Healthcare Management: Application of Humanistic and Strategic Management

Healthcare Management: Application of Humanistic and Strategic Management

Introduction

Strategic issues are commonplace in any healthcare setting. They vary in nature and the kind of remedies required but often require as a whole, a strategic management approach. The latter refers to a structured, purposeful and comprehensive framework that can be rolled out to operationalize various strategies at the workplace. Strategic management entails among other facets, strategic thinking, strategy formulation, strategic planning, monitoring and evaluation as well as allocation of resources (Ginter et al., 2013). However, for issues to be addressed using such a broad and encompassing approach, their strategic nature must be proven. Otherwise, short term tactical approaches are sufficient to address a number of issues that often emerge in daily healthcare practices. In applying strategic management concepts and methodology in the healthcare discipline in recent times, a humanistic management model has been emphasized. This refers to an approach to management emphasizing on human values, ethics and stakeholder involvement (Melé, 2013). It was developed as a reaction to the pervasion of scientific management models in the 19^th century that emphasized on productivity and profits over the people involved in the process. As such, the model sets humanity as the center of organizational success and more so as the most valuable resource. This report offers an overview of current practice settings, a shortlist of strategic issues in the environment and applies both the strategic and humanistic management models in addressing them. 

Overview of Healthcare Settings and Role Played

My current role is that of a registered nurse in a public hospital. This is quite an overwhelming role given that the Australian public health system is the most utilized healthcare service with few opting for private healthcare. The number of patients requiring care is overwhelming and range from both the higher and middle classes of society to the lower classes. Though there is always remarkable effort to deliver quality care, the large patient population sustains a struggle to match healthcare resources and the attendant demand. However, there is considerable funding from state, national and territory governments as well as some non-state actors who come in to fill some gaps on a need basis. Apart from performing core nursing duties such as offering primary care, I also work as the team leader in my shit, liaising with the nurse manager to resolve any emerging issues as well as supervising others during my shift. 

Explanation of Managerial Duties and Responsibilities

As glimpsed above, there are a number of managerial duties and responsibilities that come with the role of a registered nurse in my practice settings. These include taking charge of colleagues during shifts and thereby resolving any issues involving patients or the ward at large. A similarly important managerial duty is to work closely with the nurse manager in planning of care, resolving issues at the work settings and exercising oversight over other nurses in the ward. At all times, there is an extended responsibility to address all stakeholder interests as necessary, including the queries and demands of the families that may have their kith and kin in the ward area. In a nutshell, the managerial duties and responsibilities entail:

• Supervising fellow nurses on shift
• Resolving issues affecting patients and care in the ward at large
• Liaising with the nurse manager in the planning of care delivery, general oversight and problem solving
• Ensuring stakeholder satisfaction within the ward settings.

Strategic Issues &Rationale

There are several issues in the present healthcare settings that can be described as strategic. This section summarizes four of the main ones and justifies their strategic nature using normative concepts of strategic management.

Healthcare cost is one of the strategic issues evident at both the health sector level and the current practice settings. State, national and institutional efforts have proved inadequate to address this problem, with the indication being that a more sustainable solution is needed. Granted, the Australian healthcare system ranks favorably internationally with a comparatively higher life expectancy rate and low infant mortality (Armstrong et al., 2007). In addition, there is Medicare, universally catering for the cost of healthcare in public facilities as well as several options in private insurance. However, it is apparent that the funding model for the healthcare system is complex and not cost-effective, while issues of affordability also persist. Notably, funding of healthcare in the country is coordinated between the federal, state and territory governments, which has been a subject of wastage and in the process, efficiency has been lost (Armstrong et al., 2007).  There is need to streamline the flow of financial resources in the public healthcare system through all the three sources for cost effectiveness. Elsewhere, insurance premiums are also quite high for a section of the impoverished Australians, sometimes with a heavy burden of chronic diseases. There is need to rationalize the funding to offer incentives to such groups and cushion them from further impoverishment from the healthcare system (Macri, 2016). This issue is strategic because it touches on the long term health planning in Australia and the current practice settings. In addition, it touches on the goals and mission of the healthcare sector at large on ensuring equity of care. More importantly, both issues raised require a coherent strategy to address them.

