Profile of a Rural Community and its Health Service in Perth - Case Study Example

Running head: Hospital Management Name: Tutor: Date: Roles of the hospital: The described hospital is very important in providing specified acute emergency treatment a role which is especially important owing to the remoteness of the area and due to the cases of emergency that can not immediately be transferred to major towns. This means that cases that are manageable by the hospital are quickly attended to. The hospital also provides a quick response to complex cases that need urgent attention by flying the patients to public hospitals in the urban towns that have better facilities. The hospital also provides primary health care which deals with day to day cases of sickness e.g. injuries, accident victims, diabetes patients etc this in line with general role of a hospital in any particular setting. Provision of care is essential in the Perth area due to its rural setting. The region’s population is mostly comprised of the elderly who at times don’t need the cure but rather good care. This becomes an essential role of the hospital by virtue of its population composition. Another role played by the hospital is the provision of employment to the locals in the area. Although the larger professional work force is from outside, the subordinate staff that includes; cooks, cleaners among others get income from working in the hospital. The hospital also serves as an asset for the area due to the funding channeled towards the running of the hospital. The involvement of community members running the hospital offers a sense of partnership in the community especially among schools, business owners and elders in the area. Barriers to change in the role of the hospital: Over the years the hospital’s role has continued to deteriorate especially due an increased access to other health facilities in the city. The lack of progress in terms of facilities as well as services offered by the hospital can be attributed to various barriers. Cultural barrier is one such setback. This occurs mainly because the larger workforce remains non Aboriginal thus no great change can be achieved due to the lack of a sense of ownership by the local community. This is also evident in the fact that the practitioners opt to retire early. The hospital generally doesn’t meet the local people’s particular needs and therefore hinders adequate change in its role owing to the fact that the local people don’t feel that it is efficient enough to solve all their health problems. Lack of an educationally prepared population in the area that will adequately replace the foreign doctors as well as those who wish to retire early remains a major set back to the change in the hospitals service delivery to the people. Lack of increased innovativeness in health programs which would bring change in the effectiveness in service delivery also serves as another great challenge. The hospital for example lacks proper implementation of information technology that is an important step towards improving service delivery. The use of telemedicine is one major progress in the health sector that has been promoted by the adoption of information technology. Another major setback to change is inadequacy in manpower required to work in the hospital. This is due to lack of motivation as well as qualified locals who would be willing to bring about change in the hospital. Long term threats/challenges that might face the hospital: By assessing the current state of the hospital, a number of threats can be identified and expected in the future. These threats include: Lack of adequate funding towards the maintenance and progress of the hospital as well as the lack of proper management framework to ensure that the hospital is maintained in proper conditions is likely to result into the hospital’s downfall and closure. Lack of adequate manpower to work in the hospital due to inadequate number of students who are joining the medical field to enhance the local workforce in the hospital. This is due to the few placements of students in the rural area within these fields and in higher institutes of learning. Lack of manpower can also result from lack of community training in proper health practices. There is need therefore to put in place vocational educational training in schools in order to increase the number of students that are taken up in the field. Lack of community participation. This reduces the representation of the local people and thus reduces the level of responsibility and community ownership in the area which in turn affects service delivery in the hospital. This therefore calls for active involvement of all stakeholders as a way of enhancing self management that has a greater impact in service delivery. Lack of sustainability: This is mainly due to the management, funding, maintenance of workforce loopholes that exist in the hospital and which are all threats to the future of the hospital. The fact that many of the local doctors plan to retire or leave the community in the next 5 to 10 years puts the hospital’s future at risk in terms of having qualified medical personnel that have experience working with the people in the area. Inability to deal with emerging diseases: The hospital mainly deals with injuries, diabetes cases and seems to lack the capacity to deal with complex cases. Owing to the potential emergence of diseases, there could be a problem in managing these diseases especially due to lack of infrastructure as well as manpower to deal with such cases. The presence of government policies that are not directly favorable to the rural health centers. Bearing in mind that policy changes are technical and needs mass movement as well as mobilization of local resources, the policies put in place are not likely to meet the local people’s immediate health needs. His is mainly influenced by the high level of illiteracy level among the community members that makes it difficult for them to advocate for a lot of changes in areas like; funding, management among other things. Steps in enhancing the role of the hospital The establishment of Health Services which are controlled by the community promotes the responsibility and understanding that rural people need to be involved in health service delivery. This includes ensuring the active participation of the local residents by increasing the number of locals working in the hospital. Implementing health training programs would be one effective way of enhancing the community member’s participation and empowerment through the acquisition of skills (Singh, 2003). . Service planning can be increased through the inclusion of the local people in the health boards as a way of representing the local needs as well as active participation in the decision making process, this would also produce positive outcomes in the way local health services are delivered and received. The administration should also enhance monitoring and evaluation through collection of data among the locals so as to ensure proper planning for services offered in the hospital (Humphreys, et al, 2002).