Health Planning in the Shu Region - Case Study Example

Bringing it all together Student’s Name Subject Professor University/Institution Location Date Who are the key stakeholders in the region and what stakes do they hold? The Shu region which is under Hong Kong Special Administrative Region (HKSAR) has a population of about eighty thousand people according to the statistics of the case study carried in 2003. Health planning, programs and services is an important consideration and an analysis of the case study from Harris & Associates (2006) is an array revealing the infrastructural, services and future plans that are to be implemented to achieve a relevant, integrative and comprehensive health coverage for its people. Information in the case study is an important tool to recap the current constraints in the health services and help in management of health funds in equitable development based strategies. To manage health system wholly different aspects of the sector has to be considered. The four branches are an integrative system headed by the Director General –Shu Region who reports to the secretary for Health. The extent of each branch is analyzed whereby the support services branch enhances development of training and manpower, personnel, financial information ,registration and licensing; medical care service branch attends to inpatient, outpatient, pharmacy, pathology and imaging; health care service resolves to family health, health education, disease prevention, environmental sanitation, food quality control and dental; planning and capital works branch deals with policy, capital works, service planning and equipment (Cotlear, 1998). The four stakeholders however vary in their share depending on multiple factors like population density, infrastructure design, leadership and health services personnel. The established four hospital facilities are dispersed in the four regions Ottassol, Oldorando, Osoilima, and Matrassyl and as mentioned earlier, vary in the services and number of patients they attend to according to the data. Oldorando as the main referral hospital attends to more than 50% of the patients in Shu region. Ottasol contribute to 25% of the region’s health services, Matrassyl about 15 % and lest percentage falls to Osoilima. A critical analysis of hospital activities in terms of support services, medical care, health care and planning and capital works for each facility provides the Director General of Shu region with a report that can be acted upon to implement changes and development of the health system to the Secretary for Health. It is therefore important to carry an analysis of each and the extent of range of services that they offer. Oldorando area hospital is the referral hospital located in the far north with the largest population as it is the main business centre. It has a capacity of 169 beds with a range of medical or surgical services and a sophisticated diagnostic service. Most of its services personnel and specialists are from the area and lives around and that gives it an added advantage of continuous service provision when attendants are settled nearby. It offers all types of services outlined from the highest in number of patients beds; long-term care beds (63),medical and general(58), surgical(50), nursing home(50) , rehabilitation(18), pediatric(15), obstetrics(11) , psychiatric(10), clinical care(7) . Amongst the four hospitals in the region it is the sole facility that offers beds for critical care, adult and neonatal, psychiatric, and rehabilitation services. Population projections 2006-2011 estimates an increase from 51,708 to 72, 549. Currently the degree of service complexity is very high at 5 for obstetrics, 4 for surgical, critical care, rehabilitation, medical and general, and 3 for pediatric. Ottassol is the second facility and shares the largest bed services in long-term care beds (75), nursing home (53), and hostel for aged (22). Its obstetrics degree of service complexity is at 4, followed by surgical, medical and general at 3. It provides sophisticated services in the south. Matrassyl to the south of Oldorando has the heritage feel and older population. The hospital is small with 28 beds and the scope of its services is limited. Its beds covers are; surgical (8), medical and general (15), obstetrics (2), pediatric (3). The degree of service complexity is at 3 for all services. Osoilima is a 20 bed hospital and has a highly growing population. The bed for services are as follows; surgical (6), medical and general (10), obstetrics (4), and hostel for aged (10). The degree of its services complexity is at 2 for both surgical, medical and general and 3 for obstetrics. Describe the essential views and the planning/ management style of Ahn Esom Ahn is taking a systematic approach to bring about changes in the health system in the region. People are core consultants and agent for change and therefore he is doing this through a change agent; the people; general managers, district representatives. To progress toward the predetermined goals people must be put first since they are the catalyst for change. As other participate and are shown concerns they will be responsible to take effects, members and groups identifies with the system they will support the structure, policies and practices bringing change. Highest commitment in the organization will result from leadership articulation of the vision, provision of intellectual inspiration, and promotion of the group goals. In his presentation he exposes the negative attributes of the current system of services, shows the ways to tackle the organizational problem and demands a collaborative effort to bring the change in the subsystems. This aims at making the health system an n effective organic system, having an enhanced capacity to solve its problems and to cope with changes in the external environment. Collection and analysis of data is important to guide the decision making. The use of action research model and methods