MPH5304 Leading and Managing in Public Health and Health Care

1. Major Management Challenges

Health care is one of the largest service providing industry in the world. Our organization is always working towards providing the best health care services for which it needs continuous growth, development and advancements in order to improve the quality and safety by introducing clinical guidelines and pathways. Being one of the largest among the service providing industries, it regularly has to face some management challenges like delayed or incorrect treatment or failure of technical support, which should be resolved for the proper functioning of the organization .Thus, following are some of the major management challenges that need to be faced for introducing new clinical guidelines and pathways:

Challenges for the Organization and Management

For the effective working and proper functioning of the health care organization, it is of utmost importance to make sure that the facilities for health care are dependent upon the correct type of health care organization and management theory and also to ensure that all these theories are properly implemented. The organization faces many challenges, some of which might include delays in treatment, inefficient system, fatal medical mistakes, service failures, etc. There are other forms challenges as well, like insufficiency of staff, lack of funds, less exposure of the trends in the health sector, leader’s fail to understand the requirements etc. such challenges create a setback to the introduction of new guidelines and pathways.

The following challenges would be faced by the organization in the introduction of new clinical guidelines:

Performance: The health care centres have to maintain a performance chart that includes the performance level after each activity. It is important to maintain the average performance level that the organization provides before and after the amendments made to introduce the clinical guidelines.

Authenticity: An authorised team of specialists who will go through the new guidelines before implementing them. The implications and the after effects that will be realized by the organization are to be pre-determined. Any sort of inefficiency in this might lead to severe problems for the organization.

Cost-effectiveness: The new pathways that will be chosen must be formulated in the most cost effective way. There may be runtime problems like changes in any government policy or new laws could be undertaken, that are against the smooth functioning of the new guidelines.

Developing Technologies: The new guidelines and pathways to be followed must be in accordance with the trending advancements in the healthcare sector. The changes must be such that the organization is able to update the new technologies.

Quality: The quality given to the patients must not be compromised. Any new clinical guideline will be condemned if the patients are not satisfied like they used to be before implementing the new pathways.

Workforce Shortage: To implement a new pathway, more staff is required. There arises a sudden need to employ more people. Oversupply or undersupply of staff is another problem that arises while implementing new guidelines. (Wadsworth, 2010).

Designing Organizational Roles and Structures

The organizational roles and structures must be determined and applied in a very appropriate way to produce better outcomes in the field of health care. A large number of staff members, health care workers and professionals including the doctors, nurses, ward boys, etc. work in the organization. Hence, each one of them must be aware of their roles and responsibilities in order to provide an efficient working environment to patients in the health care centres.

In order to face the above mentioned challenges, it is important to design the roles and responsibilities of the staff under the most appropriate form of leadership. In addition, this fore alarms the leader about the required number of staff required in achieving the success of the new guidelines. The leader can now extend or compress the amount of labour to be put in the direction of the new pathway. (Lewis, 2009).

Applying Coordinating Mechanisms

For the better management of the organization, developing coordinating mechanisms can prove to be quite important and critical. When work is well coordinated, it is expected to produce superlative and more effective outcomes. Applying coordinating mechanisms might help in dealing with the challenges due to the introduction of the new clinical guidelines. While working in coordination, the work of the staff is reduced to half the effort and the problems are combated without any serious stress on the leader or staff members.

Coordination can be brought in the environment of public health organizations in multiple ways, some of which are described below:

Cross - functional communicators:These are also known as boundary spanners who are basically responsible for integrating and combining the work of people. For ex - primary nursing in which every patient is assigned to a nurse who has to coordinate his care throughout the day.

Routines:They involve coordination through specifying the tasks and order in which they need to be performed. They can be considered as protocols for the tasks that need to be completed and their sequence. A disadvantage lies with this coordination mechanism that it reduces interaction between participants, hence producing less effective outcomes.

Group meetings:This kind of coordination mechanism provides an opportunity to coordinate their tasks while working together in groups and teams directly with one another. These meetings involve discussion on the condition of a patient's case, taking regular rounds of patients, conducting research at the centre, etc.

2. Dealing with Challenges

These challenges need to be faced in an appropriate way for the proper management of our health care organization. To deal with the challenges mentioned above, the organization must follow a set of rules and strategies. The organization is able to cope with the challenges of introduction of new clinical guidelines and pathways by following a few simple strategies. These can be explained as follows:

2.1 Designing and Managing Staff Performance Systems

Before managing the staff performance system, its performance to attain best possible outcomes. Performance can be managed in the following ways:

Setting up performance standards:This is for establishing goals, guidelines, standards and targets associated with performance management of staff members, which makes the vision and mission of the organization clear and hence easy to assess their performance.

Performance measures:For assessment of the attainment of goals and target of performance standards, performance measures are efficiently applied. It evaluates the performance of the staff on the basis of their job descriptions, thus making the objectives of the job clear (HRSA, 2015).

Progress reporting:A system presenting regular reports of the performance of staff must be maintained so that they can improve their performance by receiving feedback.

Reviewing performance:Reviewing of performances of health care workers not only keeps the higher officials updated about the type of care being provided to the patients but helps them to improve their existing approach.

Improving performance:Supervisors must always be available for help and motivating the staff to perform better.

Rewarding:Offering opportunities for promotion, bonus and other fringe benefits, motivates the workers towards better performance.

Staff training:To carry out their roles and responsibilities in an efficient way, training of the staff needs to be provided for overall effective performance (Lutwama, et. al, 2013).

2.2 Applying Principles of Change Management

Principles of change management can be applied in the following ways:

Transparency:Keeping the workers and staff informative and all aware about their newly initiated changes and decisions for ex- regarding patient care and being open about the process can lead to an effective approach to change management.

