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1300 words essay is needed

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Topic 7

Health Care Case Study 2015

Kirklands Health Authority and the fate of the Health Education Unit

What follows is a scenario, based on actual events. In class (or before classes start), read through and assessthe situation presented. Work with your team in class to identify key players and the primary factors that might facilitate changes with respect to health education services in Kirklands and those that would tend to inhibit change.

The composition of the District Health Authority is that of a partly professional and partly political body with added community representation. It is charged with overseeing all aspects of planning and delivery of health services in the city and surrounding areas with a total population served of about 200,000. It is a heterogeneous area in terms of employment, socioeconomic groups and culture and local political parties are all active in the community, each possessing significant influence and sharing power in local government. Population health status in Kirklands is average for the country and so lifestyle diseases andchronic problems feature strongly in health and social services planning. The Kirklands district is one of manydistricts that make up the government health service,which is a centrally funded organisation under the authority of the Minister of Health. The separation of roles between service provider, purchaser and regulatorhad not yet been accomplished for this area at the time of these events.

Reporting to the Authority, the top management team, responsible for the day to day supervision of operations in the main hospital, clinics and other community health services, includes the Director of Administration(DA), the Director of Finance(DF), the Director of Nursing(DN), the Director of Public Health(DPH), Consultants representatives(C), and several other members(OM).

DA is a very experienced health administrator with substantial knowledge of the diverse operations and services provided in Kirklands, so he is influential in the context of the top management team and day-to-day administration within the Authority. While being extremely confident in his role and keen to maintain organisational stability, he is open minded and can be convinced to support change if a strong and persuasive argument is presented to him.

DF’s primary concern is to maintain order in the financial and accounting system of the Authority and its component departments and to balance accounts appropriately at the end of each financial year, in line with government procedures and targets.

DN is a forceful and experienced character whose primary concern is to maintain and improve the quality of nursing and the clinical care of patients, but she alsoaims to enhance the role of nurses in care and inprevention generally.

DPH is a doctor by original training but is now a qualified Public Health specialist. He is the only member of the management team with specific training in population health. He is an experienced health service professional but is not an especially creative, strong or ambitious manager.

The consultant representatives (C) bring the highest level of clinical and technical expertise to themanagement team and their focus is strongly on advocating provision of the best possible quality of medical services for Kirklands, especially in the hospital departments.

The Health Education department (responsible to the DPH) is led by a fairly experienced health education professional (HE). A range of HE services are offered to various clients and constituencies. They are standard and traditional programmes, competently managed. However, he feels that he and his department are under pressure due to increasingly stringent government budgets and feels threatened by talk in the Authority about cost-cutting. He is angry as he does not feel that his area is recognised by higher management for the important role he believes it fulfills.

One ’community member’ of the Authority is aUniversity representative (UNIV) who happens to be a health services management specialist and an experienced WHO consultant. He takes a serious interest in the management of Kirklands health care services generally and has a special interest in HealthEducation and Primary Health Care. He has conducted research on the development of health care internationally and the way it has changed to encompass broader and more effective approaches incommunity care and health promotion.

Kirklands authority has a new Chairman (C) who is an ex-industrial senior executive and he is seeking to make his mark in this new role. He is a political appointee,has considerable authority and is a strong and assertive character, manager and leader. He is very committed to improving effectiveness in the Authority’s service delivery and, while he is still learning about the specifics of health care, he has quickly become convinced that a major part of the Authority’s servicequality problems lie with key post-holders. Examples of posts he is now scrutinising closely are those of the Head of Health Education (HE) and the Director of Public Health (DPH) listed above.

The university representative and Chairman have a very good interpersonal rapport, based on mutual professional respect and understanding and a wish to move the Authority forward effectively. They sense that Health Education has a role to play, but they are not yet in a position to fully understand and articulate that role and so remain to be finally convinced. They alsoface resistance from other Authority members who have their own service priorities and seek a redirection of budget elsewhere. Each and every area of health care services now has to justify and account for itsannual operations in a way never experienced before.

Continued/

Task 1 (of 2)

Read and discuss the above case study within your teams in class. If necessary, ask for clarification of the background situation. Make notes about likely group dynamics within the leadership team in Kirklands Health Authority. Who will probably be more amenable to change and who more likely to support the status quo? Who is showing power and influence and of what kind? Where do the vested interests lie? What options are there with respect to the future of the Health Education department? What scenarios can you envisage? Which do you think is most likely? The actual outcome in Kirklands will be revealed at the end of this class.