of evaluation of the levels of services aims at diagnosing problems, gathering, analyzing and exploring data for problem discussion, planning and act on implementation of changes. Data is relevant if a meaningful, continuous and programmed management and change is to become possible. Ahn gains authority from this knowledge and skill and this allows him to set challenging but realistic goals. Information will also produce a viable system that they can organize in a number of ways depending on the tasks that are to be performed. Long-term, continuous planning and management process is manifested. Ahn has set an ongoing change and this will help to plan a change reflecting the demands of the health system. It will also make it efficient to lay down a strategy for resource distribution and prioritizing the most pressing and needs. Responsive health services can only be put into effect on a long term basis, considering the current financial constraints to support the four facilities in the region. Problem solving procedures based on Ahn’s plan that prioritizes on important factors including facility capability and pressure, population growth as well as location. This guides in response to funding and supply of the immediate needs. The lack of optimum care has failed Ahn’s purpose as a General Manager. The requirements to respond to matters of political and socioeconomic pressures have escalated. In the region there are no effective responses to these matters in a more pronounced conventional manner. Thus Ahn has lacked a focused and effective process of policymaking to cope with socioeconomic concerns. Ahn need to develop and extend a broad socioeconomic effort consistent with regional health care and services activities (Nigam, 2011). However the timely task by the department is important for him to address how the health structure will reflect the health needs amid care reform and economic uncertainty. Critical problems that need to be addressed in the region The Shu region and its community are at a stage of increasing response to health challenges and crises. The major focus in the region is on how to increase access of essential services and mobilize financial resources. A combination of health education, economic development, access to sanitation facilities like safe drinking water, and better basic programs of health are constrained. Thus the status of health of the population has not improved. There are challenges that are demanded to modernize the health sector financing, improve service provision, and develop appropriate regulatory framework and policy for social security. In the evaluation of the current state of affairs for the Shu region many considerations such as facility management, area development, politics, and significance of each facility’s services affect the distribution and allocation of funds and resources. Population growth patterns, long-term planning and continuous quality improvements are other major issues resting on the decision making and planning process outcomes. The management of health systems is in the midst of emergent response to health crises in the region. The main focus is mobilization of financial resources and to increasing access of the population to essential medicines. One major shortcoming is the management lacking a strategy to tackle one of the most essential part of health-care systems—the personnel to make the system work. Human resources in the region’s sector for health as the personnel in the delivery of clinical, public-health, and environmental services are overburdened .The disorder has a complex reasons for instance building facilities efforts are given preeminence in the budgetary allocation. A problem of human resource occur as their demand , supply and mobility in regional becomes central and therefore, without considerable improvements in regional workforces, there will be a failure in delivery of commodities and mobilized funds as it is expected (Cooper, 2004). One important thing for the management is to have strategies to increase the profile of human resource issue ; extend the theoretical base and statistical data presented to decision makers; share experiences through collection, sharing, and learning from other regions and country; and initiate formulation and enactment of policies at the regional level that influence all the aspects of health problem. All the four hospital are in dire need of medical care services for the outpatient and inpatient while the planning and capital works program requires equipment, service planning, and policy. In general status of health is low, a high diarrhea disease among children and traditional modes of birth attendant services. All the hospitals are in poor physical conditions which can receive much of the health funds. To address these major problems health care services need to carry out family and health education, environmental sanitation, food quality control and disease prevention which can solve the traditional attendance and reduce diarrhea cases (Rovinskiĭ, 2009). Since the worker force delivers all the health interventions in the region from clinical services to public-health and both the primary and tertiary care, there is a need for training the health professionals and to enhance reliable information system and dissemination to the public. Health care program critically faces population control, birthing service improvements, immunization and access to necessary drugs and vaccines problems. Disease prevention as a priority has a lot to be done. The three issues demands personnel and financing to achieve long term management and outcomes. Health education is an important tool in this case to promote public participation in decision making and choice of the best implementation strategy (Costenaro, Lacerda & Fereira, 2008). This target may include the different levels of health workers, from professionals to indigenous healers who se contribution to the protection and promotion of health has