The Affect of Quality Management on the Hospital Setting and How It Affects Hospital Management - Research Paper Example

Management in HealthCare

In a modern society, a successful development of any sphere of human activity is unthinkable without effective management. Healthcare services management is an activity aimed at improving the efficiency using a set of principles, methods, and means of activating the labor force, intelligence and motives, both individual health care workers and the whole team. Healthcare in the system of socio-economic relations takes on a special importance and complexity of the situation, which is due to objectively existing features of the main subject of medical practice – human being. Among these features are highlighted as the main uncertainty that permeated the entire medical activity: the uncertainty of the dynamics of human health, the uncertainty of the result of medical intervention.

Paramount importance in healthcare has the problem of the quality of care, which cannot be overestimated, as it relates to health, and sometimes even to human life. A solution for the problem of quality is possible only if the optimization of the management of healthcare system at all levels. In addressing these issues, the priority is given to managerial staff of health care institutions. Development and improvement of management and adaptation to a particular situation is one of the main levers for improving the performance of health facilities. Risk management is a natural inner state. The problem is in their studying with the aim to develop methods for overcoming and adapting to the region where the working manager.

Any social system in its patterns of development at a certain time achieves the highest level at which the existing forms and methods of management of such exhaust system with adequate resources and personnel intellectual potentials. There is a moment that requires the search for new forms and methods of management not in the framework of the quantitative changes in these forms and methods of management - their intensive development, but in the form of a qualitative transformation of the intellectual component of the decision-making function as most forms, methods, and management techniques.

In the last decade, throughout the world significantly increased the interest in the problems of organization and management in health care. One reason for such attention of researchers and practitioners in the field of public health is a legitimate integration processes taking place in the health system, a certain consolidation of the structures, in one way or to some degree to ensure the preservation and improvement of public health: hospitals, clinics, insurance and pharmaceutical companies, governments, social protection institutions, etc. Observed processes are characterized both at the level of national health systems, as well as in the international sphere.

In terms of priority economic components of development of states, the unique nature of health as part of the social structure of society, manifested in the fact that institutions and health subjects, as the largest employers, providing economic stability of the population, and how health structures are not important enough responsibility for productivity, health of the nation, national defense.

Modern health systems, functioning and developing in terms of the liberal organization of society, in terms of the existence of civilized market relations and specific marketing, will inevitably feel the impact of the processes that characterize this relationship. However, this process of mutual influence, of course, two-way: health systems around the world are increasingly exposed to the impact of market fluctuations and the integration of marketing and political structures.

Today, any country in the world can not manage the health care system without taking into account the impact that could have the organization and operation of the system of government, both on the domestic and world markets, both domestic as well as on global health status of the population.

It is worth to mention that in hospitals there is a special system of board managers. Distinction between senior, middle and frontline management was as follows: senior management holds trust-wide responsibilities (Merali, 2005); middle managers are in the middle of the organisational hierarchy chart and have one or more managers reporting to them (Mintzberg, 1973); frontline managers are defined as managers at the first level of the organisational hierarchy chart who have frontline employees reporting to them.

The road to increased efficiency of health care as a system passes first of all through the improvement of the quality management. Of course, reform of any country depends on the history of this country, from the economic and social infrastructure, but even initial consideration of reforms, not to mention the establishment of and implementation of, should begin with a reconsideration of the role and functions of management. Constructive management, backed by the knowledge economy is the center of any health care reform, which includes everything person needs to improve the health of the population without increasing the cost of services

Despite the general understanding and acceptance of the fact that effective management is the cornerstone of both the industrial and social prosperity of society, unfortunately, still remains an extremely topical issue of building an effective system of education and quality production in the field of health care managers. Recently, the problem of training of health managers betrayed attention on the pages of scientific journals.

For the purpose of evolutionary transformation of the health system and management of the industry in the new conditions, along with other methods and forms of management decisions and implementation of complex tasks on two interrelated strategic directions.

Direction One: qualitative improvement of the intellectual component of management in health care - a gradual transition from intuitive, experimental and pragmatic management industry as a whole and its constituent bodies to do evidence-based methods and forms of classical management. The second direction: the formation and use in the management of industry, in modern conditions the priority of economic relations in medicine, a brand new health personnel resource managers.

Practical implementation of the first line of thought under the provisional name “sectoral strategic situation-simulation of the health system center.” The purpose of creating such a ministry of health departments and social policy could be formulation and solution of industry management tasks using modern and advanced methods of situational modeling based on computer technology and artificial intelligence systems.

