ADVANCED PROFESSIONAL DECISION MAKING

Ineffective communication between the managers and the clinicians in Indian healthcare

Assignment

Dr Senaka Fernando

Assignment
Deadline for submission-05 August 2020, 2pm (UK time) via GRADEMARK ®.

The module is assessed by one essay of no more than 6,000 words,  excluding list of references, tables, figures, diagrams, in-text references/citations, appendices .

In your essay:

Choose a major organisational problem experienced by healthcare/social care organisation(s)/Service(s) and identify real root cause(s) of this problem by applying the relevant theoretical concepts/research evidence (i.e. prior research studies)

Having identified the root cause(s), recommend solution(s) to resolve this problem. Your recommendations should be supported and justified by the research evidence/theory. However, your recommendations should not ignore the practicalities of the situation by outlining where practical difficulties are likely to occur in the implementation of your recommendations

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Part 1

  • Choose a major organisational problem experienced by healthcare/social care organisation(s)/Service(s) and identify real root cause(s) of this problem by applying the relevant research evidence (i.e. prior research studies)/theory.

Part 2

  • Having identified the root cause(s), recommend solution(s) to resolve this problem. Your recommendations should be supported and justified by the research evidence/theory.
  • However, your recommendations should not ignore the practicalities of the situation by outlining where practical difficulties are likely to occur in the implementation of your recommendations

Organizational problem

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ProblemRoot causesSolutions
High cost of servicePoorly design process, poorly trained employeesNew process using business process reengineering Innovative training programme
Low moraleLack of communication between management and employees
High employee turnoverLack of supervision, poor working conditions
High rate of absenteeismEmployees believe that they are not valued

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The chosen problem area

The chosen problem area could be at higher level or lower level

Higher level(generic) – Examples – problem in Mental Health Services , A&Es in India , IT sector in health care organisations in the UK etc

Lower Level – Examples – problem in your department, your organisation, a NHS Trust, a NHS hospital, a ward/unit of a NHS hospital etc

Topic Areas –Examples

Employee Motivation in health and social care

Lack of motivation among nurses in mental health services

Conflict

Poor working relationship between doctors and managers within the NHS

Poor working relationship between doctors and IT professionals

Gendering of work

Women’s career progression in health/social care

Career obstacles for women in medicine

Decision Making

Lack of opportunities in organisational decision making (for doctors, nurses and other healthcare professionals)

Employee wellbeing

Occupational burnout of nurses and the negative effects of it on the delivery of services

Poor mental health among junior doctors

Communication

Ineffective Communication between Nurse manager and healthcare staff on ward A in hospital B

Scientific Management and Human Relations

Lean Management in health and Social Care

Topic areas-Examples

Information systems in healthcare

Barriers for implementation of healthcare information systems in the NHS

Health Professionals’ resistance to healthcare information systems

Innovation

Barriers to implementing Robotic Surgery in private hospitals in India

Barriers of developing and implementing innovations in healthcare organisations in the UK

Reducing waiting time in the colorectal outpatient department in the NHS

Entrepreneurship

Organisational Barriers of entrepreneurship in healthcare

Turnitin Originality Report Similarity Index

The color of the report icon is linked to one of five tiers of the Similarity Index. This is based on the amount of matching text found by the repository comparison. The possible similarity index percentage ranges are linked to a corresponding color:

blue (no matching words)

green (one matching word – 24% similarity index)

yellow (25-49% similarity index)

orange (50-74% similarity index)

red (75-100% similarity index)

Suggested Structure

1. Introduction (Maximum words limit – 600)

2. Description of the organisational problem (Maximum words limit – 1000)

3. Root cause(s) of the problem and proposed solutions (Maximum words limit – 3700)

4. Potential practical challenges of implementing the solutions (Maximum words limit – 500) 

5. Conclusions (Maximum words limit – 200) 

6. References

1.Introduction (Max words -600)

Attract your reader’s attention

Introduce your topic area (i.e. organisational problem)

Get your reader’s attention early on, by demonstrating that your organisational problem is an important issue.

background information in the form of a short literature review- Argument for the significance of the problem

