Asia-Pacific Journal of Health Management (ACHSM)
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Going Forward, Going Back: Covid pandemic where to from here?
No full text‘Going forward, going back: Covid pandemic where to from here? It is a collaborative effort that raises concerns and perceptions based on events predominantly but not entirely Australian and the events traversed continue to ‘be in play’ as we write. Some authors also to some extent editorialise in their articles, particularly in contrasting between different nation states approaches to the pandemic. We make no claim to having the solutions but believe we have raised issues that need further consideration in future debate about health systems approaches to pandemics....
In This Issue
No full textReaders should be aware that this Special Covid Issue was not a planned or promoted issue but has been published as a direct result of authors submitting articles on the topic. In fact, some 17 articles were submitted with 13 articles being published. This represents articles predominantly from Asia Pacific countries, some eleven countries that reflect both the authors origin and the health system of the country on which they report.
The decision to publish what amounts to a third issue half way through our normal three issue annual series responds to that demand and a sense that the APJHM should respond to our authors and readers in what is a significant moment in health systems globally. The Journal believes it is important to record the pandemic event as perceived by academics and health professionals so that their voices are heard and that this might provide a basis for further research and publication as events unfurl and the pandemic continues....
Health Leadership Lessons From a Fine Detective
No full textObjective: To explore lessons on leadership from interactions and success of two very fine detectives – Sherlock Holmes and Dr. Watson Methods: From the review of Sir Arthur Conan Doyle's depiction of Sherlock Holmes, some clear and useful lessons have been drawn for health leaders. An erratic, unsystematic Sherlock Holmes and an analytical, systematic and introspective Dr. Watson provide useful lessons for health leaders on trust, teamwork and how complementary abilities enable the achievement of a great outcome. Conclusions: It is really important for health leaders to not forget the elementary message to remain focused on care provision, enable the provision of care that the community wishes to receive and avoid of the temptation of making decisions without appropriate information set to inform those decisions.
Commentary from Dr Neale Fong FCHSM : President Australasian College of Health Service Management
No full textIntroductionAs this unprecedented year of 2020 draws to a close, many of us across the health sectors globally are considering the implications of the pandemic for the way in which we work in the future. While it seems that Australia, New Zealand and some of our near neighbours have wrestled the Covid19 beast into near submission, for much of the world the battle is still unfolding. That global inequity will keep our local health systems on high alert for the coming year.
As leaders we should pause to appreciate what we have been able to achieve for our communities this year in dealing with a multitude of complex challenges.
How we will workDepending on the organisation, large swathes of the workforce are unlikely to shift back to a pre pandemic “business as usual”. Most pundits suggest it will settle into a hybrid model of working where we balance the efficiencies of remote work with the social needs, creativity and innovation generated by working with others.
A key element of this shift to remote working is that managers and leaders know how to manage, coach, collaborate, evaluate performance and motivate a remote team. Another is facilitating a workplace culture of trust and belonging where interpersonal connections are fostered and prioritised. People in management roles will have to undergo a major transformation with a focus on emotional intelligence and social skills. In the past, we promoted and hired people to leadership roles based on their technical skills; in the future, we will need managers who balance their technical and people skills.
One of the key challenges for the health sector will be to transform the delivery of care at pace with the broader world of work shifts that are occurring around us. Policy and delivery will need to stay in touch with the expectations of our patients – shifts to telehealth made possible in a crisis have become a consumer expectation going forward. It is both a formidable challenge and an opportunity to enhance the efficiency of great patient care that awaits all our health leaders.
Together we can support that futureThe College (ACHSM) has pivoted to meet the demands of virtual operations in 2020, changing many aspects of how and when we support our members. Increased and shorter briefings from health leaders via webcast presentations and panels has been welcomed by our members and critical to staying in touch. Branches have been innovative with other forms of virtual learning experiences and the Board has developed and approved a new vision of learning and development value from 2021 onwards.
