Future Challenges in Healthcare Management

ANALYSIS OF THE FUTURE CHALLENGES FOR HEALTHCARE MANAGEMENT           

            Mintzberg observes that management is acquired by acting, practicing the confrontations and prospects of leadership.¹ However, the best and most accomplished are intuitive performers who insightfully know their demeanors, approaches and deeds. In addition, their influence on others, the organization, the ability to look into, review deeply their own performance setting it in a broader context that is enclosed by relevant theories, models and concepts.[1] According to Peter Drucker, health care institutions are among the hardest institutions to supervise. Supervisors are required to expect the results of modern technologies by choosing those that give better returns than costs. They must scrutinize and agree on tricky financial undertakings that give required financial resources without jeopardizing long-term monetary liability. Supervisors are required to resolve internal differences between professionals, thereby regulate rival needs of society, stakeholders, taxpayers, patients and staff.[2]

            Smith and Walshe observe that very developed country health care system will be faced with four unavoidable challenges. Namely:

Ø  Population change

Ø  The rate of technological development

Ø  Shifting user and customer needs; and

Ø  Increasing prices under international fiscal depression.

The population change means as people tend to live longer, the population of aged people increases at a fast rate. The elderly comprise usage of health care institutions much more because of their degenerating body functions. As people live longer the cost to keep them alive and the likelihood to develop complicated and persistent illnesses increases.[3] World Health Organization postulates this as a result of health hazards such as cigarette use, unfitness and proper eating habits.[4]

      The rate of technological development relates to population change in that it mirrors the upward ability to contain persistent illnesses therefore extends life. By increasing technological advancements in pharmaceuticals, surgery, diagnostics and service delivery through cell phones new ways of managing disease and cure are discovered each day. Largely, this means treatment methods that are not only effective, but unfortunately quite expensive to administer than the existing ones.

      Nowadays people need more from health providers in terms of service delivery than their parents needed. They are not satisfied with the traditional reception of health service prescribed and distributed by the health providers. They want to know exactly what is ailing them, ways to prevent relapse and so on. Like any other areas of specialization such as banking, housing, education, they expect to be consulted and up to date since they are the end users. This represents a population that has more information, is coherent and likely to be informed and ask for new and exorbitant treatments.

      The increasing cost of health care is the result of the three challenges highlighted earlier. Each of the challenges exerts pressure for more funds. Even under acute international fiscal depression, governments have little or no alternative but to increase their spending on health facilities which never seems to be enough. This normally forces governments to reduce spending on other equally important economic sectors such as education. Over the years innovation of better and cheaper computers, cars and banking have been witnessed. On the other hand, health care costs are quite high and continues to rise along with the demand for it.

      A report by Andrea Chipman for the Economic Intelligence Unit observes Africa as home to the world’s poorest populations and at the same time grappling with numerous health crises. The report continues to assert that terminal ailments are now being matched by preventable communicable and parasitic diseases. It identifies the mode of funding as inadequate in the health care delivery system. Government expenditure continues to be insufficient while international funding looks uncertain in the current economic environment. Lack of adequate public health care means the poorest Africans have little or no access to care. Moreover, they sometimes lack the basic requirements of health such as clean water, sanitation and balanced diet. This provides a major challenge in managing healthcare in the continent[5]  

      Global health care systems are at a verge of change. The transformations that countries carry out in the next few years will be important to reducing the mortality rates especially in developing economies. As more and more people become informed health care measures especially with the increased use of the internet, governments must be at the fore-front to provide sufficient, quality and timely health care solutions. Medical students should be taught managerial skills to assist in the management of health delivery institutions.

