Health care Management - Essay Example

Introduction Workers in the healthcare industry are facing eternal challenges. Public expectations from them are continuously rising. On the other hand, as a result of various fiscal constraints created most commonly by the degrading economic conditions, these health care workers are asked to give more as well as higher quality health care services with much lesser resources. Apart from the above challenges, skill bases as well as knowledge required for effective performance in this field is continuously growing and changing (Greenhalgh, 2010). It can be noted that health care professionals will continue working in this industry for many years; however, the information gathered during their study period will become obsolete. The major challenge in this industry is to improve or maintain quality of the healthcare provided as well as introduce changes in various service or delivery mix in order to reduce unnecessary budgets and increase profits (McKee, Ferlie and Hyde, 2008). Also, governments at regional, local and national level are trying to get more value for money spent on health care. It is very important to evaluate whether the suggested strategies and action plans fall within the SMART category or not. It is one of the most common and efficient test for evaluating the feasibility and efficiency of any strategy or plan. In the current report, the strategies and outcomes are specific so that they pass every criteria of SMART test. The strategies identified after literature surveys are simple, easy to understand and very detailed, where a step by step approach is used for identification of the underlying issue to implementation of the appropriate solution. The current report examines various strategies that can be implemented in order to improve the overall quality of services offered by health care professionals. The report analyses various strategies and skills, required to bring effectiveness and improve the quality as well as examining their exact application. It also explains the responsibility of a hospital manager that how he/she makes an effort to reduce waiting time by 10% for the next 3 years. Health care There can be many definitions for healthcare. However, the characteristics differ with respect to its various stakeholders as well as its application in various perspectives. Health care can be described as the treatment, diagnosis as well as prevention of illness, disease, injury or other mental and physical impairments occurring in human beings. It is practiced and offered by professionals and practitioners in optometry, medicine, pharmacy, nursing, allied health as well as other health care services (Bacon, 2001). Other important attributes which can be associated with quality healthcare are ensuring support and safety in the environment, reducing morbidity and mortality and overall improvement in the value of life as well as functional health condition of patients (Senge and Kaeufer, 2001). Figure 1 Matrix for Healthcare (Source: Schofield, 2009). The above diagram very aptly represents healthcare management at its best. Few of the basic questions like, what and how, provide the health professionals with exact answers to their issues. In order to describe an appropriate and effective health care system, the entire process can be divided into three stages; structure, process and outcome. Structure involves features like, determining number and type of healthcare personnel, type and age of equipments as well as other facilities required for service delivery and organisational aspects such as, committee structures (Mullins, 2010). Characteristics like, safety and coverage, can also be related to structure. The next stage is process which includes activities involving receiving and providing care. It might include aspects of process indicators such as, continuity, timeliness as well as patient compliance. The third stage is outcome which includes the result of the structure and process. Outcome involves effect of the healthcare on the overall health status of patients. It can also include measuring the functional status, life quality and overall patient satisfaction. The delivery system and its various structures such as, health care workers, combinations and level of funding, availability of equipments as well as expertise of the management, play a vital role in the overall quality of healthcare offered. However, establishment of a good structure does not guarantee quality care. Structures are the easiest measurement for quality healthcare. However, the process of delivering service is crucial (Kotter, 1999). Quality healthcare can also be evaluated by the presence of three interrelated elements. First is technical care, involving use of technology and medical knowledge with the objective of maximising benefits of healthcare for patients and minimizing various risks involved. Second is interpersonal care, which involves giving attention to various psychological care aspects as well as provider-patient relationship. It encompasses the bigger social background, where healthcare is provided, along with social circumstances with which patients must cope. The third element is organisational care which includes factors such as, timeliness, accessibility, efficiency as well as the various amenities provided by the healthcare facility (Hanse, 2006). Thus, it can be noted that even though healthcare management has an ancient origin in the service industry, the offerings are continuously evolving as per arising needs (Gopalakrishnan and Damanpour, 1997). As a result, there is a need for contemporary, up-to-date as well as modern process for decision making and leadership in order to create a significant influence and practical contribution in increasing the effectiveness of the health care services (Adair, 1998). Quality Assurance: Quality assurance can be one of the influential and determining factors resulting in an enhanced and effective decision making process. Older approaches emphasize on meeting and exceeding the required minimum performance standards, generally set by individuals or group excluding those who need assessment (Osborne and Brown, 2005). Decision making can be enhanced by determining appropriate implementation of explicit or implicit criteria. Quality Improvement: Quality improvement can be described as the leadership process with less concern towards activities such as, inspection and detection of minimum standards and criteria and focussing on conditions and positive changes in the performance of the healthcare system. The process of quality improvement runs on the philosophy that there is always a scope of improvement, even in the