Human Resource Planning for Healthcare

The WHO defines HRH (Human resource for health) planning as "the process of estimating the number of persons & the kinds of knowledge, skills, & attitudes they need to achieve predetermined health targets & ultimately health status objectives".

HR planning is a dynamic process, involves 3 stages; stocktaking, forecasting, & designing temporary workforce. In the first stage of stocktaking, recruitment & selection of key types of employees align with strategic business plan to achieve specific targets. The second stage of forecasting is subdivided into two phases, forecasting future people needs (demand forecasting) & forecasting availability of people (supply forecasting). The third & final phase involves flexible strategy to recruit temporary employees as per need assessment & cost-effective benefits.

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1. Stock-taking: - The principle is to identify how many people are needed at every level of the organization to achieve business objectives- in line with overall strategic plans - & what kind of knowledge, skills, abilities & other characteristics these people need.

Human Resource Planning for Healthcare

The optimal staffing of modern health services requires many different types of staff. These include; -

1. Clinical workers - doctors & nurses.

2. Technical staff for diagnostic services, such as laboratory & radiology, pharmacy staff.

3. Environment health workers, such as health inspectors.

4. Preventive & promotive staff, such as community health workers, administrative staff, etc.

In a healthcare organization, traditional quantitative approach are used to make enumerative judgments based on subjective managers prediction to allocate certain budgets for employee's payroll expenditure & need assessment of key employee potentiating responsive to organizational system & design. Resource allocations are best executed with the help of activity based cost management, that controls cost & labor required for specific job/event & reduce wastage.

For example: Comparative rates of healthcare activity: -

Inpatient care bed days per capita

Acute care bed days per capita

Acute care staff ratio - staff per bed

Acute care nurses ratio - staff per bed

Inpatient admissions per 1000 population

Acute care admissions per 1000 population

Doctors consultation's per capita.

The types of health staff in a particular country are dictated by the kinds of health services provided & level of technology available.

For example: -

Nature of health organization: primary, secondary, & tertiary.

Types of sector: public, private, non-profit funded organization.

Infrastructure: size of the hospital (200 beds, 400 beds, 1000 beds).

General (multispecialty) or specific care providers (cardiovascular, cancer).

2. Forecasting: -

Demand forecasting: - Planning for the medical workforce is complex & determined by relatively mechanistic estimates of demand for medical care. Dr. Thomas L. Hall (1991) proposed 5 generic methods for estimating demand for health care, such as

1. Personnel to population ratio method: - This method calculates ratio of number of health

Personnel as compared with the population count. However, with inappropriate data available, it has serious limitations, such as it is only applicable with acceptable health conditions, a stable health sector, & a limited capacity for planning.

2. The health-needs method: -This method requires & translates expert opinion about people's health needs to staff requirements. Health needs are derived from the determination of disease specific mortality & morbidity rates. The staff requirements are evaluated from the norms for the number, kind, frequency, & quality of services,& staffing standards that convert the services into time requirements by a certain category of health workers to perform the services. This method initiates the need for sophisticated data system & survey capabilities, & a high level of planning expertise which are not readily available.

3. The service -demands method: -This method accounts the numbers & kinds of health services people will use at an anticipated cost of obtaining them, rather than their professionally determined need for such services. This specifically provides data about economical regression pertaining to utilization of private healthcare sector as compared to government funded health sector.

4. The managed healthcare system's method: - The managed health care system's entails a known client population who would have reasonably good access to health amenities. But flexible socio-political trends & economical recession influence healthcare reform policies.

Supply forecasting: -

Forecasting HR supply involves using information from the internal & external labor market. The calculation of staff turnover & workforce stability indices measures internal supply for HR Planning. External labor market gives detailed spectrum on tightness of supply, demographic factors, & social/geographic aspects.

Internal supply: - The evaluation of the gross number of people needed for a specific job & arrange for other provisions of HR processes, such as training & developmental programs, transfer & promotion policies, retirement, career planning, & others have crucial importance in maintaining constant supply of HR in an organization.

1. Stock & flow model: - This model follow the employee's path through the organization over time, & attempt to predict how many employees are needed & in which part of the organization.

a)Wastage analysis; - This analysis refers to the rate at which people leave the organization, or represents the turnover index.

The number of people leaving in a specific period

Wastage analysis= x 100

The average number employed in the same period

b) Stability analysis ( Bowey, 1974): - This method is useful in analyzing the extent of wastage in terms of length of service.

Total length of service of manpower employed at the time of analysis

Stability analysis=x 100

Total possible length of service had there been no manpower wastage

2. Replacement Charts: - Replacement chart is a list of employee's for promotion, selected upon the opinions & recommendations of higher ranking people ( Mello, 2005). Some replacement charts are more systematic showing skills, abilities, competences, & experience levels of an employee.

3. Succession Planning: - An aging workforce & an emerging "Baby boom" retirement waves are driving the need for new management process known as succession planning that involves analyzing & forecasting the talent potentials to execute business strategy.

Will Powley,senior consulting manager for GE Healthcare's performance solutions group says, that the first step in effective succession planning is a quarterly talent review that begins with an examination of the hospital or health system's organizational chart.

