Healthcare management refers to the Act of supervising the functions within the healthcare organization. The managers get tasked with various tasks like providing direction, managing, and offering leadership to all healthcare system units. They ensure service delivery is up to standard. Healthcare systems are operating under pressure because of the increased cost of technologies used in medical services, the aging population, increasing expectations, and budget austerity. To overcome these challenges, a better method of improving healthcare productivity needs to get improvised. The paper focuses on management practices within the healthcare system.
Evolution of the U.S. Healthcare System
Considerable variations are documented within and between countries. According to Bloom's and colleagues' research, United States records the highest management score on average, and the lowest score gets given to India (Bloom et al., 2014). Hospital outcomes get correlated with the type of management score. When the management is effective, the quality of services offered is also of a good standard. Various features get reported to associate with quality management in healthcare.
Firstly, clinically trained managers get higher scores than untrained ones. Secondly, extensive healthcare performs better than small ones. Thirdly, competition is said to improve how hospitals are managed (Bloom et al., 2014). Public healthcare has the lower score on the management sector than the private. These four factors i.e., state ownership, competition, scale, and skills, are interestingly applied in schools, retail, and manufacturing.
From 1750 to 2000, the United States healthcare system evolved to a more complex, bureaucratic, scientific, and technological system called medical, industrial complex (Bloom et al., 2014). Initially, the method used involved simple itinerant doctors, home remedies that had less training. The complex system gets made on technology and medical science as well as medical professionals' authority. Evolution includes the “germ theory” acceptance as the leading cause of diseases, medical insurance advent, doctor’s professionalization, the rise of big institutions of healing and training, and advancement in treating technology (Bloom et al., 2014). Healthcare programs, medical insurance, governmental institutions, drug regulations, and controls too evolved in this period.
Before 1800, medicine was a family affair in the United States (Dovlo, 2016). Women got expected to care for the sick and only on very serious occasions like when a patient had a life-threatening disease were doctors called. Women got also tasked with the role of delivering babies and childbirth. It was so since births were performed at home by midwives. Western drugs got based on Greek four humors ancient principles up to the mid-18th century (Dovlo, 2016). The principle entailed the yellow bile, black bile, phlegm, and blood.
Scientific training and medical degrees physicians showed up in the late colonial era on the American landscape. The first medical college was opened in 1765 by the University of Pennsylvania and in 1781, MMS (Massachusetts medical society) incorporated in physicians licensing (Dovlo, 2016). Physicians were responsible for opening the medical schools whose aim was to raise medical professions' status and improve the medicine in America. Scientific training led to doctors becoming more authoritative and was able to practice medicine where they began to charge a fee for their services.
The early 1800s, physicians in the United States and Europe, began stressing the social conditions and inform people that germs might spread and cause disease mostly in cities (Dovlo, 2016). Most of the municipalities came up with dispensaries that provided medicines and free medical services to the poor. City governments created many health departments after the epidemics of diphtheria, yellow fever, tuberculosis, and cholera. Healthcare policy tends to affect the care quality, access, and cost of care to citizens. For instance, the ACA (affordable care act) policy signed by President Obama in 2010 expanded the healthcare insurance to all United States citizens (Dovlo, 2016). It also reduced the costs and spending people used for healthcare. However, lowering the cost of healthcare led to a quality decreased of healthcare delivery. Healthcare cost and spending have been the priority for the federal and state legislators after evolution generated employers and consumers also results from a redesign in hospital work results in dramatic staff mix changes. The RNs (registered nursesstaffced by 20-50% whereas the unskilled staffs increases (Dovlo, 2016). As a result, the critically ill patients’ proportion is going up in hospitals whereby the only patient with a severe critical illness gets cared for in public hospitals.
Yet another Act that got introduced after evolution is the health insurance accountability and portability. It got enacted in 1996, and it took away some authority from insurance companies (Dovlo, 2016). The companies were limited to the extent to which they could exclude individuals that had preexisting conditions. A company's culture dramatically affects the manager’s attitudes since management gets driven by the company’s culture. The achievement of any given company gets tied to the manager’s capabilities. Managers can influence the business negatively or positively, depending on their drive. Their leadership is also affected by the company's traditions. A company whose traditions are employee-centric, any manager hired tend to possess same attitude (Dovlo, 2016). Company cultures that fail to establish their goals may change managers' attitudes from being positive to negative. Companies that uphold ethical standards match up with a manager with same strong values.
