CONTEMPORARY ISSUES IN HEALTHCARE MANAGEMENT

1. CONTEMPORARY ISSUES IN HEALTHCARE MANAGEMENT
RAJU AJMEERA
UNIVERSITY OF HYDERABAD

2. • Healthcare management essentially describes the
leadership and general management and administration
of hospitals, hospital networks, public health systems
and/or health care systems.
• It is also referred to as "Medical and health services
management", "Health systems management“,
"Healthcare systems management" or
"Health Administration".
Healthcare Management

3. HEALTH CARE SPECTRUM

4. • The Domain of Healthcare
is distinct because of the
uniqueness of their –
 product,
 people,
 Processes,
 Structure,
 Technology &
 Quality
Do we require Healthcare Managers?

5.  The variety and range of products
may include laboratory, radiology,
cardiology , surgical services. The
services must be mixed and
matched according to the specific
need
 The process seldom occurs in
standardised manner.
 Consumption of one product often
leads to another.
Products

6.  Hospital environment brings both
problems and opportunities, as it
deals with knowledge workers in
many fields (doctors, technicians,
nurses, hospital executives,
financing, marketing and material
personnel.)
 Decision made in hospital are
critical to a degree incomparable
with any other business as it deals
routinely with problems that result
in life and death.
People

7.  The healthcare process
begins with consulting the
doctor about the ailment and
can sometimes end in
invasive surgery and
intensive care in hospitals.
 Can never have a
standardized process
Process

8.  The organisational structure of a hospital is neither
pyramidal, steep, nor flat like a matrix. But is rather like a
galaxy where small spheres and clusters comprise a
whole system.
 The locus of control within the galaxy is continually
changing.
 Each time, unique teams are assembled from a different
combination of specialists, doctors, technologists and
expert nurses.
Structure

9.  The greatest medical and
technological advancements in
the history of hospital care
have happened in the past two
decades
 50% cost goes into technology
while setting up a new hospital.
 80% have a very short life
span.
 New diseases and solutions
emerge almost daily.
Technology

10.  Quality is the crux of the hospital industry.
 Providing Quality care at an affordable price for the
steady stream of customers seeking preventive health
care check ups or diagnostics or curative is a major
challenge.
Quality

11. Contemporary Issues
 The ultimate Objective of Health management is to
mold numerous departments with unique person
power, unique equipment, unique problems and
unique yet differing view points and a general lack of
finances into a smooth running machine.
 Like any other Organization, Healthcare Industry has
its own share of Management problems which can be
classified under the following heads -

12. Issues in
Health
Management
strategic
Financial
Human
Resource
Operations
Healthcare
reform
Quality
Maintenance

13. • Rapidly Changing Environment
• Data Availability
• Competition with other healthcare providers
• Problems and challenges of increasing complexity, and
decisions taken can have a profound effect on the
providers and receivers of care.
• Find a balance between providing outstanding care,
Quality expectations and reducing operating costs.
Strategic Management

15.  Concentration on core services that can be provided
well and with more efficiency
 Plans can be redundant if considered for long term
objectives
 Evaluation at regular intervals is a must
 Set realistic goals
 Provide Direction to the entire Organization
 Support and concurrence of the Board are essential
for almost every major activity

16.  It is the corner stone for successful hospital management.
Financial Management
 Although hospitals and
outpatient centers hope
to reduce illness and
improve client well-being,
these institutions are also
places of business that
must continue turning a
profit to stay open.

17.  Preparation of departmental budgets
 Consolidation
 Negotiation, Prioritization
 Decision making on essential and non essentials
 Precise statement of requirements and their utility -
essential to avoid “drifting in a sea of ambiguity”
 Make a detailed presentation to the Board and indicate a
monitoring process
BUDGETING

18.  Standard equipment surveillance
can pick up minor problems early
and easily
 A continuous process of training
in maintenance and repair
procedures is absolutely essential
 Every hospital should have a
maintenance organization
 Records of equipment and the
repair status
 Annual maintenance contracts
COST CUTTING THROUGH
MAINTENANCE

19.  Helps in cost reduction
 Assures equal quality
 Effective purchase
planning
 Good communication
among participating
hospitals
 A pre-established central
clearinghouse to facilitate
receipt and dispensing
GROUP BUYING

20.  Use of computers
 Equipment and drugs lying
un-utilized
 Fixing responsibilities
 Cost recoveries
 Forward planning
 Basis of calculations
 Storage
 Maintenance mechanisms
INVENTORY CONTROL