On the basis of statistical information and analysis, modern means of artificial intelligence today allow for situational modeling of economic efficiency of the whole health system, the health care facilities in a particular area. An expected result of the functioning of such a center is that situational modeling programs allow to dynamically and efficiently simulate various scenarios, search optimization states with a high proportion of the control system and predict the likely outcome of those or other administrative actions.

The second task is presented in the framework of the formation of the industry multilevel medical and social management structure. (Laffel G, and. Blumenthal, 1989) The purpose of the proposed system in the health sector may be the formation, training and retraining of personnel potential for the solution of management problems in the production and consumption of health care services through the establishment and operation at all levels of the health system of the Institute of Managers.The result of the operation of such a permanent system for training managers and subsequently the use of this personnel in medical practice will allow for the evolution of the health care industry translation service and fiscal structure of the state in the modern sector, adequately built into the internal and global health markets.

Figuratively speaking, under the decision of the designated task implied a kind of “transplanting” managers in the health care system. The case is about managers, who got the latest knowledge on how the classical management theory and management, marketing, economics, law, information technology; managers - armed with modern tools of artificial intelligence based on advanced information technologies, management - based on evidence-based management methods, not only on intuition and experience. Without a qualitative change in the form, method and content of the sector of public health administration, it will be extremely difficult to modify existing, in some way, became a conservative model of governance, both at the level of a particular medical facility and the health care system as a whole.

Over the past five years, against the backdrop of the myth about free medical clinics and poverty began to come to understand that the medical business (even paid services in a public hospital) profitable business and the profitability was higher than in the neighboring supermarket. And for many entrepreneurs is the moment when medical clinics have become the object of investment analysis, the study of all the features of this business in the first place professional management. And then the views of investors, managers, and experts appeared to be divided. Some of them said that the control laws are the same for companies in any industry and of any principal features in the management of medical organizations say makes no sense. Others believe, on the contrary, that health care - such specific services, that along with the traditional management need to know as well self-healing and health care system. No other type of business so deeply intertwines into one inseparable tangle of professional (ie, medical), psychological, ethical principles and principles of management, creating a new specific type of control that "baptized" as "medical management".

So, what is that special about the management of the medical establishment? The doctor, as the main employee of the company. The task of management to provide a joint and effective work of doctors. What could be simpler? Here and begin the test for the manager. Doctor, and I wrote about it, Michel Foucault in his work "The Birth of the Clinic," a representative of the free profession, which means that it is historically "worked" only for himself, helping the needy. Poor fit psychology and medical identity (and even modern), to the status of wage, forced laborers, working for the owner.

That is why today in the labor market, we see a shocking traditional managers physician behavior: permanent migration in search of the perfect clinic, fear of doctors academies and universities to move to a permanent job in a new, well-equipped private clinic, the desire of physicians to address issues of compensation for their advice for cabinet doors directly with the patient, bypassing the cash or free inspection of their relatives on expensive equipment, "star" disease, rejection of accepted and traditional forms of contract PR. In many hospitals, doctors talk openly about freeloaders - accounting, executive management, specialists of IT, - they really do not understand where they leave their earned money and why they are paid no more than 30% of the money received for consultation.

As considering these “innate characteristics” of the modern doctor, to build a profitable medical business? Leaders are the advocates of strict discipline, surveillance, and fiasco - doctors, receiving from them the knowledge base certificates and patients fled to another institution, their place in the coming 2-4 months other, etc. and so the circle. Others are desperate to fight, especially in dentistry, where the growing trend of renting premises clinic medical staff. And only rare leaders are trying to build a clinic really new formation, where the quality of the treatment with the best international standards. It is no secret that the majority of organizations dominated by the spirit of competition between the employees and the informal atmosphere encourages individualism.

This can move the development of the enterprise other spheres, but is detrimental to the health organization where the task manager to build a system of information exchange and cooperation. It is no accident in the medical traditions have such an institution as the consultation, involving discussion of a few doctors a difficult situation and find the optimal solutions. With all the negative features Dr. House - the eponymous hero of the American medical series, its indisputable advantage was that he was able to provide a joint and effective work of its doctor's diagnostic department, enabling them to realize their strengths and neutralize their weaknesses as much as possible. The result is one of the best in the US diagnostic departments.

What is the key to the commercial success of the medical enterprise? The response can be illustrated by an example from one clinic, where fighting for a trade secret created the situation in which the mystery is named everything from equipment to the price list. Unfortunately, there did not realize that the biggest mystery in health care lies in another plane, how the doctor is able to communicate with the patient and provide quality modern medical services. The key to the commercial success of the entire hospital is stored in a doctor's office, in the “sacrament” that occurs between doctor and patient, and it is worth all the medical business since the time of King Hammurabi.