In a 2008 White Paper on succession planning, GE Healthcare identified a few best practices for healthcare for succession planning:

1. Identify & develop talent at all levels

2. Assess top performer's talent rigorously & repeatedly

3. Link talent management closely with external recruiting

4. Keep senior management actively involved

5. Emphasize on-the-job leadership & customized employee development

6. Create systematic talent reviews & follow-up plans

7. Maintain dialogue with potential future leaders.

External supply: - HR managers use outside information, such as statistics concerning the labor market from the organization & external labor market, in other words external & internal statistics.

External statistics: - Graduate profile

Unemployment rates

Skill levels

Age profile

Graduate profile: - There is substantial public sector regulation of all health care markets, & entry to labor market is highly constrained by licensing & professional regulations.

Unemployment rates: - There is lack of economic principles, the role of incentives is largely ignored & supply elasticity in the labor market is mostly unknown & poorly researched.

Skill levels: - Higher education (specialization & super-specialization) are proportionally restricted to limited seats of admission governed by medical regulatory bodies.

Age profile: - The organizational charts of recruitment gives details of rates of recruitment, retention, return & early retirement of employee's, which helps to enumerate future vacancy rates, shortages, & need for replacement.

Internal statistics: - Demographic profile

Geographic distribution

Demographic profile: - Demographic changes (e.g. the number of young people entering the labor force) affect the external supply of labor. Age composition of workforce will force to review recruitment policies. The trend of increasing proportion of women in employment has lead to progressive development of both organization & country.

Geographic distribution: - The attraction of workforce to urban areas are influence by following reasons; employment opportunity, access to facilities - transportation & technology, & others.

3. Temporary workforce planning: -

Herer & Harel (1998) classifies temporary workers as: temporary employee's, contract employees, consultants, leased employees, & outsourcing.

High social costs has initiated work sharing strategy which are flexible & provides more benefits, such as

1. Part- time temporary workers numbers & hours can be adapted easily with low maintenance cost to meet organizational needs,

2. Employees possessing appropriate/ specialized skills benefits functional areas within & outside the organization.

3. No responsibility for exclusive benefit enrollments, such as job security, pension plan, insurance coverage, etc.

In today's work environment, outsourcing can be added as a temporary worker planning technique. Outsourcing requirement is assessed & evaluated on cost & benefit decision. Ambulatory services, pathological or diagnostic testing services, laundry, catering, billing, medical transcription, & others are most commonly outsourcing services promoted in healthcare organization.

Human Resource Planning for Healthcare

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Top 10 Salon & Spa Promotions and Marketing Ideas

1. Networking and Connecting to gain the Leading Edge.

Getting out and making a name for yourself is important. It's not enough to place a sign out front and run an advertisement in the paper and wait for the phone to ring. You are more likely to get business from people who have made contact with you or know you. Participate in your community and join groups where you can network with people in your suburb or town, you'll be able to make connections, get the word out about your salon and spa and bring in some new clients. Get out, meet people and increase your business visibility.

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2. Stealth Marketing

Top 10 Salon & Spa Promotions and Marketing Ideas

Use Viral Marketing to build your brand awareness and enhance your marketing efforts. By using pre-existing social networks like Facebook, YouTube and Twitter you can get the word out and create buzz for your salon and spa. Stealth marketing can encompass social networks, text messages, blogs and blog posting all with the purpose of gaining visibility and increasing your marketing objectives.

3. Email Marketing

As a day Spa, Beauty or Hair Salon owner your client list is a precious asset. Consider the lifetime value of a client. How much does each of your clients spend on average per month, per year and over a lifetime? It costs anywhere from 5 to 8 times more to gain a new client as opposed to retaining your clients. Therefore, you need to place a strong emphasis on keeping existing clients. Keeping in touch with your clients to stay top of mind is important to gain repeat business. Email Marketing is a highly effective way to build and maintain relationships.

4. Praise from Happy clients

The marketing giants use celebrity endorsements (testimonials) to expose their products and give their products credibility and appeal. You too can get testimonials from your happy clients. Identify people who can influence your target market and get them to endorse your treatments and techniques. Get key leaders within your community to try your products and treatments for free and get their feedback in writing. Get their permission to use their feedback, comments and photos in your promotional material.Endorsements can come from friends, the most powerful endorsement is when friends and clients recommend your product or service to another friend. This is powerful word of mouth advertising and more believable than any other form of endorsement.

5. The Power of Free!

We all like getting a little bonus, a gift, a little something extra. Your clients do, too. The acronym "GWP" stands for "Gift with Purchase". As the name suggests, a GWP is an item that is given to your client when she spends above a specified amount on beauty treatments, hairdressing or skin care products. The Gift with purchase (free item) could be anything from cosmetics, skin care products, hair care products, salon voucher, product samples, etc. Free offers for example Buy 10, Get One free, Buy a Facial and Pedicure and Get a Free Manicure adds transactional value and enhances allure. Free introductory offers entice clients to trial a product.  Free offers help with the buying decision and increase sales. 

