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Working as a health service manager in present Australian healthcare environment is a highly demanding role. Government mandates and requirements such as implementation of value-based reimbursement are a major challenge. This management report is aimed to identify the major contemporary issue which poses a challenge for health service managers. The report starts with an overview of overall contemporary issues existing in present Australian healthcare settings along with citation of a particular aspect, namely “quality maintenance and regulation” by managers, on which further research is conducted through review and analysis of secondary data sources. Furthermore, this report will demonstrate the management strategies and the concept of those strategies which are relevant to the newly implemented strategies of the organization. Finally, the report will be concluded including focus on major findings and recommendations for curbing cited problems.
Australian Health service management has faced issues of regulating and maintaining health service quality in accordance with the National Healthcare Standards. Working as a health service manager in present Australian healthcare environment is a highly demanding role. Government mandates and requirements such as implementation of value-based reimbursement are a major challenge (Kvedar, Coye, & Everett, 2014). Meanwhile, with advent of new technologies implementations such as electronic records, data analytics and overall technology system monitoring and maintenance, is not an easy task. In addition to these, significant rise in pharmaceutical costs continue burdening the system (Mirzaei et al. 2013).
The costs of technology infrastructure maintenance within healthcare service systems have evolved as another major challenge for managers. Although technology along with technological breakthroughs have enhanced healthcare quality in terms of effective disease management and efficient diagnostics, such expenses of technological infrastructure facilitates budgetary constraints in overall infrastructure maintenance, thereby, imposing gaps between quality and business (Kvedar, Coye, & Everett, 2014). Managers struggle to strike a balance between technological demands and overall infrastructure budget maintenance.
Moreover, Australian healthcare systems are complex in structure regarding its responsibilities and funding which is shared in between state, territory and federal governments. Such fragmented modeling backed up with asymmetrical information exchanges in between healthcare providers and patients continue to complicate healthcare managers’ coordination with their clients (patients). Although publicly funded healthcare systems rank well globally in terms of high expectancy of life or lower mortality rates of infants, such management systems continue to face challenges and issues in terms of quality improvement and overall system maintenance (Mossialos et al. 2013). Therefore, “maintenance and regulation of healthcare service quality” is the most persistent and evident issues faced by health service managers in dimensions of existing challenges.
The main purpose of this management report is to identify the major contemporary issues that are making problem in healthcare management. This report will further illustrate on the management strategies that can be implemented in order to overcome the issues. Healthcare organizations are facing serious problems currently. The organizations should try to change their internal environment as per the requirements of patients. In order to solve the problem, the healthcare authorities should try to implement new management strategies in their organization. This report will also demonstrate the management strategies and the concept of those strategies which are relevant to the newly implemented strategies of the organization. This report will state the information about how the healthcare service providers can improve their services and moreover how to help the employees and professional to cope up with the new culture of the organization.
Selection of an appropriate methodology for research conduction and analysis of collected data is of significant important in successful attainment of research objectives. Essential emphasis on selection of appropriate methodology for collection of data as well as for efficient collected data interpretation adds on to the quality and precision of conducted research. Since the present report aims to analyze the issue of “maintenance and regulation of healthcare service quality” by health service managers for evaluation of its current status, management strategies and impact on current Australian Health Service sector, an approach of qualitative analysis will be appropriate for realizing the research objectives (Perkins et al. 2013).
Data collection sources
The source for data collection for this research is identified by secondary data sources including published literatures, Federal government websites and survey interviews of Australian Health service managers. In addition to these, additional information on existing managerial strategies of quality management are explored through various published books and reports published by the Australian Healthcare Ministry (Pulvirenti, McMillan, & Lawn, 2014). Special attention has been dedicated for selection of associated data sources, in terms of data reliability, data sustainability as well as adequacy, for attaining accuracy in collected data for its appropriate analysis.