Context of the problem(e.g. hospital ward, hospital, national health/social care system etc)

The introduction need to have a clear definition of the aim of your essay

Argument for significance of the problem

You need to argue briefly that

the problem has negative impact on patient care /service quality ; patients are suffering because of this problem

the problem contributes to the inefficiencies and ineffectiveness of the service

This argument needs to be further developed in section 2 (i.e. Description of the organisational problem)

Argument for significance of research area -An example adapted From a Journal paper

: Shortage of primary health care workers in Kenya

Significance -An example adapted From a Journal paper -Introduction

Shortage of primary health care workers in three disparate regions in Kenya

 Introduction :

“Kenya currently faces significant challenges in overcoming health care worker (HCW) shortages and low HCW retention, as well as difficulty attaining equitable distribution of human resources for health (HRH) – particularly in hard-to-reach areas. A 2008 report indicates that the Ministry of Health had an overall vacancy level of 29% (Smith 2016, Markus 2015). There are 1.5 HCWs per 1,000 population in Kenya, which falls below the figure of 2.3 per 1,000 population reported in analyses by the World Health Organization (WHO) on the minimum staffing threshold to achieve minimum coverage (Binn 2017, Henry 2016). Vacancy levels based on WHO suggestions were highest in Northern Kenya, with 85% and 93% health worker vacancy levels in Turkana and Mandera -counties, respectively (Porter 2017).”

Research Evidence/literature

Aim (Example from Trimester 3, 2014)

This assignment sets out to discuss the problem of work-related stress among care staff/nurses in care homes. First a description of the problem will be given along with a definition of the concept of work-related stress. Next the root causes of the problem of work-related stress in care homes will be identified and discussed. After which potential solutions for each root causes identified will be proposed and discussed. Finally, possible challenges with implementation of the solutions will be discussed and conclusions will be drawn at the end.

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2. Description of the organisational problem (Max words limit -1000)

Extend the introduction and discuss the problem in depth

Argue that the problem has negative impact on patient care /service quality ; patients are suffering because of this problem

Argue that the problem contributes to the inefficiencies and ineffectiveness of the service

One common way to approach a literature review

Broad Issue

Studies with Overlap with Your Research

Studies that are directly related to your investigation

One common way to approach a literature review

  • First briefly explain the broad issues related to your investigation; you don’t need to write much about this, just demonstrate that you are aware of the breadth of your subject.
  • Then narrow your focus to deal with the studies that overlap with your research.
  • Finally, hone in on any research which is directly related to your specific investigation. Proportionally you spend most time discussing those studies which have most direct relevance to your research.

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Search Procedures

(1) Identify databases

e.g. ProQuest, EBSCO, SSCI (social science citation index), Psychinfo, etc)

(2) Identify Gray Literature (e.g. Government Research reports)

(3) Identify as many research studies as possible with the potential to analyse the organisational problem and then propose potential solutions

Critical Review of Literature

Authors

Kallis Morkel Tahir Villers

Claim 1

Claim 2

Claim 3

Compare Contrast Author’ ideas

Compare Contrast Author’ ideas

Compare Contrast Author’ ideas

Example adapted from a journal paper -Problem of low motivation among healthcare workers in Kenya -Start from theory ….

An example from the journal paper:

“…..Health worker motivation (defined as the extent an individual is willing to exert and maintain effort towards the achievement of an organization’s goals) has frequently been cited as a critical barrier to effective health service delivery (Smith 2016, Markus 2014). In this regard, several themes characterize motivation and these include financial aspects, career development, continuing education, health facility infrastructure, availability of resources, relationships with the management of the health facility, and personal recognition…..”

Research Evidence/literature

Significance of the problem

Theoretical Concept – Motivation

Problem in the context…

  • “…..A study on health worker motivation in Kenyan district hospitals demonstrated that altruistic motives are important in these settings, but that their organizational commitment (in terms of decisions on performance on the job depending on whether the senior management/the organization appreciated the particular staff or not) and motivation was threatened by the many challenges that service providers face in public sector health care provision in Kenya(Moberly 2014)….”