Bibliography

Chipman Andrea. The future of healthcare in Africa .Economist Intelligence Unit. The Economist http://www.economistinsights.com/sites/default/files/downloads/EIU-Janssen_HealthcareAfrica_Report_Web.pdf [accessed June, 17 2014]

 Baker R.G. PH. D (n.d) Healthcare Managers in the Complex World of Healthcare, 24 www.researchgate.net/Healthcare_Managers/9c96052aca [accessed on June, 17 2014]

Mintzberg, H. Managers Not MBAs. London: Prentice Hall, 2004

Peck, E. Organizational Development in Healthcare: Approaches, Innovations, Achievements. Oxford: Radcliffe Medical Press, 2004

Smith Judith and Walshe Kieran. Introduction: The current and future challenges of healthcare management. https://www.mcgraw-hill.co.uk/openup/chapters/9780335243815.pdf [accessed June, 17 2014]    

World Health Organization. Preventing Chronic Diseases: A vital investment, Geneva. WHO, 2005

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[1] Peck, E. Organizational Development in Healthcare: Approaches, Innovations, Achievements.(Oxford: Radcliffe Medical Press,2004)

[2] G. Ross Baker. PH. D (n.d) Healthcare Managers in the Complex World of Healthcare, 24 www.researchgate.net/Healthcare_Managers/9c96052aca [accessed on June 17, 2014]

[3] Judith Smith and Kieran Walshe. Introduction: The current and future challenges of healthcare management. https://www.mcgraw-hill.co.uk/openup/chapters/9780335243815.pdf [ accessed June 17, 2014]

[4] World Health Organization. Preventing Chronic Diseases: A vital investment. (Geneva. WHO, 2005)

[5] Andrea Chipman. The future of healthcare in Africa .Economist Intelligence Unit. The Economist http://www.economistinsights.com/sites/default/files/downloads/EIU-Janssen_HealthcareAfrica_Report_Web.pdf [ accessed June 17, 2014]

Scenario Thinking

An Article on Scenario Thinking

Scenario thinking also known as scenario planning is described in WIKIPEDIA (2013) as “a strategic planning method that some organizations use to make flexible long-term plans. It is in large part an adaptation and generalization of classic methods used by military intelligence.” (WIKIPEDIA 2013). Scenario thinking is based on a model that is drawn like a cross with the X-axis representing one variable and the Y-axis representing another variable. According to WIKIPEDIA, introduction of scenario planning is attributed to Herman Kahn through his work for the US Military in the 1950s at the RAND Corporation where he developed a technique of describing the future in stories as if written by people in the future.”

Scenario thinking or planning can further be described as the experimenting to find out how something or someone change or behave when certain variables are shifted. Scearce,D. Fulton, K. and the Global Business Network community (2004) notes that “ scenario thinking is a tool for motivating people to challenge the status quo, or get better at doing so, by asking “What if?” Asking “What if?” in a disciplined way allows you to rehearse the possibilities of tomorrow, and the to take the action today empowered by those provocations and insights” (Scearce, D. Fulton, K. and the Global Business Network community, 2004, p.3)

Benjamin Franklin once remarked thus, “Only three things are certain in life, birth, death and taxes.” To add to that, I say change. Bruce Sterling a science fiction writer argues, “Futurism is the art of reperception. It means recognizing that life will change, must change, and has changed, and it suggests how and why. It shows that old perception have lost their validity while new ones are possible.”

Scenario thinking at a glance may seem as a complicated economic concept that is the reserve of economists. An example will help de-mystify this concept. Imagine you want to measure the economic development of your country.

You grab a piece of paper and draw two lines. One vertical running on the left hand side of the paper from top to bottom. Draw another horizontal line from the base of the first line running from left to right. Now you have a sample of graph paper with x-axis and y-axis.

Now name the y-axis at the base, “Bad Governance and at the top, “Good Governance.” Likewise, name the x-axis at the base, “Weak Economy” and at the far end, “Vibrant Economy.” Note that the x-axis will represent economic development.

Next, draw two diagonal lines one starting at the base of the intersection between the two lines running from left to right. The other diagonal line starting from the top of the y-axis running diagonally from left to right. The result is a diagram similar to that of a supply and demand curves as used in economics.

Now assume the supply curve to represent the effect of good governance brought about by for instance democracy, peace, and order etcetera. You will notice that as you move further and further away from the base of the curve the resultant effect is a vibrant economy or economic development. The reverse being if there is bad governance the result is a weak economy or stalled economic development.

Let the demand curve represent enemies of development for instance war, anarchy, corruption. In addition what you notice is that as we move further from the top of the curve  towards the far end down along the curve, represents better economic development and vice versa. The intersection of these two curves will represent the equilibrium; the point at each economic development is at any particular time.