Data analysis process
Analysis of data is a crucial the collected data will be analyzed using a qualitative approach. It will also involve result deductions through the deductive reasoning approach. The approach for such type of reasoning is selected for development of associated research hypotheses based on existing literatures in quality management domain. The analysis will employ a precise evaluation of literatures, statistics obtained from government sites and overall survey of health service managers obtained from various websites and reports.
The Australian health system has been characterized by a well built public sector component. Public health care services are complemented by most of the private healthcare charity houses, private hospitals and the independent clinics by the practitioner. The healthcare delivery system of Australia is structured into many levels.
Quality service: Quality now becomes a dominant factor in our life. Most of the people are not satisfied with the quality of services that are offered by the healthcare service providers of Australia. The desire for the standard quality has caused the reason for considering it as the essential component of healthcare service. Quality is considered as the main strategic differentiator tool. Quality is a term which is really very difficult to define as it is a subjective and intangible characteristic (Buchbinder, & Shanks, 2016). However, if a health service organization can improve their quality of service then the structure of the organization will change automatically (Blank et al. 2017). As a result market share of the organization will increase. As many people will come to know about the organization and their services, this will leads to lower cost of the services and products. There are high chances of increase in productivity and profitability of the health organization. This will bring a positive image of the health organization. Value, excellence, conformance of requirements, meeting the expectation of the customers, specifications and satisfying the sponsors or the stakeholders are the key terms for defining quality.
Crisis regarding service quality in Australia is now becoming a vital topic. Numerous recent studies and research have conveyed the same statement that the problem related to health service quality maintenance now becomes a headache to the whole community and the impact of this issue is also not negligible". Moreover, this is the reason of burden to the people and as stated in an American journal, nowadays there is no guarantee of getting high-quality service or care from the authority of any health service organization. As per the survey made in the year of 2000, more than 98,000 people are dying every year and the result shows that the reason behind the disaster is nothing other than medical errors (Duckett & Willcox, 2015). The negligence of the authority, not getting proper treatment, high-cost services which are rarely affordable by the people who lived under the poverty line and poor management is the reason for this disaster. The health professionals of Australia are more concerned: 57% of the healthcare physician said that providing standard quality service is not in their hand and it has been reduced in the last some years, 41% amongst them are not interested in reporting about medical errors.
The authorities and the experts of health service have identified some reason for the critical issue that most of the community is currently facing- poor design of the structure of the health service organization, system's inability to respond quickly as per the requirements of the customers. Failure to grow with the latest science and technology, the adoption process is much slower than required, high-cost services offered by the health organizations, poor working condition and the shortage of the products and personnel.
Apart from all of these the health care providers across Australia do not aware of they are responsible for this situation. The professionals of the health organization work together but they are not interested in working cooperatively. Lack of co-operation, misunderstanding between the authority and the patient party, communication gap, excess cost has resulted in patients is suffering in poor condition. Chronic condition is another issue, as population age is now added in this. More than 125 million of people are suffering from the serious chronic disease. The majority of Australians are suffering from multiple chronic conditions (Perkins et al. 2016). The health service providers are trying to provide acute care to meet the needs of chronically ill people but inadequate resources the main barrier in this case. A recent study underscored the issues faced by most of the Australians, 72 percent of the people are dissatisfied with the obtaining medical care from the general physician, and 78 percent are dissatisfied with the specialist doctor.
Many strategies can be implemented in order to improve quality service. The strategies are listed below:
Increasing resources: The first and the foremost aim of any health service is to provide better service to the patients and treating them in the better way. To improve the services offered by the health organization they should try to gather more fund so that they can increase personnel and equipment used in the health sector.
Strengthening management: The main responsibility of the authority of the health services is to make better management plan. They should make the structure in a way so that it can change the whole culture and this will result in better quality.
Financial reformation: Changes in the organization structure is important to facilitate better decision-making for the improvement of the whole structure of the environment. If the company can make more funds for the organization, then it will definitely help to improve better quality. This strategy is often used as a part of other strategies too.