significance. Without competent, motivated, and sound funded personnel, a danger arises in such a way that the funding and drugs addressing the health problems in the region will be wasted, misused or both. There are some forces within and external to the region’s health-care system which weaken the management potential contribution. Political pressures influences and act as a threat to professional decision making. Taking an account of Matrassyl hospital Jahn the representative and the community would fight to retain the facility as 15 years ago they failed to downgrade it and redistribute the acute services. Infrastructural improvements along Osoilima have made it of significant and its importance cannot be sidelined. The size, location, other hospital significance, and changing nature of health delivery make it a significant consideration (Nigam, 2011). Ottassol Hospital with a reputation of medical excellence and good management needed upgrading of its ageing facilities. Forces of personal characteristics, networks in the political arenas and distribution of funds have a significant interplay in regions planning. Overall there is a problem facing planning and organizing the hospitals into district network. A new approach to the delivery of services is lacking and therefore a shortfall in service capability, and lack of funds for hospital capital and acute services results. The level of care in the region is not satisfactory and this is manifested through the complaints of the representatives. Ethnic and area disparities exist and care quality and health outcomes imbalance are manifest due to unequal growth and development. The system of care and health plan is experiencing a major challenge due to lack of data and department effort to eliminate them (Cooper, 2004). Therefore disparities would be eliminated through data collection, putting standards, use, and protecting privacy. The outcome is uninformed population and patients lack of access to relevant information through support and training. What difficulties do you suspect Ahn will have in proceeding as he plans? The health system planning in Shu, require planning committee since consultation and communication is needed. Failure can result if Ahn will not focus on the process of involving health managers and service providers in decision making and planning. In an objective to create a productive and manageable regional health plan, Ahn requires to understand the strategic planning process. He must therefore show the importance of choice of change strategies that is appropriate for the anticipated change, address what these change mean to all involved, and confront the contextual and related factors that may undermine this change (Nigam, 2011). The requirements by the Department of Health will demand Ahn and his team to carry out an objective research. This will mean that they have to assess health legislation and how they impact on Shu region and other Hong Kong hospitals to identify various provisions which would apply to the new planning and management. The role includes assessing the health standards in order to develop management model in Shu region, and assess the current health practices to identify common planning and service deficiencies (Light, 2002). Finally the issue demands them to develop an efficient process to enhance the gradual application of a new system and management in the district and referral hospital in Hong Kong. There are exigency forces in the region that must be accounted in the planning and management of health services. Changes in the economic base, development of residential condominium in the region, the age dynamics as the retirees come to settle in the region and shift of young people in areas like Oldorando are some of the factors to be considered (Nigam, 2011). As Ahn is less concerned of Matrassyl and his plan to impugn it, such factors might pose a challenge to change. Osoilima has opened opportunities as the highway made it of significance. The two facilities with less services demands a share in financial distribution and therefore the facilitators and stakeholders in the region will not welcome Ahn’s less concerns. Ahn is faced with political forces that might criticize, oppose or fail to support his vision. Jahn, the GM of Matrassyl considers himself ‘a man of action no event would he allows erode the importance of the facility and respect the people in the region have on him’. There are others who see him as an activist who would convince the DOH through his powerful influences in the local community. The board members are concerned about the ethnic groups in the eastern area, the core of farming ad fishing activities in the north of the region, land for residential and commercial growth, and agricultural significance in the region. Other GMs also have significance from their past networks, status and input in the region’s health system. These are extraneous factors that determines Ahn’s planning and management. Another major difficult is the poor management in human resource as the four facilities increase their services and demands. Demographic factors set an interface of new challenges such as ongoing population growth, and rapid spontaneous residential developments and emergency of new health cases. This will challenge the human resource in the health sector of the region (Light, 2002). The workforce gaps will compound in relation to the number of nurses and other health workers. This will also bring in geographical misdistribution, skill imbalances and morale problems among the workforce who are already complaining about the current constraints. The support services branch will encounter difficult in training and manpower development. In a bid to improve health services, data and information, the learning methods and curricula have to include community orientation, problem-based culture, field orientation, and specialties, like clinical epidemiology. This will be a new challenge requiring programmed and long –term