6. Referral Programs

Getting clients through referrals is one of the best ways to build your business. Have a referral incentive program in place to encourage clients to refer business to you. Having a specific referral program gets people thinking about who they can refer to you. A referral program encourages word of mouth advertising. Make it a habit to ask your clients for referrals. Tell them you would really appreciate it if they could recommend you to anyone who would be interested in a cut/colour/any service you provide." And of course tell them about your referral incentive program - let them know what's in for them. 

7. Effective Words that Sell

Copywritingis the use of words to promote your salon and spa. You know the saying, "It's not what you say, but how you say it. You can tell clients we cut hair, do facial and waxing. Or you can start defining your product or service in a whole new light. Literally turn the spot light on what you say.

Before: We sell xyz products

After: The Best Clinically Proven Anti-ageing Formulation for Fine Lines and Wrinkles.

Before: We do Facials

After: Our Facials will Rejuvenate your Skin, Leaving it Looking Radiantly Healthy and Feeling Absolutely Fabulous.

Every word in every single message, advert and presentation forms a perception, either good or bad. Choose your words wisely. Too many salon and spa owners study what the competition is doing and do and say the same. Make you words count, make them unique, succinct, persuasive, enticing, juicy and delicious.

8. A Niche Strategy to Focus your Marketing efforts

Don't try to be everything to everyone. Focus on your specific niche. Know what makes you different from your competitors. Analyse your competitor's strengths and weaknesses. Offer more value by differentiating your specific treatments and results. One of the biggest niche strategy advantages is the ability to quickly become a dominant player your specific area of expertise. There are salons that cater specifically for rejuvenation, slimming, tanning, hair design, waxing and massage. Niche marketing can be a focused strategy at a niche group such as pregnant women, teenagers, couples, men. A massage and relaxation niche may encompass Yoga, Shiatsu, Meditation and an array of Massage techniques such as deep tissue, Swedish, aromatherapy and Thai massage. Spas are increasingly offering unique services and products to differentiate themselves from the usual facials and body treatments. A new spa niche may be carved out with Asian healing practices and rituals.

9. Win them over and Build relationships

Treat each client like they are special. Listen sincerely to their concerns. Communicate with your clients, what are their interests, likes, dislikes. Educate your clients on the many benefits of your service and products. Have promotional tools such as educational Pamphlet/Flyer/Email/Booklet/Blog/eBook which includes interesting and useful information. Make sure your clients are pampered, comfortable and give them your full attention. Recognise that you serve clients, that client relationship is part of your job. Be helpful, friendly and courteous at all times.

10. Bold & Beautiful Business.

Who gets the attention? Attractive men and women, the loud mouth and the exceptional offer. Start attracting attention to your salon and spa. Have attractive staff with flawless skin, well groomed with full make-up. You think I'm joking, but its fact that good looking people attract more business. And as a salon and spa, you are in the health and beauty business, so your people need to look the part. Would you go to an overweight personal fitness trainer, or would you want the lean muscular trainer? Who gets the attention? The budget salon with posters on the wall or the salon with a gorgeous reception, water feature, glossy magazines, top notch furnishing and finishes. We know that packaging is everything; clients pay big money for professional skin care because the marketing messages tell us its special and the packaging supports the message. Is your salon and spa supporting your marketing message? Attractive people, places and objects are attractive because they literally attract attention and interest. Is your salon and spa attractive and attracting attention? Attractive refers to everything: your marketing messages, the way you answer the phone, answer questions, the way you present yourself, your advertising. It all needs to be bold, beautiful, attractive, and appealing to draw people in.

Top 10 Salon & Spa Promotions and Marketing Ideas

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Warning: Lack of Exercise Is Detrimental To Your Health

You just put in a good 10 hour day in front of your computer screen, and the last thing you want to do is exercise. Let's see, exercise, and improve your fitness level, or sit down with a glass of wine and watch your favorite evening television show. What would you do?

Seventy percent of individuals know they should exercise, but
choose the wine and the television program instead.

Health Promotion

Do you know this simple daily decision can end up being detrimental to your health? According to the USCDC, 54.1% of adults don't do the minimum level of exercise or physical activity recommended for wellness. The slogan "use it or lose it" has never been more true.

Warning: Lack of Exercise Is Detrimental To Your Health

The simple innocent choice of not exercising has shown, in studies, to promote 10 serious health conditions you don't ever want to develop. The bottom line is physical inactivity has a lot of unhealthy implications even at our bodies cellular level. At the cellular level, inactivity decreases
the ability to transfer oxygen from your blood stream to your cells, and also decreases the number of power activating mitochondria. However, the worst cost of not exercising or being physically active can result in the following 10 devastating conditions:

1. CANCER - Studies have shown that fitness enthusiastic men and women who are physically active have a 30 to 40 percent lower risk of colon cancer compared to individuals who are inactive.

2. DIABETES - Studies show lack of regular physical exercise increases insulin sensitivity. Diabetes is considered the "sedentary disease" which is striking people at an alarming rate. If it is not controlled, it can destroy the body's organs.

3. HEART - Lack of consistent physical activity, over time, decreases the function of the heart muscle, affects the blood vessels, including the large aortic artery to the veins and small capillaries. According to many studies, scientists have good reason to believe that regular exercise protects the
heart.