It follows that scenario thinking is a concept that can be used on any kind of situation in our lives so long as we have shifting variables. It is important to note that various assumptions are made while using this model.

REFERENCE

Global Business Network. Available from: http://www.monitorinstitute.com/downloads/what-we-think/what-if/What_If.pdf [Accessed: 12/04/2013]

SCEARCE, D. FULTON, K. AND THE GLOBAL BUSINESS NETWORK COMMUNITY (2004) What if? The art of scenario thinking for non-profits [Online] Available from: http://www.monitorinstitute.com/downloads/what-we-think/what-if/What_If.pdf. [Accessed 12/4/2013]

WIKIPEDIA (2013) [Online] Available from http://en.wikipedia.org/wiki/Scenario_planning [Accessed: 12th April 2013]

Psychology In Practice

Gestalt Therapy in Practice

Edwin Nevis describes gestalt therapy as "a conceptual and methodological base from which helping professionals can craft their practice." In the same content, Joel Latner stated that Gestalt therapy is built upon two central ideas: that the most helpful focus of psychotherapy is the experiential present moment, and that everyone is caught in webs of relationships; thus, it is only possible to know ourselves against the background of our relationship to the other. Latner, J. (2000) The theory of Gestalt Therapy, in Gestalt therapy:Perspectives and Applications, Edwin Nevis (ed.) Cambridge. MA: Gestalt Press

 

Gestalt therapy, although looked upon rather suspiciously by many people, grows ever more popular and widespread over time, and begins to be well known to people who are generally very far from the problems of psychology. Here is the exemplary account of one of cases when it helped a person to develop her inner potentials and make a decision that changed her life.
A woman in question, for the purposes of convenience let’s call her Jane, moved to the new place of residence in another town and only managed to get a job of boiler-house employee, because there were not much job opportunities for outsiders. After a while, she entered a course of Gestalt therapy, which was formed along the following pattern. All the participants of this group therapy in turn communicated with the psychologist who directed the course, and were told to form images of two living beings: the one that they liked and the one they disliked. Jane liked “the fox” (for being cunning, brave and active) and disliked “the hen” (for being passive, silly and inert).
The idea of the therapy is that the liked image is what the person wants to become, while the disliked one – what she is. Over the course of communication with the psychologist, the patient and the whole group come to a decision how close the patient is to his or her desired image. In two subsequent sessions the patient imagines herself to be what she likes and what she dislikes in turn; in the course of this study, the patient together with the psychologist decide what keeps the patient from becoming what she wants to be, what makes her resemble the disliked image, what hampers her when she imagines herself to be what she likes.
The connection between the two images led the group to decide that the thing that kept Jane in the image of a hen was her job, and that her real aspiration in life was to start a center for children’s development. Jenny followed that idea and started such an establishment with surprising (for a former boiler-house employee and a resident of a town with population less than 10,000 people) success. Thus, we can see how this therapy is able, by means of a series of seemingly senseless procedures, to define the underlying motives of a human being and direct him or her accordingly.

I Fear This Might Be Overlooked

LEST YOU FORGET

Many are the times we are tempted to disregard the little things that happen in our lives. We are unaware and take for granted the things we do automatically.

Consider this: you are not aware of how important your left shoe is until you cannot trace where you kept it the last time you wore it. You are probably unaware of the importance of your right hand until you lose it. What about that friend that you have always scorned, ridiculed, ignored or maybe gossiped about? What about him? You may not know his importance until you lose him. What about your talents, your God-given gifts or abilities? You may never know about them unless you explore them.

It is my firm conviction that every human being has a passion for something, has some talent, or is gifted in something. Our levels of exploring the gifts bestowed upon us are what set the world apart from mediocre people. Statistics show that we mostly only utilize 5% of our brainpower in our lifetimes and the other 95% goes down the drain. I beg to ask then, why have the 95% for it to be wasted? We either do not know or are unaware of our potential or are simply in the wrong kind of profession. It is true that there are some multi-faceted people among us, meaning one can be a very talented brain surgeon for instance and still be a very good writer. I am reminded of one Dr. Yusuf Dawood. He juggles between an extremely busy medical schedule and still has time of his favorite pastime, writing. His passion for writing knows no limits. He is a regular columnist for The Sunday Nation a local daily and writes a column called “Surgeons Diary” every Sunday. Why are you not using your full potential? Why let 95% of your abilities just go down the drain? Remember the simple rule is, for whatever you do not you lose it automatically. It is that simple. You fail to use anything that is dealt you; you lose it. That is the rule.

