How does health services utilization link

Health services utilization links services capacity reserved for patients with patients need (demand). High patients’ demand increases utilization, the pattern of increases are affected by the capacity of the services such as number of services delivered, number of health professionals, and budget provided to ensure that equipments and other requirements are available. The following diagram shows the link between patients’ demand, services capacity, and utilization. [diagram is here]

Several studies have been published that focuses on measuring utilization relating to the patients’ demand and services capacity. These studies can help health organizations in targeting their optimum utilization point, where the efficiency is high. For out-patient departments, measuring utilization can be done by using time frame measures (waiting time, length stay, and/or access time), or other UR measures. For patients’ demand, number of registered patients, number of appointments, and payment schemes can be used as measures.

Finally, the capacity of services can be measured by the number of staff, number of beds, etc. For in-patient departments, before admitting a patient, physicians with insurer must certify the medical necessity to avoid overutilization. Through concurrent and retrospective reviews, the reviewer can easily identify whether the decisions that have been made were appropriate. The reviews also help identify local norms needed to identify over/underutilization. Discharge planning is beneficial for decreasing waste costs (overutilization).

Managers in healthcare sector should be careful when they allocate resources because it is the toughest decision with limited resources, highest demand, and ethical considerations. 2. Describe the fundamental rules of managing others? In my opinion, managing others means managing relationships, and any successful relationship must be within the following frame: • Ethics: means respecting others, validating justice and human rights, and taking responsibility. • Leadership: means effective use of power, conflict management, value for diversity, effective handling of difficult people, and negotiating.

• Motivation: means self-motivation and motivating others. Many motivation theories emphasize that every one seeks power, control, supported ego, and achievement; every one needs his/her beliefs to be consistent and his/her goals to be motivated. • Communication: means effective interaction and understanding barriers (environment and/or personal). Spoken language, misunderstood body language, interpersonal past experience, and culture are some of these barriers. The responsibilities of human resource managers are usually divided into the following categories: i. Staffing. ii. Employee compensation.

iii. Defining/designing work Human resources managers should know the following rules in order to manage employees: • Focus on select, promote, pay, evaluate employees; do succession planning; and recognize and develop employees. • Managing human systems in the organization is not isolated; that means don’t distinguish between quality patient’s affairs from the quality of employee’s affairs, they are interrelated — interdependent. • Protect all employees against discrimination, and provide a safe and healthy work environment for all employees • Emotion frames the relationships within the organization.

It’s more powerful than only rational thinking. • Manage and measure employees locally; each department should have certain activities. • After all, the poor health of an individual is a sensitive issue. If an organization were to begin discriminating against workers who have health problems, its productivity would be adversely affected. • Understand the relation between pressure and the performance of the employees. (Inverted U) 3. What do you think are the key differences between management of manufacturing industry in private sector and those in healthcare organization in the public sector? What (key) similarities apply to both?

Before I start comparing management between manufacturing industry and healthcare sector, I should compare within this framework (product, management, pricing, payment, customer, public expectation /accountability, and regulatory environment). First, manufacturing industry is production sector while healthcare is services sector. Customers in healthcare are mainly patients. In manufacturing industry, customers are the clients who purchase their products. Second, the manufacturing industry is focused on producing high-quality products whereas the healthcare organization must provide high-quality services.

Quality is vital concern for both; they apply same methods and tools to improve quality such as Six Sigma. TQM plays an important role in both healthcare and manufacturing industry. Third, management in both the private and the public sectors includes analysis of the external environment. But management in the public sector must consider “political accountability” as the very basis of organizational existence. Besides, management of the manufacturing industry does not exclude the consideration of public accountability — for example, laws on product safety are considered.

But management of the healthcare organization in the public sector includes unique features that management of the manufacturing industry in the private sector is not typically concerned with. These features include the following: i. A greater degree of public accountability. ii. Objectives and priorities that are often vague and/or conflicting. iii. Complex networks of stakeholders. iv. Less competition. v. A distinctive legal context. Fourth, the management of change should be considered the number one priority in the manufacturing industry.

Other strategies included in the management of manufacturing industry in the private sector include the following: i. Human capital strategy. ii. Product strategy. iii. Market strategy. iv. Financial strategy. v. Technology strategy. Of course, the healthcare organization in the public sector must also consider the above-mentioned strategies as its own, replacing the product strategy with its service strategy. The technology strategy of the healthcare organization must especially take into account the management of information across the organization.

Fifth, pricing is not an issue in public healthcare sector while it is an important issue in private manufacturing industry in order for the latter to gain their profit. It depends usually on the economic situation, competitive environment, etc. Also, payment scheme in public healthcare is free while it is out-of- the-pocket in private manufacturing industry. 4. Describe the different types of skills required of managers in health services? Management process in health sector is similar to others sectors (industry or educational). It has many functions (planning, organizing, staffing, directing, and controlling).