4. STROKE - Regular exercisers are 25% less likely to have a stroke than their sedentary counterparts. Being fit lowers blood pressure, raises HDL cholesterol, and reduces the risk of blood clots.

5. BRAIN - People who are physically active, according to solid evidence, are at lower risk for cognitive decline and dementia.

6. MUSCLES - If you don't exercise on a regular basis, you are at risk of losing some 6 percent of your muscles mass every decade of life from the age of 30 on. This also translates into a 10 - 15 percent loss of strength per decade. Once again, if you don't use the muscle, you will lose the muscle quickly.

7. OSTEOPOROSIS - Fragile bones cause more than 1.5 million fractures each year in the U.S. Bone is like muscle, if you stress it, it responds. If you don't, you gradually lose its strength, and increase your chances of breaking them. Regular weekly strength training can help prevent osteoporosis, and decrease your chances of breaking a bone.

8. MENTAL HEALTH - People who don't exercise on a regular basis are more prone to develop depression. According to a recent study, people who were more active were nearly 20 percent less likely to be diagnosed with depression over the next five years than less active people. Fitness conscious individuals also generally display an improved self esteem, or self image.

9. WEIGHT - If you are inactive, year in and year out, you will eventually gain weight and lose fitness which increases the chance of a heart attacks, and diabetes.

10. IMMUNE SYSTEM - Moderate amounts of exercise reduces the
risk of upper respiratory infection. Regular exercise may boost
immune function.

Now I would like to ask that same question I asked above. What
would you do? Wine and television, or physical activity?

Now for the good news! In as little as 30 minutes of exercise or
fitness work each day, you can significantly decrease your chances of developing any of these horrible conditions mentioned above. This is the best "medicine" any doctor can possibly prescribe!

I hope I have encouraged you to become more physically
active today, and beyond. Your quality of life depends upon
it. Consider these the most important words you will hear
today!

Remember, you have a choice. Make the fitness choice.
_______________________________________________

For information on how to develop a fitness program
which delivers twice the results in half the time, visit
Wellness Word Multimedia Newsletter at http://www.WellnessWord.com
________________________________________________

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Feel free to reprint this article in its entirety in your ezine, Blog, Autoresponder,or on your website as long as the links, and resource box are not altered in any way.

Warning: Lack of Exercise Is Detrimental To Your Health

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Leadership Model For A 21st Century Health Care Organization

There is a growing trend for leaders to break the old autocratic model of leadership to newer models using the concepts of shared and participatory leadership. With the every increasing complexity of health care delivery and the new skilled work force, leaders will have to communicate in an atmosphere where a reaching organization objective is a shared responsibility. According to Bennis, Spreitzer and Cummings (2001) in the future the landscape of health care organization will become more decentralized, which will promote agility, proactivity, and autonomy. Future leaders may move away from singular roles to shared leadership networks that may themselves alter the foundations of the organization. The demands for shared leadership or leaders shifting roles on teams will continue to increase. Health care organization will foster the development and empowerment of people, building teamwork and shared leadership on all levels. The leaders of the future will be guides, asking for input and sharing information. Telling people what to do and how to do it will become a thing of the past (Bennis, Spreitzer and Cummings, 2001). In the 21st century the dynamics of health care will offer leaders who have the ability to motivate and empower others a platform to maximize an organization human resources. Leadership will have to be committed to encourage a two way communication in which the vision meets both the organizations objectives and the employee's needs. This assignment will develop a leadership model for the 21st century that addresses the role of commitment model of shared and participatory leadership in health care organizations.

Commitment model of leadership

Health Promotion

Fullam, Lando, Johansen, Reyes, and Szaloczy (1998) suggest effective leadership style is an integral part of creating an environment that nurtures the development of an empowered group. Leader effectiveness is simply the extent to which the leader's group is successful in achieving organizational goals (Fullam et al., 1998). In the 21st century health care organizations will need leaders that are committed to developing employees in a team environment. In an environment where leadership is transferable according to objective commitment leadership has a shared purpose. Kerfoot and Wantz (2003) suggested in inspired organizations where people are committed and excited about their work, compliance to standards and the continual search for excellence happens automatically. In these organizations, compliance continues when the leader is not present. This type of leadership requires the team leader to use all available means to create three conditions among individuals: (a) shared purpose, (b) self-direction, and (c) quality work. Leaders who create commitment among their employees believe in creating a shared vision that generates a sense of shared destiny for everyone (Kerfoot & Wantz, 2003).

Leadership Model For A 21st Century Health Care Organization

Involving others in leadership is a unique process which is deeply rooted in individuals believing they are a part of the process of meeting organizational objective and purpose. Atchison and Bujak (2001) suggest involving others in the process is important because people tend to support that which they help to create. People resent being changed, but they will change if they understand and desire the change and control the process. Sharing information promotes a sense of participation and allows people to feel acknowledged and respected (Atchison & Bujak, 2001 p. 141).