best health care services provided by organisations. This decision making process assumes that service providers in the healthcare industry should be concerned about doing a good job as well as aiming for the highest quality work possible (Palfrey, Thomas and Phillips, 2004). Habits for Everyday Greatness and Effective Management Although effective decision making process is essential for improving the quality of healthcare, what it more important are the daily services provided by healthcare professionals. Decision making might be implemented by higher management and top executives, who have control over the healthcare organisation. However, breaking those decisions into actionable plans and providing right direction for personal working in the floor level, is an important as well as necessary strategy, in order to achieve high-end and successful results. In order to produce effective practices on a daily basis, focus should be on attitudes, skills, behaviour as well as knowledge of the healthcare service provides and various other factors which improve the overall leadership quality among these providers. Factors such as, availability of health care personal for various situational tasks, deployment and distribution of work, influence the quality of daily services. The speed at which various changes are taking place; availability of right equipments and technology, style as well as expertise of health care and availability and management of resources on a daily basis, are determining factors influencing the overall quality of healthcare (Martins and Terblanche, 2003). Leadership and change management Leadership plays an influential role in supporting change as well as employing innovation in the healthcare system. Healthcare industry is constantly facing challenges such as, providing better services with lesser resources, managing safety and quality issues, especially in case of over-extended workforce, seeking ways for improving efficiency and productivity with the objective of improving patient quality as well as appropriate and timely treatment (Ewens, 2002). Thus, leadership quality in health care system impacts both directly and indirectly and also, plays an influential role in the change management process. Reducing waiting time in hospital The healthcare industry has been facing huge challenges which can be identified as the issues regarding the safety and quality along with the type of services provided to the patients and their parties with the help of lesser resources. Often the great hurdle faced by the patient parties and the patient in the Out Patient Department (OPD) is the long queue which increases their waiting time and creates harassment for them as they remain unattended for a long time. The workforce in the hospital is often not responding to the issue which creates harassment for the patients. The managers of the hospital are responsible for the improvement of the quality of services that are provided to the patient and the patient’s parties. They are responsible for increasing the productivity of the workforce so that the patients are encountered with any types of issues. Waiting time has been the common issues in every hospitals and clinics. Thus it is very important to take strategic decisions by the managers in order to take care of reducing the waiting time in the near future by at least 10%. By applying the theories that are elaborated in the paper, a manager can make an effort of reducing waiting time by 10% in the next 3 years. The strategies are elaborated as below: 1) The managers should be trained in such a way that they can deal with any complaints that are arriving from the patient’s parties or the parties. The manager should possess such leadership qualities which will solve the problems arising and it will also give the patient parties and patient a positive feeling about the hospital. Positive changes are expected from the management for leading a peaceful day-to-day operation in the hospital. 2) Quality assurance is to be provided to every patients and patient parties so that they are not deprived from their rights. They are paying quite a lot of money for the services that they are expecting from the hospital. The managers should increase the number of trained and skilled personnel who will be attending the patients and the patient parties. They will be solely responsible for looking after the issues. The patients are to be attended carefully and they are to be explained the reasons for the delay. The schedule that are provided to the OPD patients are to be maintained and if there is any changes in time then they are to be informed from earlier so that they are not held waiting for hours. The managers should take the consent of the doctors and adjust the time of visit of the patients. 3) Quality of the services should be improved by responding to the immediate requirement of the patients who are getting admitted in the hospital. The accident or the emergency cases are to be handled with great care. The services like the oxygen cylinders, stretchers and immediate Intensive Care Unit (ICU) are to be arranged for the critical patients. They are not to be kept waiting. These can only be done by increasing the number of on duty personnel and the equipments. These changes are needed in the hospitals so as to continue peaceful operation in the hospital. Not only literature, but practical surveys have also reflected the criticality of leadership in various health care services. After studying more than 1200 hospitals around Europe and United States, it was found out that hospitals, which were well-managed and has clinically qualified with skilled leaders, generated a higher standard of healthcare for patients (Markle Foundation, 2011). Evidence came from healthcare survey conducted in United Kingdom, which clearly indicated that the rate of organisational performance was directly related to the leadership quality of managers and senior staffs. It also indicated that higher leadership among these service providers also resulted in less number of complaints from patients. Another study by Roebuck (2011) had revealed that leaders have the ability to transform disengaged staff into highly engaged service providers and possess capability of lifting individual performance up to 57 percent. Proper leadership can also enhance the alignment between corporate and individual objectives, thereby improving the performance up to 39 percent. Situational leadership Various new trends have emerged in the field of healthcare leadership. It can be noted that there is no particular leadership style which can be implemented in every healthcare facility. Leadership styles, successful in