In order to function the management process effectively, managers must have technical (e. g. , technology training), conceptual (e. g. , formulating ideas and high IQ), and human/communication skills (e. g. , leadership, including active listening, better public speaking and presentation; writing skills; making a great first impression; running effective meetings; easing group contribution; and communicate complex ideas successfully. ). They should play many roles such as strategist, decision maker, leader, and designer. Each management level requires a certain degree of skills.

High-level management usually needs high conceptual, human skills, while middle-level management needs higher technical skills. The supervision management needs high technical, human skills. In addition, managers in health services are facing many challenges, including: • Changes in the financing and payment structure such as health insurance. • Pressure to provide uncompensated care. • Greater accountability for quality of care. • Competitive environment enforcing managers to change configurations. • High degree of uncertainties created by policy developments.

• Maintainance of the integrity of health organization through high ethical standards. • Staffing challenge due to the expansion of the number and types of health professionals. All the previous challenges require managers with high conceptual, technical, human skills to get through it. Charismatic leaders with strong background in health administration field are skilled. In Saudi Arabia, epidemiological surveillance program is significant due to the geographical diversity and epidemiological problems, which come into sight recently such as Avian Flu, Rift Valley Fever, and Dengue Fever.

MOH is the government health agent that responsible for creating and applying strong and effective surveillance program. Any surveillance program needs good plan, high technology, skilled staff, and high capacity in information management. Indeed, all health programs require high conceptual skills for the planner’s decision makers, and human skills for health staff and professionals who deal with patients every day. 5. Discuss the steps of problem-solving method as a contingency approach in management

Problem-solving method is a kind of map used mainly to ease the process of problem solving and helping managers look at as many factors as possible in a structured and methodical way. Problem-solving method contains sequential phases, which are the following: 1. Define the problem clearly and objectively, as well as the goal that we want to achieve after solving the problem. 2. Analyze causes (e. g. , primary causes and secondary causes). 3. Identify possible solutions. 4. Select the best solution. 5. Develop a contingency plan. SWOT analysis is needed in this phase while dividing the best solution into tasks.

6. Implement solution. 7. Evaluate progress. To go through the problem-solving phases, we can use many tools. We have to choose the most suitable tool for the situation (problem); we can use more than one tool. Some of those tools are: 1. Appreciation: Extracting maximum information from facts by asking questions until we have drawn all possible inferences. 2. Drill-Down: Understanding problems in detail. It helps us to break a large and complex problem down into its component parts, so that we can develop plans to deal with these parts. Mind maps are useful for this tool.

3. Cause & Effect Diagrams: Identifying possible causes of problems. Their major benefit is that they push us to consider all possible causes of the problem, rather than just the ones that are most obvious. Managers can use brainstorming while applying cause & effect diagrams tool. 4. Flow Charts: Understanding how a process works. They can be used to define and analyze processes; build a step-by-step picture of the process for analysis, discussion, or communication; and define, standardize, or find areas for improvement in a process. 5.

Systems Diagrams: Systems diagrams are particularly helpful in showing us how a change in one factor may impact elsewhere. Discover the positive/negative loops between factors. 6. SWOT Analysis: Analyzing Strengths, Weaknesses, Opportunities and Threats. It is essential for the planning phase. 7. Cash Flow Forecasts with Spreadsheets: for cash moves and costs or sales. It helps us to understand the process of the current situation (problem). 8. Risk Analysis: Risk analysis and risk management can help us to assess risks and decide what actions to take to minimize disruptions to our plans.

They will also help us to decide whether the strategies we could use to control risk are cost-effective. Mostly we use the following simple formulation, (Risk = probability of the event * cost of event), in order to apply complete the decision tree. Problem-solving phases are sequential; we can’t apply more than one phase at the same time, or apply the last phase before any other phases. But we can trace the process through inverse direction. The time it takes to solve problems depends on the complexity, the priority of the problem, and the effective leadership.

Switched birth babies in Saudi Arabia are the hottest issue these days because it has horrible consequences on babies and their families. Hospital administrators must do a full analysis to find out potential and primary causes. It could be lack in the number of nurses or lack in motivation that might cause low performance. It’s clear that this problem is an administration problem within the nurses’ division. 6. Describe a framework that you would use to analyze the resources and competences of a healthcare organization/department, etc? Analyzing resources and competences of HC organization or department should be within a framework.

The framework includes four boundaries (factors): 1. Configuration: analyzing the configuration of the HCO or department usually includes : • Policy analysis: to figure out if it’s within the national/international framework, or if it needs some modification due to the external changes. • Financial position: financial professionals can do certain analysis such as stability and/or profitability (for profit hospitals). • Information Management: to analyze the capacity of the organizational information processing and investment in information system.

• Communication and coordination: to analyze miscommunication or coordination problems within or from HCO to outside organizations and agencies. 2. Personnel: including recruitment strategy planning, recruitment process, performance management and evaluation, promotion system, personal data record, training programs. 3. Infrastructure: number of beds, buildings’ (medical rooms and non-medical rooms) capacity and positions, and water and power. 4. Equipments & supplies: equipments, supplies, and sources of supplies (suppliers).

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