Toseland, Palmer-Ganeles, and Chapman (1986) suggest when individual leaders cooperate and share their expertise and skills, a more comprehensive decision making process can be achieved rather than when leaders work independently. For example, in a geriatric team, a psychiatric nurse may lead a group focused on heath concerns, a social worker may lead a therapy group, or a mental-health therapy aide may lead a structured reality-orientation group (Toseland et al., 1986). Shared commitment form the leadership in the future will help to develop, coordinate, and integrate the complex and ever changing health care setting for the 21st century.

Respect for authority and work ethic

Haase-Herrick (2005) suggested shared leadership gives the opportunity to enhance or build trust among individuals. Leadership is mobilized around refining the roles of individuals creating positive health practice environments that support the work of the group (Haase-Herrick, 2005). Leadership ability to lead a team in ways that build morale and reinforce work ethics empowers others to perform to their potential in a group. Leadership is the ability to lead individuals towards achieving a common goal. Leadership builds teams and gains the members shared commitment to the team process by creating shared emotion within the group (Pescosolido, 2002).

Collaboration among leaders in health care

There are new models that are emerging which add a new perspective on how to produce effective collaboration within leadership. Wieland et al., (1996) discussed transdisciplinary teams in health care settings, where members have developed sufficient trust and mutual confidence to engage in teaching and learning across all levels of leadership. The collaborating is shared but the ultimate responsibility for effectiveness is provided in their place by other team members. The shared responsibility for example might be a situation where clinicians on a team each serve in a leadership role regardless of their particular disciplinary expertise (Wieland et al., 1996). The shared commitment model of leadership allows for the independence and equality of the contributing professions while pressuring team members to achieve consensus about group goals and priorities. It is important to emphasize the importance of collaboration in a complex and changing health care environment. The focus on the primary purpose for partnership of leaders will ultimately rest on the shared belief in meeting organizational goals though a collaborative effort. Atchison and Bujak (2001) suggest it is important to reemphasize the importance of keeping everyone informed on the primary purpose of achieving success though a collaborative effort. Clarifying expectations and specifically illustrating how proposed changes are likely to affect the participants is important in achieving commitment leadership (Atchison & Bujak, 2001)

Leadership competency on all levels

The ability to lead in the 21st century requires leaders to be competent in motivating and empowering others to perform to their maximum potential. According to Elsevier (2004) leadership is the ability to lead a team or number of individuals in ways which build morale, generate ownership and harness energies and talents towards achieving a common goal. The leadership competency is all about motivating and empowering others while accomplishing organizational objectives. Leadership is the vehicle in which the vision is clarified though the encouragement of two-way communication on all levels of the organization (Elsevier, 2004).

Leaders in the 21st century will have to be competent in identifying change as they occur and encourage others to adjust to those changes for the mutual benefit of achieving objectives. Elsevier (2004) suggest leaders will have to be comfortable with change because which change comes new opportunities for collaboration among followers and peers (Elsevier, 2004). Improving the results of change initiatives while making sure those changes are fully understood will be a priority for leaders who choice to lead by commitment leadership.

Leadership as a changing agent

Longest, Rakich and Darr (2000) suggest organizational change in health care organization does not occur absent certain conditions. Key are the people who are catalysts for change and who can manage the organizational change process. Such people are called change agents. Anyone can be a change agent, although this role usually is played by leadership. Change agents must recognize that any organizational change involves changing individuals. Individuals will not change with out motivation introduces by the changing agent. The changing agent must create a body of shared values and attitudes, a new consensus in which key individuals with in an organization reinforce one another in selling the new way and in defending it against opposition (Longest, Rakich and Darr, 2000). As health care organizations change in the 21st century successful leaders must have the skills that are necessary to make change possible with in teams of individuals. Longest, Rakich and Darr (2000) suggest one of the important category of change is team building or team development, which "remove barriers to group effectiveness, develop self sufficiency in managing group process, and facilitate the change process (Longest, Rakich and Darr, 2000). A leader who leads by commitment must seek to minimize the resistances to change by building a consensus of objectives with in the organizations culture.

Conclusion

Leadership in the complex health care environment in the 21st century will need individuals to be committed to the promotion of team effectiveness. Sarner (2006) suggest leadership is a "power- and value-laden relationship between leaders and followers who intend real changes that reflect their mutual purposes and goals." In plainer language, leadership is the dynamic that galvanizes individuals into groups to make things different or to make things better -- for themselves, for their enterprise, for the world around them. The essential components of leadership have remained more or less constant: intelligence, insight, instinct, vision, communication, discipline, courage, constancy (Sarner, 2006). In the 21st century leaders must know how to gather, sort, and structure information, and then connect it in new ways to create clear objectives that satisfy both the organization and individuals needs. The important skill that can be learning during this process of leadership is the ability to listen to colleagues and collaborators for the sole purpose of foster a shared consensus. In order to communicate a vision in the future a commitment leader must work with others and sometimes defer some part of the leadership process to ensure organizational objectives are achieved.

References

Atchison, T. A. & Bujak, J. S. (2001). Leading transformational change: The physician-executive partnership. Chicago, IL: Health Administration Press.

