeon General. Retrieved from http://www.healthcare.gov/prevention/nphpphc/strategy/report.pdf NEHTA. (2011). NEHTA Strategic Plan Refresh 2011/2012. National E-Health Transition Authority. Retrieved from http://www.nehta.gov.au/component/docman/doc_download/1338-nehta-strategic-plan-20112012 New Mexico Department of Health. (2008). State of New Mexico 2008 Comprehensive Strategic Health Plan. Retrieved from http://www.health.state.nm.us/pdf/2008%20Comprehensive%20Strategic%20Health%20Plan.pdf North Coast Area Health Service. (2007). A New Direction for North Coast: Health Service Strategic Plan. North Coast Area Health Service, NSW Health. Retrieved from http://www.ncahs.nsw.gov.au/070723_North_Coast_AHS_strategic_plan.pdf NSW Department of Health. (2007). NSW Immunization Strategy 2008-2011. NSW Health. Retrieved from http://www.health.nsw.gov.au/pubs/2008/pdf/immun_strategy2008.pdf NSW Ministry of Health. (2012a). Towards an Aboriginal Health Plan for NSW. Aboriginal Health & Medical Research Council of New South Wales. Retrieved from http://www.health.nsw.gov.au/pubs/2012/pdf/aboriginal_hlth_pln_discu.pdf NSW Ministry of Health. (2012b). NSW Health and Medical Research Strategic Review. Population Health Division, NSW Ministry of Health. Retrieved from http://www.health.nsw.gov.au/pubs/2012/pdf/medical_strategic_review_.pdf Sambo, S., Bakeera, S., Kirigia, J. & Diarra-Nama, A. (2009). Status of Health Sector Strategic Plans in Five Countries of the WHO African Region. East African Medical Journal 86 (Supplement). Retrieved from http://www.ajol.info/index.php/eamj/article/viewFile/54464/42980 Spiegel, A. & Alving, B. (2005). Executive Summary of the Strategic Plan for National Institutes of Health Obesity Research. The American Journal of Clinical Nutrition 82 (1). Retrieved from http://ajcn.nutrition.org/content/82/1/211S.full Sydney Local Health District. (2012). Strategic Plan 2012-2017. NSW Government. Retrieved from http://www.slhd.nsw.gov.au/pdfs/SP12-17.pdf Sydney South West Area Health Service [SSWAHS]. (2007). Community Health Strategic Plan 2007-2012 Summary Document. Division of Health Service Planning, Sydney South West Area Health Service, NSW Health. Retrieved from http://www.sswahs.nsw.gov.au/Publications/CommunityHealthSummary.pdfhttp://www.sswahs.nsw.gov.au/Publications/CommunityHealthSummary.pdf US Department of Health & Human Services. (2010). Strategic Plan Fiscal Years 2010-2015. Retrieved from National Parks Service (2011). Strategic Action Plan. US Department of the Interior. Retrieved from http://www.nps.gov/public_health/hp/hphp/press/1012-955-WASO.pdf Vancouver Island Health Authority. (2009). VIHA Five-Year Strategic Plan 2008-2013. Retrieved from http://www.viha.ca/NR/rdonlyres/0496C63E-96FE-4A36-852F-20E408AA02AB/0/VIHAFiveYearStrategicPlan.pdf Read More