FEATURE HEALTHCARE MANAGEMENT
W
hether it is a clinic, a primary/ secondary/ tertiary hospital or a major
healthcare system; the primary objective of a Healthcare (HC) Executive can be summed up as follows: “Provision of service with high and sustainable quality, cost-effectively”
THE OUTCOME The priorities of the ‘strategies/tactics’ and the ‘grade of service aimed at’ will differ according to the organization’s goals. However, the basic approach to achieve the above outcome will remain broadly similar, as follows: Provision of service by achieving the following: Availability Accessibility Affordability
Holistic patient care through seamless integration of diverse service components: Clinical services Non-clinical support services Wellbeing services Alternative medicine, where suitable
High and sustainable quality of service evidenced through suitable: Infrastructure through optimized acquisition, maintenance and upgrade
HR through attracting, acquiring, allocating, developing and retaining HR that is the best-fit to organizational strategic objective
Organizational environment that promotes high employee performance
Educational and Continuous professional development (CPD) activities
Research activities Comparison parameters (benchmarks, KPI, etc.) customized to organizational strategies
Cost-effectivity can safely be said to have been achieved if sum of all tangible and non-tangible outcomes satisfactorily justify sum of all tangible and non-tangible inputs. Benefits and costs to all the stakeholders need to be factored in, especially to those that are enumerated later under ‘expectation management’ (see table 1).
CHALLENGES Obviously, achievement of the above objective is fraught with several challenges. A holistic approach to micromanagement
«Management of expectations of stakeholders is vital to achievement of high performance»
without losing sight of the ‘big picture’ is needed. The major challenge areas that need particular attention by a HC executive are as follows:
Expectation management: Management of expectations of stakeholders is vital to achievement of high performance. Key stakeholders and their important expectations are listed in table one. Only with the implementation of organizational structures, systems and culture that address genuine expectations of all the stakeholders can we expect service operations with sustained high quality. The nearer an organization is to achieving this goal, the nearer will it be to ‘institutionalization’. Institutionalization is a state where customer has full trust in an organization while the product / services on offer and the people behind them become irrelevant. The state of institutionalization in turn ensures sustainability.
Opportunity management: It is a fact of life that the situation keeps changing. Continuous executive vigilance is needed to spot and manage opportunities and threats that any change may create. Opportunities can also be created by
futuristic and innovative thinking about prospective changes in the world in general and the geography of operation in particular. Only with the futuristic and innovative thinking can a HC executive make major leadership contribution. Opportunity and threat are
perspectives. Lack of organizational structures, systems and culture can be viewed as a ‘major turn-off’ by some executives while ‘an opportunity to take on the challenge and make a difference’ by others. Not-so-well performing organizations may be more amenable to change, as they usually are convinced about the un-tenability of the current situation. Also, making a difference in a not-so-well performing organization stands out much better than in a well performing organization.
Complexity Management: HC organizations are one of the most complex organizations. Several diverse and highly technical categories (medical, nursing, allied health professions, support service categories, etc.) working within a single team is a norm in healthcare. With increasing size and scope of healthcare and wellness functions, this task is becoming increasingly complex by day. To bring in team culture that focuses on delivery of high performance at optimal resource utilization is one of the major executive challenges.
Diversity Management: Healthcare consists of highly differentiated professional types and several levels of capabilities within each type.
TABLE 1: KEY STAKEHOLDERS IN HEALTHCARE AND THEIR MAJOR EXPECTATIONS Stakeholders
Major expectations
Patient and family Society
Environment
Employees— direct caregivers and support function staff
Executives and Managers
On time, available, accessible, affordable healthcare Sustained high levels of healthcare services Protection from hazardous waste
• Financial compensation, professional upgrade and recognition: Based on personal competency and performance
• Favorable working environment
• Financial compensation, professional upgrade and recognition: Based on personal competency and performance of the business unit under responsibility
• Favorable hierarchy support Promoters / Governors / Owners Statutory and regulatory bodies.
Achievement of organizational goals and objectives within the framework of the Mission-Vision-Values
Sustained predetermined levels of healthcare quality in the population covered; and progressive improvement in them in line with global developments
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