considerations (Cooper, 2004). The DG feel of a need for a new approach to service delivery other than through the hospital, and the mandate to organize the hospitals into a district network gives Ahn a challenging encounter. The main problem is on how to ‘resolve the large shortfall of service capability, requirement to find a large amount of funds to inject into hospital capital plant and the acute services’. Since the regional plan and practical application will be the referent point for the Department of Health Ahn and his team must be objective to convince the implementation plans support from the legislature (Smith, 2001). What advice would you give Ahn as to how he might proceed in rder to achieve a successful planning process? Implementation of a working health system is an important demand for health care providers and individuals as a way of enhancing health process administration outcomes. As a result of the study interpretation and results there are recommendations that can be applied to improve health system in Shu region. To be accountable for better outcomes, Ahn must come up with goals and objectives for the continuity of the current system operation. Through resource and funding, he should further, region’s expectations and control, through communications and considerations of alternatives methods of performance and specification. This will facilitate quality process and accessibility of management. A long term knowledge and documentation process for management of information including technology, facility, organizational, temporal and permanent changes are also needed (Forrest, et al, 2006). Expansions of facilities and acquisition of new ones with considerations of procedures to follow in expansion, acquisition, requesting, purpose assessment, shortages, location and project management To enhance more attention of region’s health by the government he should make use of a research system to study and analyse health standards as a detailed way of understanding and improving Hong Kong health services. They should study and analyse demands of health to get and put standards. The comparative study can look at the experiences of the developed countries to sit new plan and management while learning from the past failure of the system to help in the implementation. The model they should develop should explain management of health issues in both small, medium and referral hospitals taking into consideration the services level pressure and lack of facilities and resources (Cotlear, 1998). Health system in the Shu region must have services professional’s members with experience and training in critical care and technological material response. To enhance manage production deficiencies of quality and numbers in the workforce, frequent inspection procedures in the hospitals and appropriate health standards and issues must be covered. The system should be capacitated to motivate, retain, compensate and support employees to generate health outputs. Training and performance programs for new and technical employees and contractors should be planned. The procedures should be updated by a high qualified team with a background about health care system (Costenaro, Lacerda, & Fereira, 2008.). This will entail cooperation between government ministries and departments to develop health laws and legislation that link to the health sector. Ahn and his team should develop an efficient process toward gradual application of health standards in the region’s hospitals. This should look at management leadership; their commitment, performance, information sharing and accountability, technology including the design, information, change management and process demands analysis, facilities; site, standards and maintenance, and personnel proficiency, training and skills. This will improve workforce participation, process information, problem analysis, training and emergency planning responses. Rovinskiĭ, (2009) argues that there should be advice to the policy makers and implementers that the government should no longer act alone. Ahn can convince the policy makers in the department to engage pluralistic employing structures. The providers in the public, non-government and commercial systems can operate in parallel. According to Smith, (2001) most workers are demoralized since public sector is more rigid in personnel-management and practices, together with low compensation, and its lack of support in the work environment. Policies that facilitate private practice would increase the role of others whether full or part-time and therefore resolve the current shortages. There should be an increase in appreciation of the significance of primary care, leading to decentralization and downsizing the public sector. Development of service in health-sector and reforms should seek help from multilateral agencies to alter the operational environment through extension of the private service sector (Analysis & Grade, 2006.). Therefore, instead of a having only public service in the area, other health workers should be allowed to offer services in a demanding pluralistic market. This comprises of governmental, non-profit and commercial institutions, with staff from a more progressive and diverse range of workers— trained, accredited, formal and informal, modern and traditional. References Análisis, G.D. & Grade, D., 2006. 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Institutional change and healthcare organizations: from professional dominance to managed care. International journal of integrated care, 2(1), p.427.  Nigam, A., 2011. The effects of institutional change on geographic variation and health services use in the USA. Social Science & Medicine (1982), 74(3), p.323-331. Rovinskiĭ, V.I., 2009. Physician in the primary health care system.Klinicheskaia meditsina, 87(1), p.68-69. Smith, M.A. et al., 2001. Measuring the physician perspective on quality of care in health plans. Evaluation the health professions, 24(1), p.18-35. Read More