Influence of the Technology and Aged Workforce
The Healthcare industry has had a drastic change in technology, which has affected the labor workforce. Some individuals argue that technology will reduce the need for workers, while others assert that it will, in turn, generate more jobs. However, according to research, the change brought about by technology is non-linear (Karoly et al., 2004). It will either create, destroy, or transform jobs in various phases based on institutions' and societies' ability to support learning and social dialogue. The advances in healthcare technology such as the adaptation of bio- and 3D- printing, use of electronic health, mobile and online apps have demanded physicians to get trained on how to operate the machines and equipment (Karoly et al., 2004). Technology has indeed reshaped how healthcare services get offered to patients.
Technology has thus helped in facilitating care delivery by making the services more accessible. The cost of some of the machines and equipment remain the main barrier since some are very costly. The existing job knowledge and skills have become outdated, requiring new skills and knowledge (Karoly et al., 2004). Training the medical staff has also been costly. The change in retirement policies is leading to an increase in the aging workers. From 2000 to 2010, the number of aged workers got reported to have risen by 46%, which is estimated to increase soon (Dovlo, 2016). Earlier the aged were forced to retire early to pave the way for the young workers. For instance, the Act of social security, which got amended in 1983 increased minimum age of workers from 65-67 (Dovlo, 2016).
There has been a belief that older people have a negative attitude toward technology. They tend to receive what they feel is useful and when the support and training got offered to them. However, it may be costly to train these kinds of people (Karoly et al., 2004). Thus, managers find it simpler to employ younger workers with less experience since the turnover cost seems much affordable than trying to educate the older on how to use the technology (Karoly et al., 2004). Employing inexperienced individuals lead to healthcare services deterioration, and death rates are said to go up.
Three Approaches to Management and Policy
There are three approaches to policy and management in healthcare. The approaches reflect on various technologies involved, complexity degree in service delivery, and objectives. The first approach refers to active listening. The government's desire to present themselves as responsive and technologically advanced towards the community has led to instances where electronic democracy's interpretation gets termed as a thing that is to get delivered to the public (Karoly et al., 2004). The new advanced technologies interactive nature indicates that one of the vital characteristics of technology in healthcare discussion is managers' and workers' open participation. When the listening gets undertaken via the ICT based technology, information to be conveyed travel faster than the traditionally used methods, which improves the responsiveness. The approach has various benefits to the managers as they can gather information way much better without timeframes attached. Managers can listen to other points of view that might be different from theirs, among others (Karoly et al., 2004).
Cultivating is the other management approach that forces them to make use of the existing skills. The need for outside assistance is recognized and appreciated in this approach. Healthcare might offer their workers training to upgrade their skills (Karoly et al., 2004). The approach focuses more on comparing the before and after services to determine the value they add to the patients. Lastly, the steering approach reflects more on the instrumental management project approach to the delivery of policy. The approach tends to be driven by the agency.
In conclusion, managers who are aware of their competency area or preferred approach become more effective in their management process even when various management styles are required. The choice of managers thus determines the success or failure of the healthcare. Positive managers influence the workers positively, which facilitates proper service delivery.
Bloom, N., Sadun, R., & Van Reenen, J. (2014). Does management matter in healthcare. Boston, MA: Center for Economic Performance and Harvard Business School. https://prod-edxapp.edx-cdn.org/assets/courseware/v1/dd428dcc44daa742d5c5c91aeb9dcd21/c4x/HarvardX/PH555x/asset/Management_Healthcare_June2014.pdf
Dovlo, D. (2016). Does Management Matter? And If so, to Who?: Comment on" Management Matters: A Leverage Point for Health Systems Strengthening in Global Health." International Journal of Health Policy and Management, 5(2), 141. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737542/
Karoly, L. A., Panis, C., & Panis, C. (2004). The 21st century at work: forces are shaping the future workforce and workplace in the United States. Rand Corporation. https://books.google.com/books?hl=en&lr=&id=JGZqXL_MJj4C&oi=fnd&pg=PR3&dq=The+future+of+work+in+the+health+sector+International+Labour+Office+&ots=UsKsKTmYVg&sig=x8K5ipYSuvn2tvMtIvI2lOfPlZg
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