Leadership and Management in Healthcare - Book Report/Review Example

Leadership and Management in Healthcare Offering quality healthcare services depends on the skills and values of healthcare practitioners which are developed through competent leadership and management of health organization. This essay makes a critical analysis of the ideas presented by Donaldson (2001) in order to establish the how the ideas are applicable within the health system in UAE. Donaldson (2001) note the main focus of the paper is discuss the skills and values needed in the clinical profession to ensure maintenance of high standards of safety in addition to establishing effective practices in health organizations that are dedicated to clinical governance. The author further adds that these concerns are essential to organizations all over the world especially those that put patient safety and quality services at the forefront of their operations through inclusion of this skills and values in the clinical curricula. Consequently, the purpose that Donaldson (2001) aims to achieve has the potential of being useful in other health environments outside the UK, including the UAE. To address the issue of skills and values in the UK National Health Service (NHS), Donaldson (2001) first focuses on the role that quality service plays in the establishment of leadership in the health sector. The author notes a number of challenges that the healthcare systems in industrialized countries have faced over the years. The challenges include below capacity utilization of medical interventions with prior records of effectiveness, dependence on outdated methods of patient assessment, existence of a disconnect between outcomes of evidence based studies and application of the findings in medical practice, discrepancy in healthcare access especially for the disadvantaged and lastly, detrimental effects of medical practices and incidences due to errors and unsafe practices. The healthcare standards of UAE has been developed to the standards of most developed countries, therefore, the healthcare standard in UAE has a number of challenges that are similar to those experienced in industrialized nations. Consequently, the UAE healthcare system faces similar challenges that the UK has experienced over the years. However, the UAE has ensured universal access to healthcare through government funding of almost all public health sector engagements. Government funding has made it possible to eliminate the chance that there will be a disadvantaged group in access to healthcare. All the residents of the UAE have a chance to access quality healthcare through the established primary healthcare centers with secondary and tertiary healthcare facilities being access through referrals (Sharif, Al-Shaqra, Hajjar, Shamout and Wess, 2008). Therefore, the UAE has been abreast with the developed countries such as the UK in the efforts of establishing high quality training and education through adoption of the evidence based medicine. Given the challenges that the UK and global healthcare system is grappling with, Donaldson (2001) point out a number of initiatives put in place to develop the quality of healthcare systems in both on the global Scale and within the UK. Among polices and initiatives includes the recognition that the low quality of healthcare provision was due to a medical system and practices that did not depend on medical science. Consequently, Donaldson (2001) claim this recognition led to the creation of the evidence based medicine movement to develop a philosophy of medical practice, education and practice and to develop information technology with the healthcare system. The result of this movement has been development of medical knowledge and how it is managed while also focusing on how this knowledge could be used to improve the quality of health care. The evidence based medicine movement is a new phenomenon in the UAE although it has been able to take shape since introduction in 1998. The UAE is recognized the first nation to introduce the evidence based medicine in the Gulf region through the establishment of a national committee on Evidence Based Health Care in 1998. The introduction of evidence based medicine has promoted the status of healthcare system through training of hospital physicians on evidence based medicine practice. Further, this new framework for the healthcare system has ensured health institutions are equipped with modern equipments such as computers and high-speed internet connections (Al-Almaie and Al-Baghli, 2003). A second initiative to improve healthcare systems according to Donaldson (2001) has been the formation of healthcare organizations that are based on the belief of continuity in quality development. This framework has been able to rally healthcare profession to demonstrate commitment from the top, teamwork, empowerment of staff, prevention of adverse outcomes, provision of customer centered services and the simplification and improvement of healthcare processes. Thirdly, quality of healthcare has shifted to patient safety to ensure outcomes are favorable by reducing errors in medical practices. On promotion of patient safety practice and reduction of errors, the UAE healthcare system has been automated through the establishment of drug information and database system. Healthcare providers are able to generate real-time information on bout patient drug use data therefore; ensuring medical intervention is based on the health history of the patient. Donaldson (2001) examines the shift of healthcare provision towards patient centered practices especially based on the new perception of doctors which is informed by what they do rather than who they are. Donaldson (2001) note focus of healthcare provision is shifting from a practice where medical practitioners make decisions based their own judgment without consulting the patient or next of kin. The author claims such practices demonstrated paternalism while also drawing criticism from the media. This shift in perception of how healthcare is provided will result in a new reality where the citizens see themselves as consumers of services they fund through taxes, and as deserving respect as a partner in healthcare provision. The training and educational system for healthcare providers in UAE is focused on creating a leadership that insists on patient cantered approach. Just