With credentialling through Certification to commence on December 1, the College aims to enhance the visibility and understanding of the critical role of health leaders in the system. It is through a commitment to lifelong learning that health managers and leaders are best equipped to rise to the challenges and vicissitudes we may need to come to expect from a world where pandemics and the health impacts of climate change are a reality for the coming decades. These challenges compound with the continued need to drive efficiencies to cope with the ageing population.
Together we can support our future by developing, supporting and guiding current and future health leaders. Looking forward to 2021, the College will introduce a new online service where all members can undertake a free self-assessment against the ACHSM Master Health Service Management Competency Framework that generates an individual report identifying strengths and weaknesses. The College will publish and use the de-identified collective data to drive learning opportunities. We will also be reviewing the Competency Framework for its currency and reviewing several of our core free member offerings such as Mentoring. And we look forward to meeting for the National Congress in October 2021 in Canberra. Whilst we transform the way we work alongside you; we appreciate your collegiality and support as we move into a brave new future
The Role and Responsibility of Clinical Pharmacists in Rheumatology Clinic: An exploratory study in Hong Kong
No full textIn Hong Kong, arthritis is the third leading chronic disorder among the older people. It could create a huge amount of burden on the health care system if patients cannot achieve good diseases control and have recurrent flare up of diseases. To maintain stable control and minimize acute flare up, medication adherence is essential. Studies revealed that drug education has the highest evidence in improving medication adherence. Pharmacists who are expert in drugs can provide counseling to arthritis patients, improving their drug adherence and disease activities. As a result, research evaluating the effectiveness of pharmacist counseling service on improving arthritis patients’ medication adherence and disease activities in Hong Kong has been initiated in a specialist out-patient clinic of a local acute hospital.
This research aims to improve patient medication adherence and enhance medication safety. A validated Compliance Questionnaire on Rheumatology (CQR-19) is used to measure the medication adherence. From the preliminary data, over 90% of the recruited subjects are non-adherence at baseline and thus, detailed drug counseling is necessary.
During the first visit, pharmacists will provide a 20 minutes drug counseling service to the referred patients. This includes discussion on drug administration schedule, importance of drug adherence, side effects management and pain management. Besides, pharmacists also have different roles in other aspects such as drug information and procurement. Pharmacists would assist in providing evidence-based information and recommendations to physicians and nurses for drug-related enquiries. These attempts to improve therapeutic outcomes and minimize medication errors, enhance medication safety and reduce hospitalization. Design of the multidisciplinary care model and results of this study would provide a reference for the future development of clinical pharmacist service in rheumatology. 
Extrinsic Rewards, Occupational Commitment, Career Entrenchment and Career Satisfaction of Dentists
Get PDFInformation concerning occupational commitment and career satisfaction of dentists in India is incomplete. Satisfaction of dentists with their profession and commitment towards the profession are important determinants of the future of the dental profession. Therefore, the present study examined the relationship between extrinsic rewards and career entrenchment and occupational commitment of dentists. The study also measured the effect of career entrenchment and occupational commitment on career satisfaction of dentists. Data were collected from 85 dentists of two private dental hospitals of Udaipur city, India. Of the total respondents percent (n=48) 56 per cent were male and 44 per cent (n=37) were female. The age of the respondents ranged from 23 to 56 years. 54 per cent of the respondents were employed in their current jobs for less than 10 years and 46 were in the same job for more than 10 years. The data thus collected was analyzed with the help of SPSS 21 using descriptive (mean, standard deviation, percentiles) and inferential statistics (one way ANOVA, post hoc analysis, correlation and multiple regression). The study revealed significant relationship between extrinsic rewards and career entrenchment and affective commitment of dentists. Furthermore, career entrenchment and occupational commitment were found to be significant predictors of career satisfaction. The study puts forward some suggestion for future research in this area
Implications of New Zealand’s Primary Health Care Policies for Management and Leadership
Get PDFIntroduction: Reforms have been introduced since 2000 to make New Zealand’s health system primary care-led. A competent health management workforce is necessary to provide leadership for the goals of the reforms to be realised.