أ Research Local research should be carried out in order to enhance service delivery. Different bodies associated to the hospital should carry out regular research as well as produce articles, newsletters and journals for future referencing. The research should be carried out on sectors such as rural health, social practices and economic, environmental and political factors affecting health in the rural set up. This could also include other aspects such as those of workforce, rural funding, rural clinical services models and indigenous health service provision. Such a research would ensure ample collection of information on the status of local health which in turn gives way for further research and improvement of service provision. Local health profiles could also be formulated through research on common cases of diseases experienced in the area in order to enhance service delivery to the people of the area. Maintenance of a skilled and responsive work force Most of the workers in the area are oriented to their areas of profession thus there is a need therefore owing to the remote setting of the hospital for the provision of consistent support to the work force to allow them to upgrade their professional skills. Initiatives such as the commonwealth initiative that provides rural and remote area nursing scholarships in order to maintain a skilled and responsive workforce should be made sustainable to ensure a continued supply of skilled workers to the health centre. The National Rural Health Network (NRHN) in particular should be in the fore front in increasing the number of students from the local area choosing carriers in health sciences this could be done by offering of scholarships to provide motivation as well as local manpower. In corporation of a university department, rural health training comes in handy in offering services such as cultural awareness programs in local health, workshops, upgrading skills of health workers, mental health programs etc A multi disciplinary workforce should also be maintained in the rural and remote areas. This could be done by for example having pharmacists, social workers among other professionals posted in the area. The placement agencies involved in providing services to the rural people should therefore channel funds towards supporting rural medical practitioners. The professionals posted in the area could in turn work as mentors to the locals. To maintain a responsive and dedicated work force the hospital administration should increase the nursing workforce, the local workforce, health services especially mental health services, dental services, aged care etc. To deal with these problems in Aboriginal health, education and services, the Office of Aboriginal Health (OAH) should work and consult the Western Australian Department of Education and Training. There is need to expand and create new Vocational Education and Training in School programs. A working example is being applied by the West Australian Indigenous and Torres channel of Islander Employment. The framework utilizes existing training programs and support mechanisms to achieve Aboriginal employment. It aims at delivering diploma in Primary Health Care to the second year students and they intend to graduate students who have passed in Certificate III Primary Health Care (Mathers, 1999) The linkage and management of health services and other services It has come to approval that health care models are much deemed where they are successful when relevant stakeholders work in collaboration. Inter-sectoral linkage is important for the effective working of the hospital through the recognition of the interdependence that exists among different organizations to achieve a common end. To achieve this there should be: Joint projects with different sectors Collaboration on service planning and delivery The presence of these two aspects will ensure greater transparency in terms of funding allocation to the hospital; it will reduce duplication of services, help in addressing issues that are beyond the control of the health centre, and work together to find solutions to commonly agreed problems that are often complex in nature. Different associations in the area like for example the Rural Doctor’s Association members could also hold discussions with local authorities such as the chambers of commerce, the state government and indigenous bodies (women groups) to ensure provision of quality medical services and that their networking with other stakeholders is fully considered (Singh, 2003). Increase of emphasis on prevention and early intervention: Emphasis on early prevention and early intervention especially in the rural area could be achieved through building of local capacity. This reduces the burden associated with deaths caused by preventable and treatable diseases and for it to be achieved there is great need for collaboration among involved stakeholders. Intervention research could also be applied to come up with models of ensuring adoption of early prevention among locals in the rural area. A working example is with the encouragement of early prevention of mental problems in Australia based on the argument that the load related to mental health problems could not be reduced by treatment only but also through capacity building in the community that encourage community members to maintain a good mental state. This is achieved through initiatives and policies which provide an activity framework as well as by influencing resource allocation towards the same. Capacity building should also be done among the workforce in order for them to implement promotion of early prevention and early intervention. The workforce is inclusive of mental health workers, hospital services, and community health workers among others. Other sectors include the education sector, the state government, local organizations and social organizations. Capacity building could be achieved through activities such as seminars, educational forums all geared towards dissemination of information to the local residents Community capacity could also be built in order for them to maintain good health this can be achieved through promotion of networking between families as well as community groups to enhance treatment early enough(NSW Health Department, 1997). Addressing health needs of disadvantaged groups: Effective service provision among the disadvantaged rural folks have been faced by many barriers one of them being funding, service provision to the rural people among others proper planning as well as proper coordination of activities to meet the local need of the vulnerable groups can go a long way in enhancing better service provision to the disadvantaged people .this should include emphasis on provision in primary health care provision through increase of health centers in the rural areas. The local people could also be involved in identifying services they think best meet