Indigenous health is yet another strategic issue to deal with at the local and national contexts of practice. There has been overwhelming focus on this matter for sometime now, but the challenges persist and thus require a strategic approach. Indigenous groups, comprising of the Aboriginal and Torres Strait Islander people, continue to be severely disadvantaged in accessing care. Their geographical setup in the remote areas sidelines them from mainstream healthcare infrastructure, which they abhor anyway. Even if granted access, their complex cultural orientation hinders them from accessing the best possible care. Current strategies to aid their utilization of mainstream healthcare services include the training and integration of some members of their community into the healthcare system and the use of interpreters (Armstrong et al., 2007). While this has yielded some fruits, some other challenges persist. The communities are, for instance, exposed to a number of risk factors both lifestyle and occupational, leading to a higher burden of chronic diseases. Statistics indicate that they consequently have lower life expectancy and generally need special focus in the planning and delivery of care. This issue qualifies as strategic due to its multifaceted nature which requires strategies to address. There are issues on culture, risk factors, advocacy and chronic disease burden to address hence rendering the problem strategic.

Health information management is also a strategic problem in the Australian health system and the present practice settings. The healthcare industry is information and data rich, relying on the collection, analysis, storage and retrieval of medical records to provide quality care (Wissmann, 2015). In addition, diagnosing, treatment and monitoring of population health all relies on quality of information. Despite this reality, there have been little if any efforts to integrate the best practices in healthcare information management. There are no technologically sound methods of fostering access, storage and retrieval of medical records by all professionals to assist delivery of care. Technologies like Electronic Health Records (EHR) are needed to assist coordination of care and the smooth interaction of multidisciplinary healthcare teams. Healthcare information management also helps in assessing costs and streamlining them with health outcomes. In addition, there have been concerns over health records management in indigenous populations given their suppressed interaction with mainstream healthcare services and in some cases, their failure to offer accurate information out of the fear of discrimination (Wissmann, 2015). These issues collectively paint a strategic picture in the sense that they cannot be addressed devoid of long term strategies. In addition, they collectively touch on the core mandate of the healthcare institution and the system at large- provision of quality primary and advanced care. Therefore, there is no doubt that healthcare information management was a strategic issue with respect to both the practice settings and the health sector at large. 

The final strategic issue at both the workplace and the national level is demographic changes. The number of the aged is growing by day, increasing the burden of disease mortality and morbidity in Australia. In the daily work experience, a large number of people above the age of 65 appear for different health needs, majority being in need of care for chronic diseases. The aging particularly have been disproportionately affected by cardiovascular diseases (CVDs) which have not only an added fiscal burden but also demand for long term care. This demographical change has burdened healthcare resources and is likely to be a disruptive challenge in the foreseeable future. Currently, it is estimated that 14% of the population is above 65 years of age but as the baby boomers retire, this percentage is expected at around 21% by 2050 (Wissmann, 2015). This translates to a higher disease burden, healthcare costs, demand for geriatric and critical care/geriatric nurses which shall be overwhelming at the current practice settings as well as in the general healthcare setting at large. It is therefore important to keep track of such demographic changes and adequately prepare to face them both institutionally and for the healthcare system. This matter is strategic due to its resonance with the long term performance of the healthcare system. It is concerned with how healthcare delivery can be sustained in the midst of demographic shifts that intensify the burden of disease and call for a higher commitment of healthcare resources. Without a doubt, managing such a healthcare problem is impossible without the development and implementation of underlying strategies in the healthcare system. As such, there is clear justification of demographic shifts as a strategic healthcare issue.

Critical Analysis of the Humanistic Management Model

The humanistic management model is a theory in management that places human needs and values in the government of daily organizational activities. The model was developed in the early 20^th century in reaction to scientific management models in the preceding period that valued production and profits over any other element (Mele, 2016). Scientific management was widely criticized for deeming human resource as mere inputs that are necessary just like capital inter alia in the production process. The model was contemptuous to the complex needs of people working in organizations, and advocated for long working hours, measurement of production and other mechanisms of getting the most out of people (Melé, 2013). Alternatively, the humanistic management model focuses on valuing people and their values, identifying their needs and keeping them happy in order to gain their loyalty and commitment to the organization. Simply put, humans are the most important resource in the humanistic management model.