Patient empowerment: The organizations should try to make an approach so that the patients can interact with the authority. This can be implemented through developing complaint system or questionnaires session for the satisfaction of the patients. The organization should try to feel the patients that they have rights to expect high-quality services from the organization. Many other methods are also available which helps to empower the people through legal entitlement or by advocacy.
Figure 1: Effective strategy to solve the issue
(Source: Duckett & Willcox, 2015)
TQM: TQM abbreviated from total quality management (Mirzaei et al. 2013). This consists of a set of methods and principles which can be implemented in many ways. TQM focuses on giving the best experience to the patients by providing care and attention.
Continuous quality improvement: Basically, the main aim continuous quality improvement strategy does not differ much from TQM. Sometimes, it focuses on the multidisciplinary project that is running the organization and the changes in test report of the repeated cycle.
Quality indicator comparison: This strategy works like comparative data collection method where an organization participates actively to make improvement by motivating the patients and clinicians (Britt et al. 2013).
Quality assessment: In this strategy, a third party works actively to review the health service organization based on their quality of service. This strategy only considers the quality outcomes of a specific health service organization.
Management theory or model is the choices made by the top level service managers of the health service organizations (Wakerman et al. 2013). These management theories are consist of an objective of the organization, procedures and strategic plan, coordinate activities, and resource allocation. Balance theory is one of them which can be implemented in any organization where quality improvement is needed the most.
Balance theory: balance theory is based on a solid theoretical concept which helps to build interrelationship between the service providers, service organizers and the patients. Balance theory helps the organizers to plan and apply the strategies in an effective way. As the employees of the health service organization are bound to maintain the rules and guidelines of the organization, the balance in quality maintained (Drummond et al. 2015). The progress of improvement is continuous in balance theory. This theory ensures that to improve service quality by applying the management strategies, the organization should provide better services to the patients. There is a strong connection between the patient retention and service quality. Customer satisfaction leads to increase in fund tremendously and if the financial condition of the health service is strong then they can offer high-quality services to the patient easily.
TQM and CQI: TQM/CQI is hugely used in the health services of Australia for improvement in operation, maintaining quality service and profitability. This helps the nurses and the professionals of the health service to focus on improve their services and provide better care to the patients who are diagnosed with them. This model also used to improve the cost of external health services offered by the various organizations (Folland et al. 2016). Health nurses and professionals who are knowledgeable about TQM and CQI theory can help the organization by assuring service quality. Another advantage is this model also helps to reduce the rising cost of healthcare.
[caption id="attachment_7932" align="aligncenter" width="561"] Figure 2: Structure of TQM model (Source: Buchbinder & Shanks, 2016)[/caption]
Difference of quality management strategies across the range of healthcare settings
In a survey of 160 Australian health service managers from different healthcare settings, it was found that although the major aspect of quality maintenance and regulation is crucial for all, the approaches and strategies for tackling with such issues differs majorly on the basis of their service type and settings (Blank, Burau, & Kuhlmann, 2017). While the aspects for quality maintenance in mental healthcare service mainly includes quality assurance through regulation of treatment quality by effective support and diagnosis, appropriate nursing provisions and collaborative partnerships with various social care agencies, managers belonging to the chronic disease healthcare settings emphasis on quality assurance through efficient diagnosis, collaborative association with pharmacists and electronic record analysis technologies (Bowling, 2014).
[caption id="attachment_7934" align="aligncenter" width="417"] Figure 3: Standards of ACT (Source: Britt et al. 2013)[/caption]
Moreover, management professionals belonging to sectors dedicated to nursing of chronic diseases, old age healthcare or community healthcare service provisions are mainly concerned with provisions of training for their existing healthcare professionals for total quality measurement. The old age healthcare service managers are mostly concerned with quality assurance through provisions for quality nursing and assisting professionals, involvement of patient’s family, knowledge of latest policies related to healthcare insurance facilities for such patients by the Federal Government (Britt et al. 2013). In contrary to them, the management dealing with community healthcare services recognizes quality service delivery through effective counseling of patients, mainly aiming for providing services to minorities or underprivileged individuals through effective surveys and awareness programs. Such management involves in quality service delivery, to sensitive communities such as LGBTs, by strict adherence to regulations laid by the Australian government, such that problems of biased and incompetent services or patient harassments are not encountered. All Such aspects are of crucial importance to them.