Elsevier, R. (2004). Leadership and change orientation. Competency & Intelligence 12(2), 16-17. Retrieved October 8, 2006 from http://web.ebscohost.com/ehost/delivery?vid=14&hid=16&sod

Haase-Herrick, K. (2005). The opportunities of stewardship: Leadership for the future. Nursing Administration Quarterly, 29(2), 115-118. Retrieved March 23, 2006, from Ovid Technologies, Inc. Email Service.

Kerfoot, K., & Wantz, S. (2003). Compliance leadership: The 17th century model that doesn't work. Dermatology Nursing, 15(4), 377. Retrieved June 3, 2005, from http://proquest.umi.com/pqdweb?index

Longest, B., Rakich, J. S. & Darr, K. (2000). Managing health services organizations and systems (4th ed.) Baltimore, MD: Health Professions Press, Inc.

Pescosolido, A. T. (2002). Emergent leaders as managers of group emotion. The Leadership Quarterly 185(2002), xxx-xxx. Retrieved October 5, 2006 from http://www.unh.edu/management/faculty/ob/tp/Emergent%20Leaders%20as%20Managers%20of%20Group%20Emotion.pdf

Sarner, M. (2006). Can leadership be learned? FastCompany.com Retrieved October 8, 2006
from http://www.fastcompany.com/articles/archive/msarner.html

Toseland, R. W., Palmer-Ganeles, J., & Chapman. D. (1986). Teamwork in psychiatric settings. National Association of Social Workers, Inc. Retrieved May 29, 2005, from [http://www.apollolibrary.com/srp/login.asp]

Wieland, D., Kramer, J, Waite, M. S., Rubenstein, L. Z., & Laurence, Z. (1996). The interdisciplinary team in geriatric care. The American Behavioral Scientist. Retrieved May 1, 2005, from [http://proquest.umi.com/pqdwebindex=1]

Leadership Model For A 21st Century Health Care Organization

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How Traditional Chinese Health Beliefs and Chinese Culture Influence Health and Illness?

Traditional Chinese health beliefs adopt a holistic view emphasizing the importance of environmental factors in increasing risk of disease. According to Quah (1985), these factors influence the balance of body's harmony, yin and yang. These are two opposite but complementary forces and, together with qi (vital energy), they control the universe and explain the relationship between people and their surroundings. Imbalance in these two forces, or in the qi, results in illness.

In order to restore the balance, traditional remedial practices may be needed. For example, excess `hot' energy can be counterbalanced by cooling herbal teas, and vice versa. These beliefs are deeply ingrained among the Chinese, and have been found to be unchanged following migration to Singapore.

Health Promotion

Lee, et. al. (2004), found that patients with specific chronic diseases, namely arthritis, musculoskeletal diseases and stroke, were more likely to use Traditional Chinese Medicine (TCM). This was strongly determined by the 'chronic disease triad', perceived satisfaction with care and cultural health beliefs.

How Traditional Chinese Health Beliefs and Chinese Culture Influence Health and Illness?

Hence the use of TCM is not associated with the quality of doctor-patient interaction. Astin (1998) also agreed that it was seen as being more compatible with the patients' values, spiritual and religious philosophy, or beliefs regarding the nature and meaning of health and illness.

In traditional Chinese culture, taking medication is thought to be aversive, hence medications tend to be taken only until symptoms are relieved and then discontinued; if symptoms are not obvious, medications will probably never be taken.

Apart from parental cultural beliefs, minor side effects of certain antibiotics such as stomach upset may contribute to the poor adherence of medication. The use of "leftover", "shared" antibiotics and over-the-counter purchase of antibiotics by parents are common situations in the community.

They think that their children suffer from the same illnesses judging by the similar symptoms, so they would give the "leftover" or "shared" antibiotics to their children and only bring them to their doctors if there is no improvement (Chang & Tang, 2006). This may cause their conditions to deteriorate and may necessitate aggressive treatments later which may have unnecessary side effects.

However, there are small groups of Chinese who also blamed ill-health or misfortunes on supernatural forces, or on divine retribution, or on the malevolence of a 'witch' or 'sorcerer' (Helman, 1994). Such groups will usually seek cures from their religions.

In Singapore, the Ministry of Health has drawn up the TCM Practitioners' Ethical Code and Ethical Guidelines to prevent any unscrupulous practitioners from preying on their patients and taking advantage of their beliefs, for example, molesting ignorant patients.

The degree of acculturation has been evidenced in the following case. An old man was brought into our hospital with a week-long history of malaise, nausea and vomiting, and sudden jaundice. He was diagnosed to have an obstructive mass in the liver.

A biopsy revealed hepatocellular carcinoma. The serological test suggested chronic active hepatitis B. When the news broke to his son that his father had cancer, he requested not to disclose that to his father.

When we discussed end of life issues such as hospice care and "do-not-resuscitate" (DNR) orders, the son tried to divert the discussion to other issues such as when his father could go home.

Cultural Issues that may be involved in this case are:

The Chinese tend to protect the elderly from bad news.

Believing in karma - the older folk believe that discussing illnesses or death/dying is bad luck. They think that talking about something bad will cause it to come true.

There is an increased incidence of liver cancer resulting from Hepatitis B due to delayed treatment in the elderly, as it may take a long time for them to accept the initial diagnosis.