Hence, each day we should strive to discover our own abilities. We should endeavor to explore all possibilities of survival because as someone rightfully put it, “it is a jungle out there.” Our world is full of heroism, selfishness malice and jealousy that we must carefully wade through in our everyday living. We must strive to find our place in this vast room we call life and draw our cards cautiously lest we forget our purpose and sense of direction in our quest for achievement.Live a full life.

Let us in our own personal way seek to be an equal among equals.

By Chris K. Kihara

THE AGONY OF DECISION

THE AGONY OF DECISION It’s often said that a decision has to marinate before we can make it. But is that really true? We can never have all the facts and information to make a decision because if we did, it wouldn’t be a decision but a foregone conclusion. Each one of us is caught up in a state of indecision at one point in our lives. Being caught between a rock and a hard place. That’s very normal. But the problem comes when we cannot quite arrive at a decision because we claim we don’t have enough information- called the agony of decision-making. Sometimes we cry out with the indiscriminate plea-do something-anything-just do something. It is quite okay to make decisions for some of them to be wrong. But it’s quite detrimental, at least to you to just sit around and do nothing. Sometimes we have already made the decision in our minds but are not sure why we made those choices. It’s held that there is nothing like indecision. You either decide or decide NOT to decide. I agree with that school of thought. The only reason we seem undecided is because we are seeking to know we made that choice. This is more often than not a futile exercise. I believe in our bid to be at peace with ourselves we should first seek to listen to our innerself. That inner voice that speaks to us. If the choices we make in our daily life, about friends, about partners, about careers, about thought patterns satisfy our spiritual needs and are not necessarily harmful to society, then for goodness sake lets make them. There’s only one basic human right, the right to do as we please so long as it does not harm anyone. With it carries the only basic responsibility, the responsibility of being ready to accept the consequences of our actions. Lets us endeavor to be happy. Lets is seek friends, careers, and partners who make us achieve inner bliss. Let us understand that there will never be anything that is universally acceptable by all as good for us. Let us be borrow a leaf from the old adage; ‘one man’s meat is patently another’s poison. But above all let’s be guided by the golden rule; Never do unto others that which you wouldn’t like to be done to you. Then and only can we be at peace with ourselves BY CHRIS K. KIHARA

The Standard | Online Edition :: Life has given me a second chance

The Standard | Online Edition :: Life has given me a second chance

Tafakari haya

There is nothing as indelible as the memory of failure

chriskihara: Making a Life

chriskihara: Making a Life

Making a Life

We've multiplied our possessions, but reduced our values
We talk too much,love too seldom,and hate too often
We have learned how to make a living,but not a life
We've added years to life,but not life to years
We've been all the way to the moon,but have trouble crossing the street to meet a new neighbour.
We've conquered outer space,but not inner space
We've cleaned up the air,but polluted the soul
We've conquered the atom but not our prejudice
We write more,but learn less,we plan more but accomplish less
We've learned to rush,but not to wait.Becoming a successful human being is in the little things that are really the big things- in how we treat others,in how we meaningfully spend our limited time and in the enduring legacy that we eventually leave behind.Entails leaving a trail- It entails making a life and not a living.

The Paradox Of Our Times

The paradox of our times in history is that we have taller buildings,but shorter tempers,wilder freeways,but narrower viewpoints. We spend more but have less, we buy more but enjoy less,.We have bigger and smaller families, more conveniences, but less time. We have more degrees, but less sense,more knowledge but less judgement, more experts yet more problems,more medicine but less wellness...... Called the paradox of our times

The art of existence

It is wrong to claim that we are not busy. We do not have to be pre-occupied performing some task that necessarily involves strenuous physical exercise to claim we are working,or to be mentally exhausted to claim have worked.The whole business of living is working.The simple act of getting through each passing day is to have worked, called THE ART OF EXISTENCE.THE ART OF LIVING. So simple yet so hard.