3. Root causes of the problem and proposed solutions (Max words -3700)

Building on the discussion in the previous section (i.e.section 2)

Address the question of why the problem has occurred.

It is generally best to consider key causes to see how well they are supported by the organisational facts, theoretical concepts and research evidence, and how well the root causes explain everything that has happened

Then identify critical root causes (not a long list)

You need to show the depth of your analysis and the connection between analysis and the root causes


Root causes of the problem –lack of motivation among healthcare workers in Kenya adapted from a journal paper

“….Health workers are susceptible to ‘hygiene factors’, such as pay and working conditions, and ‘motivators’ factors, such as professional development (Valian 2014, Reed 2016). Ensuring that staff receive adequate pay for their work is key to motivation(Downs 2015). However, salary is not the only important dimension (McDonagh 2014). In many contexts, the low motivation of trained health staff in remote areas is due to the lack of supporting infrastructure and opportunities for staff and their families (Smith 2013, Fortin 2014)….”

Herzberg’s two-factor theory


Root causes of the problem – lack of motivation among healthcare workers in Kenya adapted from a journal paper

“….In fragile environments, these factors include poor living conditions, the lack of safety and security in the workplace, and the absence of continuous professional development (Limb 2014, Bedi 2015)……

Connection between Herzberg two-factor theory and the evidence from research

Example problem-Barriers to implementing Robotic Surgery (innovation)in private hospitals in India

Could use Rogers’s Diffusion of Innovation Theory (Rogers 2003)

  • Observability

The degree to which the results of an innovation are visible to potential adopters

  • Relative Advantage

The degree to which the innovation is perceived to be superior to current practice

  • Compatibility

The degree to which the innovation is perceived to be consistent with current systems, socio-cultural values, previous ideas, and/or perceived needs

Trialability

The degree to which the innovation can be experienced on a limited basis

  • Complexity

The degree to which an innovation is difficult to use or understand, its level of simplicity

Choosing a theory

Authors

Theory 1 Theory 2 Theory 3 Theory 4

Claim 1

Compare Contrast theories

Using a theory

If you intend to use a theory to analyse the problem

Briefly explain the theory (e.g. parameters )

Justify that it could be used (relevance)

And use it to analyse the problem integrating literature and organisational examples

If you are not confident of using theories

Use literature to analyse and identify root causes

Root causes –Not a list!

Depth of your analysis

Depth of the description of your root causes

You need to show that root causes contribute to the problem (problem on the surface)

Proposed solutions – Not a List!

Having identified root causes, you should now develop a number of possible solutions (alternatives) to the problem

If particular knowledge (from literature) or theories have proven to be useful in determining the root causes of the problem, the same knowledge and theories could be useful for developing possible solutions

Demonstrate the link between the root causes and the solutions

Proposed solutions

Root cause 1

Solution 1

Root cause 2

Solution 2

You need to show the direct relationship between the root causes and solutions (i.e. Solutions are derived from the analysis)

You need to support your proposed solution with research

Assume that you are a leader/manager in your chosen organisation/service when you propose solutions

Solutions – Example -Motivation of healthcare workers in Kenya adapted from a journal paper example from a journal paper

“………. Secondly, competitive compensation packages should be developed for health staff, particularly in hard-to-reach areas. These packages should include family health care and be reviewed regularly in order to address rapidly changing needs and circumstances over time … “Smith (2015) argues that …(supporting the solutions with research evidence/ literature )

“….Thirdly, strategies for career growth and promotion, especially for the higher cadre of health workers, such as doctors should be developed. Maxwell (2016) points out that ….. (supporting the solutions with research evidence/ literature)

4. Potential Practical Challenges of implementing the solutions (Max words -500)

Examples:

Ethical, financial, human resources etc

5. Conclusions (Max words -200 )

Bring your central ideas into sharp focus

Summarise the evidence and arguments you have presented in the essay

Do not introduce new evidence at this point

Instead you should synthesise the main points without repeating everything what you have already said

You could discuss the limitations of your study (e.g. limitation of your theoretical perspective that you used)

6. References List

Harvard references

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