Aim and objective : To review New Zealand’s key primary health care policies from 2000 to 2016 and consider their implications for management and leadership. Methods : A document analysis was undertaken using qualitative content analysis. Eligible documents were identified through the websites of relevant government and non-government agencies, World Health Organisation, and through Google Scholar. Findings :Two key policy trends relating to primary health care were identified. Firstly, a population health orientation to improve access to health care through community participation, and secondly, an integrated approach to promote collaboration within the health system, and between the health system and other sectors. The inferred management and leadership skillsets required to realise these policies included relationship management and collaboration, change management, and leadership. Conclusion: New Zealand’s primary health care sector underwent substantial reform between 2000 and 2016. Management and leadership capabilities need to be strengthened and developed for the benefits of the reforms to be realised
Does Integrated Healthcare System Reduce the Cost of Quality of Care for Older People? A scoping review
Get PDFThis study provides a summary of published reviews of academic literature on the cost-effectiveness and quality outcomes of integrated healthcare approaches for the older people of Australia. The published English-language literature between January 2001 and July 2017 was retrieved from search results in eight highly resourceful journal databases using the specific terms. The majority studies reported limited information about the cost intervention and quality of outcomes. The benefits of integrated healthcare included patients’ satisfaction, reduction of costs and increasing quality of care. However, the evidence of reduction of cost is varying with the different settings. The home and community-based healthcare for older people have garnered much attention in the past decades in Australia and many researches have been done on it. The majority of the studies focused on defined problems of healthcare service and outcomes, but did not incorporate the priorities of cost-effectiveness or quality of care. Practitioners are interested to understand how the integrated health care approach is achieved and to examine the reduction of cost and quality of outcomes. 
The Accreditation of Human Resources and Physical Space of the Iranian Heart Centre: Comparison to the national and international standards
Get PDFObjective: Standardization of hospital resources and physical space can be an important strategy to increase productivity and effectiveness of services. The study was conducted with the aim of comparative accreditation of human resources and physical space in Mazandaran heart centre compared with the standards.
Method: This comparative descriptive study was carried out in Sari city (centre of Mazandaran province) during 2016-2017. The data collection tool consists of two checklists for investigating the physical space and human resources of the hospital. To evaluate the quality of the content, a checklist was distributed to 5 experts from Mazandaran University of Medical Sciences. After corrections the checklist was applied. Data were analyzed by SPSS software version 16 and descriptive statistics.
Findings: The total number of nurses in this hospital was 288 and the total number of beds was 171. The human resources in the nursing, nutrition, operating room, anaesthesia departments were not standard. The ratio of total human resource to the number of beds was also estimated as 4.04. Results showed that the physical conditions in the hospital were moderately standard. The physical conditions of the hospital in most dimensions based on checklist, except the physical location of hospital and the features of its doors, were in accordance with the standard requirements.
Conclusion: Considering the inappropriate distribution of human resource in the hospital and the non-standard design of physical space for providing services with better quality and increasing patients' satisfaction, it is recommended that experts control more carefully standard requirements
Mapping Isolation of Risk for Sporadic Conditions: Oral cellulitis in Western Australia
Get PDFThe aim of this study was to apply geographic information system (GIS) models to predict risk of oral cellulitis. A risk isolation model using Western Australian real hospitalisation data for oral cellulitis from 1999 to 2009 (10 years), and socio-economic indicators, age and Indigenous status as risk indicators was developed. The fully integrated database was then computer geo-coded to allow the visualization of the data at three levels (core of the capital city Perth, Greater Metropolitan Perth, and State of Western Australia). Correlation coefficient analysis between the number of cases (over 10 years) and the relative risk location indicator was carried out. The GIS maps derived from application of the developed risk location indicator, demonstrate that the risk categorization paralleled the number of cases over the decade. Correlation coefficient analysis demonstrated moderate positive relationship (R2=0.55) between the number of cases (over 10 years) and the risk location indicator in metropolitan Perth