their needs this ensures relevance of the services delivered as well as its sustainability (Singh, 2003). Integration of services provided to the local people could also address the inequity faced in service provision among disadvantaged groups this is through putting in place frameworks which networking services across health ,community service, housing etc issues which are deemed to affect the health of disadvantaged people especially the rural areas. A working example is the Primary health care access program in the northern part of Australia the program sees to it that the Aboriginal people access services that tally with their specific health needs, funds have also been channeled towards establishment of a zonal community controlled health organization, community partnership, which is a move to ensure the community people own the project (NSW Health Department, 1997). Challenges I might face in assisting the local health manager: Language barrier is major setback I would face in effectively working in the area this is because the area is rural and the use of national working languages is minimal therefore it would require one to get acquainted with the local tribe in order to be in a better position to work. Lack of transport would be another setback in effectively attending to the remote areas due inaccessibility to most of the areas owing to the need for health services to be taken down to the local people this is due to the need for care provision other than cure among most of the rural folks this becomes difficult with lack of proper transport. Adaptation to the rural life could be a bit difficult due to the outright disparity in rural and urban life one needs time to adapt to rural lifestyle. Culture shock is also one of the challenges though one overcomes this with time, this is due to disparity in the cultural practices of the local people and that of the outsiders this hinders service delivery to a certain level. Poor availability of rural data is also a challenge one might face in assisting the local health service providers. In order for change to be achieved there’s s a need for collection of both qualitative and quantitative information so as to bridge the existing gap in rural health rural areas are characterized by scattered information which doesn’t give adequate material to push for change in the service provision this would greatly hinder achievement of long term local health plan that would be beneficial to the local people. Rural people also usually require help in their local environment they would rather be tended to at their local residents than visit the health centers this therefore requires special programs that are tailored to meet this specific needs though it’s implementation wouldn’t be very quick owing to the existing bureaucracy in the health system thus a set back in meeting the local needs Rewards I expect: Experience that will be gained in working with the rural people gives one an upper hand in the health field since it helps one deal with different health related cases that are only found in the rural areas. Cultural relativism is also important for one to be able to achieve good relations with different people, working with the rural people helps one to get to learn and appreciate their cultures and thus not look down upon other people or belittle their cultures. Assisting the local health services manager would call for new ideas to complement the existing ones therefore the new ideas that I will come with will help bring about positive change which in turn helps in achieving the long term goals of the health centre i.e. better service provision. A good example of these ideas is the emphasis on care provided in the local environment to ensure the specific needs of the local people are met. Working in the rural area will also motivate one to be in the fore front to push for policy changes that are favorable to the rural people this is because most policy makers do not have the rural people in mind when making policies therefore they are left out in decision making, working and staying with them gives one the mandate to lobby for better policies that will cater for their needs. Working in the rural set up will also assist one in researching on the health problems faced by the local people as well as coming up with possible solutions towards the same this would be otherwise impartial if one didn’t work directly with the local folks this therefore gives primary data to come up with a substantial research finding. Where to turn to for help and advice: Community groups around including the women groups, elders are the best sources of advice towards better change in service delivery to the local people this is because they know where the need is most felt thus they could help come up with recommendations on how to help them, this ensures participation of the local people and the sustainability of the health centre. Non governmental agencies in the area or those with rural interest may come in handy in information provision on how to improve on service delivery to the rural people this encourages stakeholders’ participation in making change in the rural area this is also because the health centre could not be holistic in catering for the locals need thus requiring assistance from the stakeholders Local health analysis papers are also a good source of information as one could make use of the recommendations provided therein in order to bring about positive change. Deprivation indices existing in the area could also be used to make changes that could be beneficial to the local people. Areas of most help to the community: Capacity building to the community members this is the area I feel is of great need and will help the local people in the area appreciate the need for early intervention and seeking of medical help in good time. this will also go hand in hand with the encouragement of healthy practices among them .Diabetes has also been shown to be one of the major problems in the area I would therefore research on how to manage it better and thus reduce the number of cases reported in the hospital. Injuries are also a common case in the hospital therefore I will take the initiative of teaching the local people simple first aid skills so as to help them manage the minor cases as well as prevent mortality rates due to major accidents at home. References Humphreys, et al. (2002) Whither rural health? Review of development and progress in rural health. Australian Journal of Rural Health, 10(1); 2-14 Mathers C, Vos T, Stevenson C. (1999) The burden of disease and injury in Australia Canberra: Australian Institute of health & welfare. NSW Health Promotion Strategies Unit.NSW Health Department, (1997) How to apply capacity building to health promotion action: A framework for the development of strategies Sydney: NSW Health Department. Singh S. (2003) Health of indigenous people local practices and practitioners can become part of comprehensive program. British journal , 327(421); 988-988 Read More