as Donaldson (2001) advocates, the UAE healthcare system recognize the right of patient to decide on what is best medical intervention for them. Donaldson (2001) also explores development in the healthcare provision in terms of the accountability of individual practitioner that has been warranted by the focus on quality and patient safety. Individual responsibility in the healthcare sector has been ensured by the establishment of corporate management structure where health sector practitioners are called upon to be committed by fulfilling various goals set by their organizations. This accountability principle according to Donaldson (2001) is shared by individual practitioner, the teams through which they operate and as part of an organization. Therefore, health practitioners will have to develop their core competencies ad skills to meet these needs and levels of accountability. The UAE healthcare system has a number of organizations that ensure accountability of healthcare practitioners. Being a federal state, heath organizations have a hierarchy and authority that is derived from the ministry of education operating at the state level. Other health organizations that provide leadership and management of health organization in UAE include those at the level of emirate such as Health Authority-Abu Dhabi (HAAD) and the Dubai Health Authority (DHA) in addition to the Emirates Health Authority (EHA). These organizations have not been in existence for many decades therefore presenting a challenge in leadership especially when modernizing the healthcare system. Continued creation of new health organizations and regulatory frameworks in UAE has resulted in a situation where the division of powers and authorities among the regulatory entities has been problematic. This is due to the fact that there are overlaps in the role played by different health organizations therefore creating frictions in their functioning particularly in relation to licensing as well as to the monitoring and control of medical institutions. However, Donaldson (2001) notes the necessary changes that will lead to the improvement in quality and safety standards in the healthcare system calls for the development of leadership and management as medical practitioners will take leadership positions in different health organizations. Given the central role that health practitioners will pay in the future, Donaldson (2001) calls for the development of a number of skills essential in ensuring healthcare practitioners transition to the management of health organizations. Combinations of qualities that make an effective clinical manger and those central to leadership are identified as key to this achievement. Donaldson (2001) notes this combination of skills and values representing the qualities of a clinical manager and qualities of a manager are necessary as most health organizations become managed. Holding formal management positions means practitioners have to develop extra skills apart from the regular skills necessary to carry out their duties as healthcare providers. Donaldson (2001) criticizes the trend where health professionals have taken management positions in health organizations with little training. Donaldson (2001) calls for a more systematic approach based on education and training which will transition health professionals into leaders and managers who are equipped with the necessary skills. The increase in government funding for health sector means the UAE healthcare system is expanding rapidly therefore, there is a need for the creation of a mechanism that will ensure effective and efficient management of health organizations (Loney et al, 2013). The ideas presented by Donaldson (2001) on leadership in healthcare system of UK have a number of applicable concepts that can be duplicated in the UAE situation. Health training and educational institutions can find ideas on quality clinical am angers combined with those of quality managers put forward by Donaldson (2001) helpful creating future practitioners who are equipped with the necessary skills and value to improve the quality of services offered to patients. The level of patient satisfaction in the services offered by the UAE healthcare system has been found to have a positive relation with the type of leadership exhibited by the health management (Jabnoun and Rasasi, 2005). Adoption of leadership and management training and education based on the values and skills noted by Donaldson (2001) will ensure provision of quality services in the UAE healthcare system. Even with the available funding by the government, the changes in healthcare system as proposed by Donaldson (2001) might not be attainable in the short time. This is because the changes in education and training curricula take time to design and to put into trial while more time is taken during the training phase. The fact that Donaldson (2001) present the changes as taking place in the future without indicating an implementation framework makes actualization of the ideas a remote reality. In his conclusion, Donaldson (2001) note this changes must be implemented quickly as a way of adapting to the changing world. This might not be possible especially considering the healthcare system in UAE is still developing with most of the available resources coming from the government. However, even without specific framework for the implementation of the ideas of Donaldson (2001) the view provided on establishment of quality leaders and managers are still applicable in the UAE situation. References Al-Almaie, S. M., & Al-Baghli, N. A. (2003). Evidence based medicine: an overview. Journal of family & community medicine, 10(2), 17-24. Donaldson, L. J. (2001). Safe high quality health care: investing in tomorrows leaders. Quality in Health Care, 10(suppl 2), ii8-ii12. Jabnoun, N., & Rasasi, A. J. A. (2005). Transformational leadership and service quality in UAE hospitals. Managing Service Quality, 15(1), 70-81. Loney, T., Aw, T. C., Handysides, D. G., Ali, R., Blair, I., Grivna, M., ... & El-Obaid, Y. (2013). An analysis of the health status of the United Arab Emirates: the ‘Big 4’ public health issues. Global health action, 6, 1-8. Sharif, S. I., Al-Shaqra, M., Hajjar, H., Shamout, A., & Wess, L. (2008). Patterns of drug prescribing in a hospital in Dubai, United Arab Emirates. The Libyan journal of medicine, 3(1), 10-12. Read More