The fundamental role of the clinic's mission in the medical business. The medical clinic acute and devilishly seductive face issues of financial gains and quality health care. Information asymmetry in which the patient resides at a reception at the doctor, making it easy prey for the doctors, not burdened by ethical and professional principles and willing to make. Who wants to be a victim of a medical emergency, which carries in the hospital, which he pays for each "brought" or get a prescription for absolutely not the right medicine, but a doctor's appointment pharmaceutical company sponsored? In the medical business, the company becomes a hostage to the doctor and sometimes a loss of confidence in the doctor appears to be a loss of confidence to all, to the whole clinic and its reputation.

A medical business is primarily a trust. Therefore, such an important part of management, which is responsible not only to shareholders, but also to their patients, and that is to create even at the design stage of a new medical business the main thing - the ideology of the clinic and to formulate a clear, understandable and succinct mission. To store or restaurant no mission bad, but the lack of a mission in the clinic - it is turning it into a bunch of part-time doctors who want to earn some money on paid patients. And it is dangerous to our health. Many patients, visiting well-equipped, renovated, clinics advertise verified that there is no respect for the rights of patients, there are no high-quality health care services, there is no certainty that you will appoint only needed you study, and the usual "scoop" is hidden behind the beautiful walls.

Specific requirements for the clinic manager. There are several established in our practice management models. In the first, all led by CEO, with no medical training, and his command is the chief physician in charge of all medicine. In my opinion, this is not the best situation, since the person responsible for all the company did not fully know all the specifics of the business, which is run, which increases the risk of making wrong decisions, getting under the influence and dependence of their health and environment chief physician, actually supervising principal activity and determines the range of services.

Examples of when someone clinic managers went to receive medical education, I do not know much, probably because they already have the feeling that they know everything. At the dawn of the emergence of private business, when doctors who know the basics of management was one, this option is the appointment head of manager - nonmedical education was the most common. But now the situation is changing. More and more doctors acquire additional professional education in the field of management, getting an MBA degree. The head, who has two degrees, a more systematic sees your company, and in the city, there are positive examples of how to obtain the chief physician knowledge management provides a qualitative change clinic. But objectively assessing the labor market, it is possible to say with regret that the managers who can successfully guide the clinic of the 21st century and understand the peculiarities of management in health care - unit.

At the head of the clinic, there is another difficult task - interaction with shareholders of investors who have invested money for profit, and sometimes they do not care how it turns out. And it is very easy to cross the line, when the purpose of profit maximization of the quality of medical services will be reduced, will not be updated and properly maintained equipment, will use a reusable instrument, break the technological cycles, simplify treatment regimens. In countries where there are transparency and strict control and on the part of the medical community united in the Association, is the behavior of the clinic quickly lead to its closure. And in developing countries should rely more heavily on integrity management clinics and the clinic's reputation than on regulatory authorities. Innovation management is the basis of clinical development. Management in the clinic should allow growth and development of both the company itself and its doctors and nurses. In medicine, where scientific and technological progress is implemented in practice faster than anywhere else and changes the diagnosis, treatment, rehabilitation, it is important to be aware of everything and will put into practice the most modern and perfect.

The efficiency of the clinic is difficult to measure. And especially the health enterprises is that they are extremely important to choose the right performance criteria and evaluation of the quality of medical care. Create a system of quality assurance and motivation of staff in the clinic is difficult not so much because of organizational issues, as because of the specific medical activity. The introduction of the world the principles of evidence-based medicine standards allows to evaluate the work of the doctors in the provision of health services more objectively and transparently. (Guidotti, 2010).

Existing diagnostic and treatment standards allow you to choose the best in terms of results and cost method. In addition, the quality of medical services is closely related to quality management. Concluding an overview of the features of management in health clinics would like to emphasize once again that many investors are beginning to realize that to build and equip the clinic - it is very simple, but to make sure that the clinic has provided medical services to the highest standards, it has successfully used the most advanced diagnostic technology treatment, rehabilitation, and it works as a doctor, as a team - a daunting task. Management is one of the oldest arts, and it permeates all spheres of human activity, is present in all systems of society. Moreover, management can be seen as a science: it has its own methods, principles, and concepts. But management, as art cannot only be based on experimental research methods. It has at its disposal another amazing tool - intuition.

Under the complex, ever-changing conditions (internal factors in the organization and the external environment), the manager must take the only right decision, you want to at the moment. Only with the help of intuition, creative approach to management can successfully carry out management activities. The economic stability of the organization, its survival, and performance in a market economy is inextricably linked to its continuous improvement and development. At the same time improving the organization should be carried out on the basis of adaptation to the external environment. We should not forget that high-quality management in the hospital setting has a great effect on hospital management.