Developing agency:Creating an environment that welcomes and appreciates new ideas and thoughts, admires sense of cooperation and coordination among the team members, making patients comfortable and satisfied with their work can help in developing agency for the upcoming changes in the health care organization.

Sharing of opinions:Creating an environment where people can easily share their opinions and ideas and can also be questioned for the same can also play an important role in applying changes.

Readiness:For better results in adaptation of change, the staff is required to be ready for any kind of action or reaction. They become open to learning and experimenting and thus provide cooperation in managing the change.

Adaptation:The workers and other staff members need to adapt themselves into the new surroundings for ex- when they are making changes in the routine of patient rounds, the nurses are expected to adjust and adapt themselves according to the time to avoid any kind of inefficiency.

Flexibility:Staff must be flexible about the changes getting adopted in the organization for ex- regarding the working hours in the organization for patient care or routine rounds.

Sustenance:In order to maintain superlative sustenance, motivation, encouragement and support must be provided so that the people feel safe in exploring and adapting to new changes (Kaminski, 2011).

2.3 Developing Strategic Plans

Developing strategic plans in order to maintain the efficiency of the health care system involves defining the vision, mission and values of the organization. Vision provides the future prospective of the organization, mission defines the main aim and objective of the organization and values present its set of rules, guidelines and principles governing its management process.

It consists of five stages:

Stage 1- Analysis of external environment:

This helps in focusing upon the clients, suppliers, providers, competitors, rivals and owners. In case of health care organizations, it focuses upon patients, medical aid providers, suppliers of medicines, etc. Identifying expectation of patients and their family members, providers being good source of resources, etc. can help in this respect (Perera et. al, 2012).

Stage 2- Analysis of internal environment:

This focuses on resources, training and research activities and other legal activities. It takes into consideration the financial budgets required for equipment and other facilities in health care, training and development of the staff members for the provision of effective health care, etc.

Stage 3- SWOT Analysis:

It focuses on the following four aspects: strengths, weaknesses, opportunities and threats. SWOT analysis of the organization must be performed in order to produce better outcomes.

Stage 4- Strategic Alternatives:

After developing and analysing the process, certain strategic plans and alternatives need to be developed for taking appropriate action regarding them.

Stage 5- Strategic areas and objectives:

Strategic areas must be identified and strategic objectives need to be assigned to them (Cacchetti, 2003).

2.4 Implementing Effective ProjectManagement

Health care organization can be improved much more in its performance by implementation of effective project management. This can help in improving the organization by introducing clinical guidelines and pathways in this respect. It can be implemented as follows:

1. Plan: Plan must include all the details about project and individual roles and responsibilities of every member of the organization.

2. Setting goals and objectives: Goals and objectives must be set and then later on discussed with the staff members. Feedback from the patients and their families can also prove to be valuable in such a case as they are the service users.

3. Adaptation:Principles of change management can be implemented effectively to make sure that staff is flexible about the change and will produce efficient results in the changed environment too. The goals and objectives need to be moulded according to new changes (Grol et. al, 2003).

4. Communication among the team members:The members of the team must communicate and share their ideas and opinions for bringing better opportunities for change in the environment. Coordination among them will eventually produce best possible outcomes.

5. Choice of staff:The team must be selected for the project based on the appropriate skills and talent required for its success.

6. Risk management: Taking such a big responsibility eventually involves a much greater risk of its success. So, all the possibilities and their consequent impacts must be well studied and proper strategies should be developed to manage them.

7. Evaluation:Tests must be performed on various aspects related to health care and then they must be evaluated to produce correct output (Kedziora, 2012).

References

1. Doucet, J. (2007). "Project management challenges and lessons" (online) available on http://www.beg.utexas.edu/energyecon/ua_2007/AB_Project_Mgt_challenges.pdf last accessed on 08/02/2017.

2. Lewis, J. (2009). "Types of health care management theories" (online) available on http://classroom.synonym.com/types-health-care-management-theories-2565.html last accessed on 08/02/2017.

3. Wadsworth, J. (2010). "The best organizational structure" (online) available on https://www.healthcatalyst.com/best-organizational-structure-healthcare-analytics last accessed on 08/02/2017.

4. Gittell, Hoffer, J. (2002). "Coordinating mechanisms in care provider groups" (online) available on https://business.highbeam.com/412156/article-1G1-95778459/coordinating-mechanisms-care-provider-groups-relational last accessed on 08/02/2017.

5. HRSA (2015). "Performance management and measurement" (online) available on https://www.hrsa.gov/quality/toolbox/methodology/performancemanagement/index.html last accessed on 08/02/2017.

6. Lutwama, G. W., Roos, J. H., & Dolamo, B. L. (2013). Assessing the implementation of performance management of health care workers in Uganda. BMC health services research, 13(1), 355.

7. Kaminski, J. (2011). "Key principles of change management" (online) available on http://www.himss.org/news/key-principles-21st-century-change-management last accessed on 09/02/2017.

8. Cicchetti, A. (2003). Strategic planning in healthcare organizations: the role of health technology assessment. Technology, healthcare, management in the hospital of the future, ed. E. Geisler, K. Krabbendam, and R. Schuring. Westport-London: Praeger.

9. Perera, F. D. P. R., & Peiró, M. (2012). Strategic planning in healthcare organizations. Revista Española de Cardiología (English Edition), 65(8), 749-754.

10. Kedziora, R. (2012). "Successful health care project implementation" (online) available on http://electronichealthreporter.com/10-tips-for-a-successful-healthcare-it-project-implementation/ last accessed on 09/02/2017.

11. Grol, R., & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients' care. The lancet, 362(9391), 1225-1230.