I Gave Reality A Human Face

In the misty and hazy situations
that life brings along
I watch as happiness passes me by
happiness stares me in the face
yet I fail to see it in its true self
I look for fulfillment in all the wrong places
I hope an' think I will be satisfied with worldly things
I think money-lots of it
means happiness like no other
I nourish all my physical needs
yet I still feel empty inside
For a while I wonder why,
then I realise all this is useless,
useless if I don't learn to satisfy my inner self
my soul,my spirit
useless if I don't learn to share it;
to share it unconditionally
to share it abundantly
to share it expecting no grattitude

I didn't know how to live a fulfilling life
A worthwhile life
to realise that my absense for just a minute
wouldn't bring the world to an abrupt stanstill
I didn't know how to live
till the day I gave reality a human face

by chris kihara

What you sow

We reap what we sow and that somehow fate almost always makes us pay for our malefactions . In the long run,every man will pay the penalty for his own misdeeds. The man who remembers this will be angry with no one,indignant with no one,revile no one,blame no one, offend no one,hate no one- (Epictetus 1BC) If you sow to the wind you reap a whirlwind (emphasis mine)

A Good Friend

A good friend is like a computer....he enters in your life,saves himself in your heart... formats all your troubles and never deletes you from his heart.

Live for today

Happy the man,and happy he alone
He, who can call to-day his own
He, who secure within, can say
To-morrow, do thy worst, for I have
Liv'd today

Live each Day at a time

Sir Winston Churchill once said " A pessimist sees the difficulty in every opportunity, an optimist sees the opportunity in every difficulty" So never stand begging for that which you have the power to earn.

Is Man Headed For Extinction

IS MAN HEADED FOR EXTINCTION?

Social disorder is becoming rife throughout the world. How we cope with it would decide the fate of our species.

Few will deny the proposition that overcrowding also has profound effects on human behaviour effects especially evident in the 19^th century. Until the rise of the city, space sheltered us. We competed, as men will always compete, for the big prices of territory, wealth, position. But as long as space was our vast asset, the territory with a fence around it was an objective all sought with enthusiasm.

Today, however as urban concentration continues to grow and competition shifts from dominance over a piece of space to dominance over fellow men, we encounter a vanishment of prices. Dominant individuals, competing as they must for the dwindling number of dominant slots find their aggressive potentiality becoming increasing uncontainable.

Thus the frustration of urban society are forcing on each citizen knowledge of his own nature: that we never have been and never shall be created equal. There is a lot wisdom when George Orwel in his book Animal Farm observed that some animals are more equal than others, that we get along more because we must than because we want to, that we are an aggressive lot easily given to violence. This we hate.

It has to be noted that the city is not a concentration camp, we freely enter the city - producing overcrowding, which eventually leads to a breakdown in the social structure which in turn calls forth urban disaster.

The paradox of the middle class is best explained by three innate and powerful needs which we as humans share with other higher animal. Arranged here is their order of importance.

1. Identity the opposite of anonymity

2. Stimulation, the opposite of boredom

3. Security, the opposite of anxiety

Increasingly, the achievement of economic security, with the resultant release from anxiety, is producing the bored society. The bored society could not be a total reality; however, were we not also an anonymous society stripped in large part of our opportunity to search for identity.

And hence the frustration of the search for identity from above, just as much as the achievement of security from below, forces us into the unendurable area of boredom – from which we can escape only through stimulation.

Violence, like pornography, is a means of stimulation. It carries with it excitement for both violator and violated, whether through the joyful hatreds of the one or the fearful rages of the other.

An urban riot is worth all the circuses that old-time kings could provide. And just like any other form of sensual shock, to retain its stimulation violence must move on to ever stronger or more novel levels of expression. That adaptable animal, the human being familiarizes himself all too easily to any present situation.

However, in so far as fresh sensory experiences satisfy only our need for stimulation, violent experiences tend to satisfy identity as well. The violent are praised whether the praised be the praise of collaborators or the condemnation of antagonists. The little world of violence is recognized. And within this cancerous world of new fellowship, blooms, a new communication flourishes, anonymity vanishes, and identity again becomes possible.

