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Global perspective on professionalization  of healthcare management

Eric de Roodenbeke

Leadership           …..Is attracting a lot of attention

We need leadership 

but this is not all 

Organizations must be well managed

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Health care management is not at top !!!!

Results from Management Matters project in healthcare

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130

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166

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•Practice scorecard: Operations, performance and people• Interviewed managers & doctors in orthopaedics & cardiology for ~1 hour

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Hospital management: low scores and high variability

Source: http://worldmanagementsurvey.org/wp‐content/images/2010/10/Management_in_Healthcare_Report_2010.pdf

Based on selected items to measure the quality of managementhttp://worldmanagementsurvey.org/wp-content/images/2010/07/Measuring-and-Explaining-Management-Practices-Across-Firms-and-Countries-Bloom-and-Van-Reenen.pdf

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Industry always better than Hospital for management

Source: www.worldmanagementsurvey.org, 22 Dec 2014.

US

UK

Germany

Sweden

Canada

Italy

France

2.2 2.4 2.6 2.8 3.0

INDUSTRYHOSPITALS

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Good management is related with better clinical and financial performanceA one point increase in management practice is associated with:

▪7% reduction in risk adjusted 30 days AMI mortality rates1

▪14% increase in EBITDA per bed

▪0.8 increase in the percentage of people that would recommend the hospital

US Hospitals

UK Hospitals

▪6.5% reduction in risk adjusted 30 days AMI mortality rates

▪33% increase in income per bed

▪20% increase in the probability that the hospital is above average in terms of patients satisfaction

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Who are the managers of healthcare organizations?

Few studies on healthcare management teams profile

Most of the countries have :• high turn over of top management 

• limited consistency between demonstrated achievements and position

• in many cases little/no management education and  dedicated career

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16 Countries Selected for the CAHME study

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Alignment (Education/Recognized Health management Careerist Credentialing is not very high)

delivery organizations 

High alignment between HME  and 

Recognized Credentialing for appointment or 

promotion in health delivery organizations  delivery organizations 

Low alignment between HME  and 

Recognized Credentialing for appointment or 

promotion in health delivery organizations Factors: 

Socio‐economical/Political/Urban/Rural

Israel Australia Sweden India PhilippinesUS UK France Chile Singapore Saudi Arabia China

Spain Brazil Mexico Turkey South Africa

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Better management requires professionalization

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• Professionalization relies on a common body of knowledge and skills

• In a globalized world importance of having similar common ground to increase credibility and impact

• Importance to show results linked to effectiveness of healthcare management. This requires pooled resources to back up a research agenda that is lacking.

• Professionalization means having career paths based on credentials, experience and achievements

• Importance of professional association to raise the profile and provide a voice for media and political arena

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International Hospital Federation

Pan American Health Organization

American College of Healthcare Executives

European Association of Health Managers

Australasian College of Health Service Management

Canadian College of Health Leaders

Taiwan College of Healthcare Managers

Management Sciences for Health

Federacao Brasileira de Administradores Hospitalares

Jamaican Association of Health Services

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The Global competency initiative 

− Health Management Institute of Ireland − Sociedad Chilena de Administradores en AtenciónMedica y Hospitalaria− Federación Andina y Amazónicade Hospitales− Federacion Latinoamericana de Hospitales−Hong Kong College of Healthcare ExecutivesTHET Partnership for Health International Health Services Group University of the West Indies

IHF established a consortium to lead this work

The Global competency initiative consensus 

• Work on a contemporary model that connects with the health needs of society

• Stay focused on developmental needs of individuals

• Agree on fundamental competencies (knowledge, skill and attitudes) for healthcare managers

• Define healthcare management as a profession in countries where it has not been yet recognized

• Promote the formation and acceptance of Health Management Associations within countries & regions 

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Why a Competency directory?There are various frameworks with a lot of ownership behind them no one wants to give them up.

Good News : they have same core content… the difference is in articulating it into categories and outcomes

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Global Healthcare Management Competency Directory

• Achieved after 3 years work

• Crosswalk and consolidation of content from existing competency frameworks throughout the world

• Validated through field review and expert feed‐back

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Agreed on five key domains

• Leadership• Communication and Relationship Management• Professional and Social Responsibility• Health and Healthcare Environment• Business

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Domains and Subdomains

1.  Leadership

A. Leadership Skills and Behaviors

B. Engaging Culture and Environment

C. Leading Change

D. Driving Innovation

2. Communications and Relationship Management 

A. Relationship Management

B. Communication Skills and Engagement

C. Facilitation and Negotiation

Total: 27 Subdomains including 11 in business 

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For each Subdomain, definition of competencies

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Leadership Skills and Behavior (3 statements)• Articulate and communicate the mission, objectives and priorities of the organization

to internal and external entities.• Incorporate management techniques and theories into leadership activities• Analyze problems, promote solutions and encourage decision-making

Financial Management (3 statements)• Effectively use key accounting principles and financial management tools such as

financial plans and measures of performance (e.g. performance indicators)• Use principles of project, operating and capital budgeting• Plan, organize, execute and monitor the resources of the Organization to ensure optimal

health outcomes and effective quality and cost controls

TOTAL: 80 competencies

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Anything new with the directory?

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NO….. We already do this with our fellowship program in Australia. !

YES….. From national we moved to an international body of reference

a major difference for credibility at national level and in international arena. the foundation to expand the professionalization in emerging countries without national biasraising the bar on scope & the level of competencies required

One Directory…. Many possible use

• Instrument for self assessment

• Guiding tool for curriculum adaptation and development 

• Tool for enhancing continuing professional education programs

• Assisting governments and organizations in identifying gaps in management and leadership

• Planning and development of long‐term career pathways

• Provide background for credentialing  healthcare managers – Demonstrated competencies verified by independent evaluation

– Continuous Professional Development translated into a plan

– Professional achievements supported by evidences and testimonies

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Next Steps for this Global initiative

• Get stronger buy‐in in regions where professionalization is still low by developing training activities based on the directory: Latin America, East Mediterranean, (with WHO)… Asia Pacific??

• Advocacy at government level for increased professionalization Global call to action (supported by WHO)

• Work with major professional associations on international standards for credentialing

• Enhance networking between association to share tools and resources for benefit of members 

• Develop common and coordinated actions: research and media through pooling or combining efforts

• Support the development of professional associations in countries where they are weak or non‐existing

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INTERNATIONAL HOSPITAL FEDERATION

info@ihf-fih.org / www.ihf-fih.org

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Thank you