There are three building blocks of the humanistic management model that underpin its application. These include ethics, human dignity and stakeholder involvement (Mele, 2016). Under ethics, the humanistic management model seeks an ethical relationship between employees and the company and vice versa. This incorporates ideas of business ethics and corporate social responsibility (CSR). While the issue of CSR is quite straightforward in the business context, ethics remains a highly convoluted, yet important topic. Many businesses today have fallen out with their customer base and regulatory frameworks due to lack of ethical decision making. Treatment of workers, salaries and wages, business models and so forth are all issues that have bordered on ethics, with far reaching implications (Melé, 2013). In applying the humanistic model, businesses must critically examine ethical issues and pay attention to making ethical decisions. This is even more profound in healthcare, given the complexity and gravity of ethical issues involving life. Human dignity on its part emphasizes on humane treatment of employees and clients in the organizational settings regardless of their characteristics or context. For employees, it may mean reorganizing the organizational structure to offer more autonomy and control to employees over their functions. This will create high levels of job satisfaction and translate to ethical and professional treatment of all clients utilizing the services of the organization. Stakeholder involvement on the other hand involves scanning the environment and understanding the stakeholders and their categories in the workplace. Stakeholders are any groups of people that are affected by the decisions of the management. They may include employees, patients or the community at large. There should be efforts to ensure that they are consulted at all times if humanistic management was to suffice. Therefore, human dignity, ethics and stakeholder involvement are the hallmarks of humanistic management.

Notably, there are various challenges in operationalizing the above management model. First, both private and public organizations have to balance all aspects with productivity. In healthcare, quality is a major consideration which may call upon ample supervisory roles. It may therefore not be possible to offer the desired level of employee autonomy under humanistic management. Additionally, medically errors are quite grave and may mortally affect patients which call for strict regulatory mechanisms. Elsewhere, ethical issues have no clear decision making formula and require an ad hoc approach (Mele, 2016). Therefore, satisfying ethical compliance can be quite a long shot in humanistic management. On the aspect of stakeholder involvement, it may be impossible to identify all the stakeholders in a case scenario. However, healthcare managers must be keen to observe these facets in the most humanly possible manner in order to qualify for humanistic management.

Incorporating Humanistic Management in Practice & Strategic Management

It is soundly important to integrate humanistic management into nursing practice. There are several ways of doing it but the most plausible remains observing professional ethics as a nurse (Melé, 2013). The ethical principles of nursing practice are quite clearly set out and not only cover the ethical element of humanistic management but also integrate the dignity part of it. This is because the latter is a prominent part of nursing and medical ethics at large, and thus is observed automatically when one adheres to nursing ethics. A nursing practitioner observing their code of ethics therefore complies with both the dignity and ethical components of humanistic management. However, it is important to ensure that other parts of the ethical code such as confidentiality, beneficence, integrity among others are also observed to fully comply with the ethical element of humanistic management in nursing. 

Integrating humanistic management into strategic management requires deliberate efforts to involve employees in various stages of the process. Strategic management involves activities such as strategy formulation and strategic implementation, which need to involve employees as major stakeholders in a humanistic framework (Ginter, Duncan, & Swayne, 2013). The management must not assume such activities as their sacred mandate and relegate employees into simply carrying their orders but rather involve them in every core process while planning and making major decisions. Organizational directional strategies can also be a suitable angle to integrate humanistic management. The mission and vision, for instance, can be designed as people-centric and cultivate a culture of valuing people in the organization. This will ensure that all operations and strategies in the organization are in tandem with humanistic management.