particular situations, may not be that effective in others. Thus, situational leadership is the demand of the hour in service industry (Hartley and Bennington, 2010). According to various researches in healthcare leadership, a new concept called behavioural flexibility has emerged (Zaccaro, et al., 1991). According to this concept, effective leaders are those who are competent and skilled across various behaviour repertoires; who are able to identify the leadership style most appropriate for specific situations as well as select various alternative styles, as and when situation changes. Considering the volatility and complexity of the healthcare industry, it can be easily said that flexibility in the behaviour of the leader is absolutely essential for an effective leadership (Silverthorne and Wang, 2001; Drath, 2001). Tools for improving quality of healthcare A wide range of strategic initiatives can be issued in order to quantify improvement or assurance. Few strategies target direct health care while few other strategies opt for an indirect approach to provide quality healthcare. These strategies may target the process or structure of various health educations or healthcare structure, either at regional/local level or national level and affect health care professionals directly as well as indirectly (Benson and Dundis, 2003). Tools as well as up-to-date knowledge and information provide a lot of benefits by screening the smaller and less detected area of improvement. These include unsolicited information mailings, usage of educational influence, development of various standards of guidelines, practice as well as care maps. It may also include academic and practical detailing of latest information, building of reminder system with the objective of practicing records, feedback as well as peer auditing based on strict guidance, technical and computer-based interventions and an overabundance of various informal and formal continuous education opportunities. Peer as well as self-assessment can also be an influential tool in determining the needs and opportunities in various situations (Currie, 1999). At the local level, various activities can be performed in order to enhance results in the overall healthcare system. These comprise adopting guidelines, standards and care-maps, giving credit to hard-working and professional employees and formation of various standing and auditing committees with the objective of constant monitoring of key activities and tasks in the healthcare facility. Initiatives for quality improvement may involve process or job re-engineering and cross-training of employees and workers. Clinical information as well as management system can be developed. Workers and employees should be given leave so that they can continue with higher education and gain new and specific skill set. Other strategies may include establishing criteria for job appointments or licence renewal, inducing caretakers to review their skills and knowledge and increase their level of motivation so that they do not miss any opportunity to learn. It can be seen that there is an urgent need for comprehensive strategies for development of quality healthcare in various local, regional and national level facilities and systems. However, development of structure or process cannot guarantee required or desired results. An important factor governing the process is the relational management in the healthcare system (Walshe and Smith, 2006). This relation runs along various departments and functions, including management, executives, floor staffs and workers, doctors and nurses and support staff as well as patients and their families. There is a dire need for proper communication among the staffs as well as higher management. For instance, various strategies such as, changes in structure and introducing new technologies and equipments, are being formulated by the higher management (Ham, 2003). However, due to lack of proper communication, these strategies take a long time to be implemented. Establishing relationship with the patients is also becoming an integral part of the healthcare management system, especially those organisations where quality improvement is the major objective. Behavioural changes for improving quality of healthcare practice An improved quality of healthcare is associated with performance of the healthcare professionals. Competence cannot be always measured by evaluating practice performance. In order to help the healthcare professionals in improving their practice quality, it is important to change their behaviour. A positive change in behaviour guarantees better service and improvement in overall performance (Gumusluoglu and Ilsev, 2009). In order to bring about positive behavioural change, leaders should involve the health care professionals in a five stage process (Paton and McCalman, 2008; Graen, 2006). The first stage is pre-contemplative stage, where the individual in unaware of any change needs; or the individual is aware, but is not mulling over change and displaying zero interest in learning the change process. Next is contemplative stage, where the individual considers a behaviour change and seeks information about various disadvantages and advantages of the change. In this stage, effective leaders can play an important role by providing a right direction, in terms of information and knowledge and how to reach the next level. The next stage is decision or preparation stage, where individuals actively modify their behaviour and the environment, with the objective of implementing the change (Austin, et al., 2003). Action phase involves active modification of the behaviour. Next is the maintenance stage, where the person reaches a comfort level and accepts the newly-made changes in behaviour (Locke, 2004). Conclusion The above study clears that, though there is a dire need for up-gradation and change in the current healthcare processes provided by various regional and local government as well as profit organisations, there remains a huge gap between the available resources and increasing demand among patients. However, the study also upholds the fact that with proper initiatives and strategic monitoring, it is possible to establish a successful implementation strategy. Therefore, it can be concluded that majority of the healthcare organisations have started to feel the immediate need to evolve and consequently, are implementing strategies and techniques for improving the overall performance of the healthcare system. Reference List Adair, J., 1998. Leadership Skills: Management Shapers. London: Chartered Institute of Personnel and Development. 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