Reference:

Astin JA. (1998). Why patients use alternative medicine. J Am Med Assoc 1998; 279: 1548-1553.

Chan, G. C. & Tang, S. F. (2006) Parental knowledge, attitudes and antibiotic use for acute upper respiratory tract infection in children attending a primary healthcare clinic in Malaysia. Singapore Medical Journal, 47(4):266

Helman, C. G. (1990) Culture, Health and Illness. Wright, London.

Quah, S. R. (1985) The Health Belief Model and preventive health behaviour in Singapore. Social Science and Medicine, 21, 351-363.

Lee GBW, Charn TC, Chew ZH and Ng TP. (2004). Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs. Family Practice, 21(6): 654-660.

How Traditional Chinese Health Beliefs and Chinese Culture Influence Health and Illness?

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5 Questions to Consider Before Accepting a Promotion

If you are working your way up in the corporate world, then a promotion is probably something that is always in your mind. Because the number of promotion opportunities that you get is limited, depending on the company you are working with and on your performance, it is important to seize the chance right away. However, you should aim for a particular promotion opportunity only if you have already had the chance of studying the additional responsibilities that the promotion entails and if you would be able to handle them. Here are a couple of tips that can help you in assessing whether you should go for a promotion or not and what you need to do before accepting a new role.

1. Check how things played out for the individual who have previously handled the position. If possible, try to ask that person regarding the position to get an idea of the responsibilities that you would be handling. Ask questions about how fulfilling the position was and if he came across any particularly difficult challenges.

Health Promotion

2. Before taking on the promotion, ask yourself whether the position that is being offered to you now is the one that you really want. Is there a possibility of being promoted to another position which is higher or one that entails the duties and responsibilities that you are more interested in doing? If this is the case, what do you think would your impression to the management be if you refuse the promotion?

5 Questions to Consider Before Accepting a Promotion

3. Evaluate the list of new or added responsibilities that the new position would involve. Make sure that they are tasks that you can confidently or comfortably handle. If they are not, do you think undergoing some training would help? If you feel that you would be needing a little training before taking on the new position, check if the management would be able to allow you to undergo some sort of a training program.

4. You should also evaluate whether the responsibilities outweigh the benefits that come with the promotion. This is needed to make sure that you would not be taking on a new role which would bring more money to the table but is too demanding that it could take a toll on your health and personal life.

5. You should also ask yourself whether the position that is being offered to you fit your career objectives. Take your long-term career goals into consideration and assess whether taking on the new role would help you reach your goals faster or not.

Keep in mind that you should not just accept all promotions or new roles that are being offered to you. Many individuals make the mistake of accepting everything that is offered to them without thinking first what their acceptance of the new role would entail. By considering the things that have been outlined above, you would be able to make sure that you are being promoted to a position where you would be able to improve your skills and gain more for your personal, financial and career goals.

5 Questions to Consider Before Accepting a Promotion

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So You Get Passed Over For That Promotion, So What?

It's happened to us all. We go for that promotion, but someone else gets it. We slog away at our jobs, putting in long hours only to be passed over for that promotion. Usually it goes to someone who is great at sucking up to the boss and is as lazy as a lizard on a rock on a scorching hot day. That's life in the corporate world I guess. Nothing is more true than in the world of management. It's a can be a cut throat profession because everyone is so obsessed with having the title 'manager'. However, what can set you apart from being a good manager to a great manager is how you handle being passed over for that promotion.

There are two ways you can react and only one of those reactions will cement your next chance of actually getting the promotion. The first reaction will not get you that promotion. It's happened to me before on several occasions that someone whom I thought was a bit of a parasite got the promotion. When I was younger, my reaction was, "so this is what I get for putting in long hours and trying to prove myself to the company and this bludger gets the promotion when all he does is sip lattes down at the coffee shop and chats all day long to the other staff! What a bloody joke!" That did me no favors at all. All it did was make me loose credibility and make me look very negative. The way I should have reacted was not to be too accepting because that would have made me look like an easy pushover but I should have expressed my disappointment in a professional and dignified manner. Emotional outburst will get you nowhere fast.

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The best way to handle being passed over is to say something like, "I am disappointed because I believe my work ethic deserves a little recognition but I will work harder so I can prove my worth to you". A statement like that can do wonders. You should even go up to the person who got the promotion and congratulate them so that way you project a very dignified manner. Sometimes you may also need to reevaluate your companies workplace politics as there might be something you can do to 'fit in' or 'play the game' a little better. Sometimes, the bigger the workplace is the harder it is to get the recognition that you deserve so that could be a sign to find another company to work for.

So You Get Passed Over For That Promotion, So What?

Keep in mind though that if the person who got the promotion only got it because he was great at sucking up to the boss, he will show his true colors very soon and show that he can't really do the job. I've seen that happen time and time again too. If you handled the rejection in a dignified manner, then guess who has the next best shot at the promotion...yes, it's you.

So You Get Passed Over For That Promotion, So What?