Nevertheless, however, in seeking identity through violence, we sow the seeds of our own destruction. If you sow to the wind, you reap a whirlwind so to speak. Aggressiveness by definition is the determined pursuit of one’s interests. Violence is the pursuit of such interests through force, or the threat of force. They are not the same.

Without aggression is an inborn force, survival throughout the entire natural world would be impossible. But, likewise, survival dictates aggression's limits. The rules of survival otherwise termed as the social contract dictates the evolvement throughout the many animal species, a body of rules and regulations which while encouraging the aggressive, discourages the violent. The problem of man today is not that we are aggressive but that we are breaking our own rules, in our violence; we are ignoring the social contact.

There are two different expressions of human violence. Namely:

1. The struggles within groups of social partners and the struggles between societies

2. War, which today is either winnable or inclusive.

As neither of these results is satisfactory, human violence, once expressed on the battlefield, is now being transferred to the city streets.

If we are to understand the civil substitute for war which is, riot, sabotage, assassination- then we should first inspect carefully the concept of the stranger.

The howling monkey roars, the spider monkey barks, the lion, without warning, attacks. It’s as though amongst the animal kingdom, invisible curtains hang between the familiar and the strange. The social rejection of strangers is as widespread a characteristic within social species any single characteristic we can study. Members of a limited group of similarities know what to expect of each other, and in such groups sufficient order come easily. But the new comer presents a problem. If his attentions persist he is driven out of a group’s social space and physically attacked.

Thus we have in our genetic make-up the tendency to reject strangers; we also have the propensity for violence. War may be nearly abolished but these tendencies are not. Faced with the question- “How do we get along without war?” We subconsciously transfer energies once directed outwards to the inward expression known as social violence. But such an expression presents an interesting problem. Now we must invent strangers.

The fundamental factor for the invention of strangers has to do with non-communication between those who speak the same language and share the same territory. In today’s society blacks and whites, parents and young, students and faculties, governments and the governed, have shown the workability non-communication, the creation of strangers and the transformation of acceptable aggressiveness into unacceptable civil violence.

A young person with a stone in hand is enjoying themselves. We rush to an accident not to help, we hurry to a fire not to put it out, we crowd around a fight not to stop it. Action and destruction are fun to us.

The concerned on-looker who will not accept this fact indulges in the hypocrisy which we cannot afford. The one who regards a taste of violent action as a human misdemeanor is not likely to make any great contribution to the control of our violent ways.

As one views the causes of violent behaviour rising before modern man, the conclusion that we are finished comes with great ease. Since men can live neither with each other nor without, extinction seems on the cards but any such conclusion is inexhaustible.

The social contact is an arrangement of biological validity. Like the sexual impulse of human diversity, it acts to pressure the species with a power which is far beyond human comprehension, Therefore what is at stake in modern times is not the survival of man, but the survival of the suggestion that man can succeed in social order through voluntary action.

The chances look good, because there is visible through all nature a prejudice in favour of such order. Lions and elephants restrict there numbers so that a habitat will not be exhausted by too many offspring. All such arrangements of animals give simple proof to the preferences for order in natural ways.

Fact: violent sub-groups threaten modern society. But likewise the very complexity of our social interdependence threatens the survival of these groups. The social animal cannot stand alone, least of all contemporary man.

Human foresight, combined with a biological need for order, should take center stage before total social disorder. The question that we cannot answer for now is when shall enough of us see the road to disaster in time?

If we do, then with whatever pain, we shall have to accept various comprises, give up certain rights which we believe sacred. We shall provide honours of identity which we now disapprove control our violent confrontations, within such ritualized aggressions as negotiation, seek to correct those true injustices that lend responsibility to violent arrangements and discourage social applause for the violator.

But what if we do not? What if we lack the will or the vision to see what awaits us?

Several years ago an eminent American journalist and historian Theodore White, wrote a simple comment that ought to be stamped in the minds of every active democracy; ‘If man cannot agree on how to rule themselves, someone else must rule them”.

If we do not have the clairvoyance, if we do not have the will, then we shall find out one day who waits to rule us.

Author: Chris Kihara