21.  Avoid under utilization of staff
 promoting services that are
more cost-effective, yet offer
the opportunity to provide more
and better-paying outpatient
procedures
 Plan the methods of marketing
– entry points, camps,
exhibitions, AV aids, mass
media approaches
 Using satisfied customers as
resources
 Hospital image is the most
important guiding factor
EXPANDING REVENUES

22.  Ear marking individuals to
search for assistance
program
 Staff inputs
 International, Governmental
and NGO based aid
 Running special programs to
generate revenues

23. • Access to affordable, high-quality healthcare is far from a
given for millions of people
Healthcare Reform

24. • Changes in culture of staff and their
expectations
• Shortage of qualified skilled personnel
• It is easy to get attached to facts and
figures and we eventually lose sight of
the human aspects.
• We some times place too much
emphasis on the end result no matter
how it is achieved and we inadvertently
create a human relations nightmare
Human Resource

26.  In medical facilities, there's usually one leadership
position in each specialty. Most of the time, the person
promoted into management has technical skills, but not
leadership skills.
 Because of shortage of staff, scheduling issues and
monetary considerations, leadership training isn't a
high priority. Therefore, there's a lack of true leadership
and good management, which means staff have to rely
on learned skills rather than good direction.
Leadership

27.  Finding the right people for the right job
 Effective communication techniques
 Formulation of personnel policies
 Employee involvement and empowerment
 Your motivation and enthusiasm will determine their
performance
 The “closed mind – open mouth” syndrome can have
disastrous effects on the working relationships.
 Communicate directly with your staff and make them feel
that you care for them.
 Consider innovative ideas from them - Staff, out of their
experiences, have some good ideas and adopting them
may enhance efficiency besides improving the self image
of employees and ensures their cooperation
 Gaining staff approval and support is an important
administrative action. Make efforts to sell any changes you
wish to propose.

28.  Weekly meetings
 CMEs
 Deputations for special
training
 Acquisition of new
qualifications
 Ensuring equal opportunities
to all
 Providing feed back at staff
meetings based on inputs
from various sources
IN SERVICE TRAINING

29.  Vital element is creation of a good
atmosphere in employer and
employee relations.
 Taking care of minimal needs will
avoid a crisis
 Dealing efficiently with the
intangibles of human feeling and
emotion
 Molding a system that is not
based on pay cheques.
 Loyalty is a bond, which holds an
employee to the hospital, is to be
nurtured and is an art.
HANDLING COLLECTIVE BARGAINING
AND UNION PROBLEMS

30.  Serve as an extended arm
 Acts as a field practice area
for trainees
 Aid in research
 Facilitates early diagnosis
and prompt referrals
 Enables follow up in the
community
 Linkages and liaison with the
base hospital essential
 Boosts the confidence of
patients
 May result in increase in
clientele at the hospital
COMMUNITY OUTREACH
SERVICES

31. New facilities are getting smaller,
specialized, and dispersed.
Managing limited Human
resources
Financial Constraints
Patient Satisfaction
Process flow and improvement -
reduce wait times particularly in
the emergency department
Operations

32.  improve operational efficiency –
scheduling
 employee education of cost / revenue
and process improvement
 resource tracking and management
 capital equipment location and
utilization
 consumable inventory location and
amount
 supply chain management
 de-bottlenecking
What can we do?

34.  collaborative planning, forecasting and
replenishment
 S&OP
 Reduced product variety for price
leveraging – stents

35.  Dilemma of maintaining high quality
of service while holding the cost line.
 Demanding Patients
 With an abundance of medical plan
and health care facility choices,
patients do not have to settle for
"second-best" treatment. Health care
managers must ensure they meet
patient expectations if they wish to
stay competitive in their profession.
Quality Management

36.  Litigations / Legal disputes
between patients,
insurance providers and
healthcare providers take
time and money away from
medical research and
treating patients.
 Patient safety concerns
include medical errors and
new diseases that are not
only dangerous, but can
spread easily. One of the
biggest worries is the
spread of hospital-acquired
infections among patients.

39.  standardization of processes and supply items, instead
of allowing physicians to pick and choose based on
their preferences.
 The broad shortage of nurses means that many duties
fall to untrained or inexperienced assistants, thereby
driving up the likelihood of error.
 Discrepancies in pay draw
medical students away
from certain fields and into
others, resulting in a
lopsided distribution of
doctors and a lack, or
surplus, of options for
patients.

40. Maintain Key Ethical Principles like:
Veracity – truth telling, informed
consent, respect for autonomy.
Privacy – a persons right to remain
private, to not disclose information.
Confidentiality – only sharing private
information on a ‘need to know basis’.
Fidelity – loyalty, maintaining the duty
to care for all no matter who they are
or what they may have done.
Non – maleficence – to do no harm.

41. THANK YOU!