Overall, the healthcare service managers are mainly concerned about quality assurance in terms of healthcare organization and health service seeker satisfaction. The quality assurance, in terms of organizational settings, involves implementation of collaborative and multidisciplinary teamwork, enhanced knowledge and skill development amongst employed healthcare professionals, and employee satisfaction while patient satisfaction is achieved through total quality management (Brownson, Colditz, & Proctor, 2017). However, both the aspects are interdependent on each other and striving a balance between both of these aspects is the identified area of improvement strategy implementation for which healthcare service managers are mainly concerned.
Based on the identified issues and challenges of quality maintenance and regulation by health service managers, it will be appropriate to state that essential focus on leadership and staff management will significantly promote ease of quality maintenance within healthcare organization. It must be noted that development of such quality must be well-focused on striving a balance between service quality monitoring and performance evaluation. Recent researches reveal that gaps regarding infrastructure investment constraints and quality service delivery are needed to be addressed through adherence to government laid standards along with frameworks development for improved efficiencies in operations, provider collaborations, medical management, compliance and finance (Buchbinder, & Shanks, 2016).Therefore, managers must be able to prioritize technological requirements for delivering high quality services, by investing in technologies which assist them in long run, such that they are exempted from facing financial constraints.
Moreover, such models of quality management must include a health plan which covers patients with higher risks to have greater subsidized premium from the Federal government. This would facilitate managers to access greater profits during exchange participations (Folland, Goodman, & Stano, 2016). In addition to this, management executives must ensure existence of a value based contract within organization for avoiding future patient relationship conflicts. Continuous enhancement of staff performance and accountability must be regulated by periodic quality development programs and training sessions for employees for catering to the demands of patients and maintenance of National Healthcare Standards in a better way. In addition to this, health service managers must also employ periodic data analysis of patients and their health performance in provided care settings. Strict monitoring of patient complaints must also be done (Wager, Lee, & Glaser, 2017). This would facilitate an exhaustive analysis of organizational staff performance along with citation of existing gap identification. Furthermore, health service managers can develop appropriate frameworks for curbing organizational performance gaps which are identified through prior analysis such that the concept of “Total Quality Management” can be attained by the organization.
According to the current status of Australian Health service management, it was found that issues of health service quality regulation and maintenance in accordance with the National Healthcare Standards tend to provide challenges to healthcare managers. As revealed through literature reviews, Government mandates and requirements such as implementation of value-based reimbursement, implementation of new technologies such as electronic records, data analytics and overall technology system monitoring and maintenance, along with significant rise in pharmaceutical costs continues burdening the system and its managers. Therefore, it is evident that Managers tend to struggle for striking a balance amongst quality service delivery, customer demands and overall infrastructure budget maintenance.
As identified during research, the quality assurance, in terms of organizational settings, involves implementation of collaborative and multidisciplinary teamwork, enhanced knowledge and skill development amongst employed healthcare professionals, and employee satisfaction while patient satisfaction is achieved through total quality management, accurate diagnosis provisions, quality nursing facilities and adherence to National Standards. Striking a balance between both of these aspects is the identified area of improvement strategy implementation. With reference to such issues, essential focus on leadership and staff management will significantly promote ease of quality maintenance within healthcare organizations. Management executives must ensure existence of a value based contract within organization for avoiding future patient relationship conflicts, Continuous enhancement of staff performance, Strict monitoring of patient complaints and periodic data analysis of patients and their health performance in provided care settings. This would help them offer quality health service along with facilitation of ease for handling complicated quality issues.
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