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Challenges Facing Nurse Practitioners

Over the last decade, the changing demands in health care have resulted in a significant demand for Nurse Practitioners. A nurse practitioner (NP) is a nurse with a graduate degree in advanced practice nursing. The NP has completed a nurse practitioner program in primary health care and has advanced knowledge and clinical expertise in assessment, diagnosis, treatment, and health care management. The nurse practitioner provides wide-ranging and constant care to patients in a variety of medical settings.
 
There are a number of challenges facing nurse practitioners. The need for a more flexible and progressive approach to a nurse practitioner's delivery of care is a fundamental challenge.  Much of the work traditionally carried out by general practitioners will need to be delegated to properly trained personnel such as nurse practitioners. This means that the ability to work with the medical profession and with other healthcare professionals is most important to the leadership challenges facing nurses.

This is particularly important in poorer communities where access to a general physician is limited. Nurses in these settings will be relied on in such areas as providing medical advice, assessing illnesses and injuries, screening and categorizing patients, monitoring and care for patients with chronic illnesses, prescribing and interpreting diagnostic tests, health promotion and education, nutritional advice, breast and cervical screening...etc.
 
The challenges that are most significant to nursing staff are to make a distinction with their roles among other health professionals, and provide a service with reliable guidelines about the clinical and effectiveness of their interventions. The Nurse Practitioner degree program is specific in its objectives that includes physical assessment and screening, diagnosis, pharmacology and drug interactions; diagnostics, emotional support and counseling, referral and discharge, case management and employing research and audit to practice.
 
General barriers that nurse practitioners face include prescriptive abilities and regulation of practice. To be able to prescribe would allow patients to be treated quickly and effectively by nurse practitioners who have pharmacology as part of their degree program. The biggest opposition to nurse practitioners expanding roles are physician organizations. They argue that the education does not train nurses to change or enhance their practice abilities, and that nursing programs are not all the same. They say that the programs provide little clinical training.
 
As nursing programs spread across the country and more nurse practitioners become involved in all areas of the medical profession, there is growing demand to modify nurse practitioner programs to quell physician concerns and allow nurse practitioners to take on more responsibilities.
 
Nurses are committed to excellence in meeting and exceeding a quality standard of care. Throughout the world, nurse practitioners are being accepted and respected as essential healthcare providers. Academic institutions are providing quality programs that integrate medical practice and research. The issue is the lack of acceptance and recognition by medical professional associations and legislative bodies. Since health promotion and disease prevention have become a concern throughout the world, in the coming years, nurses are going to be recognized as a valuable and essential asset for the entire medical community.

Health Promotion

Challenges Facing Nurse Practitioners

Challenges Facing Nurse Practitioners

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Universal Health Care - Ethical Issues in Health Care Reform

Universal health care seems to be a hotly debated topic whenever health care reform in the United States is discussed. 

Those who maintain that health is an individual responsibility do not want a system that requires them to contribute tax dollars to support fellow citizens who do not act responsibly in protecting or promoting their own health. They argue that they want the freedom to choose their own physicians and treatments, and suggest that government cannot know what is best for them.  These people argue that preserving the current system with improvements to provide better insurance coverage for citizens who remain uninsured or under insured for their medical care needs is the only reform that is needed.

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Those who believe health care is an individual right support a universal health care system with the argument that every citizen deserves to have access to the right care at the right time and that a government's responsibility is to protect its citizens, sometimes even from themselves.

Universal Health Care - Ethical Issues in Health Care Reform

Two opposing arguments arising from two opposing ideologies.  Both are good arguments but neither can be the supporting argument for implementing or denying universal health care.  The matter must be resolved through an ethical framework.

Examination of the ethical issues in health care reform would require consideration of much different arguments  than those already presented.   Ethical issues would center on the moral right.  Discussion would begin with not "What is best for me?" but rather  "How should we as a society be acting so that our actions are morally correct?"

Ethics refers to determining right and wrong in how humans relate to one another.  Ethical decision making for health care reform then would require human beings to act in consideration of our relationships to each other not our own individual interests.

Examination of some of the common ethical decision making theories can provide a foundation for a different perspective than one that is solely concerned  with individual rights and freedoms. 

Ethical decision making requires that specific questions be answered in order to decide on whether intended actions are good or morally correct.  Here are some questions that could be used in ethical decision making for health care reform.

What action will bring the most good to the most people? What action in and of itself is a good act and helps us to fulfill our duties, obligations, and responsibilities to each other? What action in and of itself shows caring and concern for all citizens?

As the answer to all  these questions, universal health care can always be considered the right thing to do.

The United States is in the most advantageous position there is when it comes to health care reform.  They are the only developed country without a national health care system in place for all citizens.  They have the opportunity to learn from the mistakes that have been made by all the other countries that have already gone down the universal health care road. They have an opportunity to design a system that can shine as a jewel in the crown of universal health care systems everywhere. 

However, all ethical decision making is structured around values.  In order for universal health care to be embraced by all citizens in the United States, they will first have to agree to the collective value of equity and fairness and embrace the goal of meeting their collective responsibility to each other while maintaining individual rights and freedoms. That may prove to be the most difficult obstacle of all.

Universal Health Care - Ethical Issues in Health Care Reform

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