Addressing Strategic Issues Using Strategic Management at the Workplace

The strategic management framework offers a credible methodology for resolving the various strategic issues identified at the workplace. To begin with, the issue of healthcare cost both at the angle of harmonizing federal, state and territory funding for cost effectiveness and addressing affordability of care can be resolved through strategic planning. This refers to the process of coming up with clear goals, drawing strategies to meet those goals and using resources to implement them (Ginter, Duncan, & Swayne, 2013). Goals that can be set in this scenario include increasing cost effectiveness by half, while strategies may entail harmonizing all sources of funding in a unified framework. On the other hand, strategic planning elements suitable for addressing affordability include strategic analysis, which helps to identify the reasons behind high costs and how they can be addressed. Generally, the strategic planning element of strategic management can be used to address costs in the practice setting as well as the healthcare system at large.

Indigenous health and demographic changes can be addressed through strategic thinking. This implies the challenging of assumptions, external orientation and scanning the environment to come up with new ideas (Ginter et al., 2013). There seems to be lots of assumptions with regards to several issues affecting indigenous health with the strategies in place proving inadequate in the long run due to poor grounding in facts, historical truth and appropriate theories. Strategic thinking can help resolve this issue by doing away with some of these assumptions and consequently coming up with new ways of improving indigenous health. Elsewhere, demographic changes cannot be resolved with static sets of data but require a constant external orientation with the nurse always taking note of changes and how they impact on care. This will help to understand all trends and therefore prepare adequately to counter them.

On the other hand, health information management requires the simultaneous application of strategic planning and strategic momentum. Specifically, there is need to develop strategies as a nurse through which accurate and secure medical records are maintained for clinical decision making. For matters of technology, the strategic planning element of situational analysis can be used to generate insights of advocacy on technology integration. Situational analysis also helps to identify the latest issues with health records management such as lack of reliable data on indigenous populations and hence plan on filling such gaps (Ginter et al., 2013). Strategic momentum on its part helps to keep tabs with the recorded data for relevance, appropriateness and timeliness. This shall ensure that in the end, the data collected and stored is not just quantitative, but also qualitative. 

Conclusion

In the end, strategic and humanistic management are essential tools that can be used to address strategic issues in healthcare settings. Strategic issues have certain features such as requiring a strategy to resolve, affecting the core objectives and mandate of an entity and alignment with the long term performance of an organization. Humanistic management entails making employees the core of organizational management and recognizing human values and needs in general as an important factor of management. It encompasses ethics, stakeholder involvement and human dignity as the central aspects. As demonstrated in this discussion, humanistic management can be infused into both practice and strategic management. Major issues identified at the workplace that qualified in strategic nature included healthcare cost, demographic shifts, healthcare information management and indigenous health. While healthcare cost can be addressed through integration of strategic planning, indigenous health and demographic shifts require strategic thinking. On its part, healthcare information management requires the mutually inclusive application of both strategic planning and strategic momentum. It is therefore important for all healthcare stakeholders to consider strategic management in their practice settings and how it can be correctly harnessed to identify, analyze and resolve various strategic issues. 

References

Armstrong, B. K., Gillespie, J. A., Leeder, S. R., Rubin, G. L., & Russell, L. M. (2007). Challenges in health and health care for Australia. Medical Journal of Australia, 187(9), 485.

 Ginter, P. M., Duncan, W. D. & Swayne, L. E., &. (2013). Strategic management of health care organisations. In P.M. Ginter, W.D. Duncan & L.E. Swayne (Eds), Directional strategies (pp. 159–194). Chichester, England: John Wiley & Sons.

 Ginter, P. M., Duncan, W. J., Swayne, L. E., & ebrary, I. (2013). Strategic management of health care organizations. In P.M. Ginter, W.D. Duncan & L.E. Swayne (Eds), The nature of strategic management (pp. 3-33). San Francisco, CA: Jossey-Bass.

Macri, J. (2016). Australia’s Health System: Some Issues and Challenges. Journal of Health & Medical Economics.

Melé, D. (2013). Antecedents and current situation of humanistic management. African Journal of Business Ethics, 7(2), 52.

Mele, D., (2016). Understanding Humanistic Management, Journal of Humanistic Management 1 (1) 33-55.

Wissmann, S. (2015). Addressing Challenges to the Health Information Management Profession: An Australian Perspective. Perspectives in Health Information Management, (International issue).