Special Session II

Developing the health service management workforce in Asia Pacific – what do we know, what have we achieved, and moving forward

Special Session of International Conference on Social Science, Public Health and Education (SSPHE) http://www.ssphe.org/ May 5 to 6, 2017, Guangzhou, China

Session chairman
Zhanming Liang

School of Psychology and Public Health, La Trobe University，Australian

Tel: 03-9479 5136
Email: z.liang@latrobe.edu.au

Temporary schedule
Responsible person Focus Timeline
Dr Zhanming Liang Welcome and introduction 15 mins
Oral presentations
Dr Zhanming Liang Health service management competency development – a global perspective 15 mins
A/Prof Felicity Blackstock Leadership and management competency development – the Australian story 15 mins
A/Prof Phudit Tejativaddhana Strengthening the District health system management – challenging facing Thailand and Thai managers 15 mins
Dr Zhijun Zhang Chinese health service managers in CHC and Hospitals: characteristics and responsibilities 15 mins
Prof Hongkun Ma Developing the competence of Chinese health managers – self-perception and roles of education and training 15 mins
Dr Simon Cheung and Prof Peter Yuen Designing a Competency Based Undergraduate Health Services Management Programme in Hong Kong in a Rapidly Aging Context 15 mins
Facilitated by A/Prof Felicity Blackstock Panel discussion:
• Current issues in health service management workforce development and health service/system management
• Formulating research questions and developing collaborative research agenda		 30 mins
Dr Zhanming Liang Sum up and way forward 5 mins

Overall purposes of the session:
The purpose of the session is to bring academics, researchers, policy makers and practitioners who have responsibilities and interests in health service management competency and health service management workforce development in the Asia Pacific Region together to explore the current trends, efforts and issues in the related areas. The session will provide a platform for knowledge sharing and exploring collaborations in the Asia Pacific Region. Through presentation of up to date evidence, a collaborative research agenda will be defined for training and development of the health service management workforce, strengthening the health service/system management in the Asia Pacific countries.

Expected outcomes of the session:
• Review of the process to determine competency levels of the health services management workforce, including understanding of the Management Competency Assessment (MCAP) tool.
• Understanding of the current workforce management competency levels and demographics across the Asia Pacific region;
• Formulation of a collaborative research agenda focusing on health management competency development and strengthening of health service/system management in the Asia Pacific region.

Presentation 1

Health service management competency development – a global perspective
Zhanming Liang1, Felicity Blackstock2
1 La Trobe University
2 University of Western Sydney
Corresponding author: Dr Zhanming Liang MBBS MSc PhD FCHSM z.liang@latrobe.edu.au Key words: health service managers, management competence, management workforce
Abstract
Objectives: The competence of health service managers (HSM) is critical for healthcare reform and efficient healthcare service delivery. The presentation will explore efforts in defining and measuring management competence of HSM internationally with the following objectives:
Examine the evidence on measurement of HSM competency and performance in the Asia-Pacific region to date;
Explore methods to demonstrate the value of management competencies in healthcare delivery
Methods: A systematic review of the literature on HSM development was conducted, extracting literature published between 2000 and 2015 from databased such as ProQuest. Medline. Two independent reviewers extracted the data from the literature, synthesizing themes on HSM competency assessment and performance management.
Results: A number of management competency frameworks have been developed globally with variable focus to reflect the local context. Although, the existence of core competency requirements for health service managers in various levels and sectors is evident. Further, the advancement of health service management workforce professional development and competency is facing a number of challenges:
Unclear definition of management roles and differentiation of management levels;
Lack of empirical evidence demonstrating the value of management competence and its relationship to executive performance and health service delivery;
Lack of agreed standards and training requirements for healthcare services executives relevant to different career development stages and levels of management, and
Inconsistent approaches to providing formal and informal educational and training to healthcare executives.
Conclusion: HSM workforce development should be a global agenda. Efforts invested in developing the competence of the workforce will contribute to the sustainability of the health service delivery. Although, to maximize these potential benefits, efforts should be through joint active research, and collaboration needs to be developed in Asia Pacific Region.

Presentation 2

Leadership and management competency development – the Australian story
Felicity Blackstock1, Zhanming Liang2, Peter Howard2 et al.
1 University of Western Sydney
2 La Trobe University
Corresponding author: A/Prof Felicity Blackstock F.Blackstock@westernsydney.edu.au Key words: Leadership, health management, managers, competency, competency assessment
Abstract
Objectives: The competence of health service managers (HSM) to lead and manage is important to the successful implementation of efficient quality health service provision and health reform agendas. The Managerial Competency Assessment Partnership (MCAP) Program conducted in Australia led to the development of a Leadership and Management Competency Framework, which can be used to guide the development of curriculum for supporting health service managers develop competency. The framework illustrates the importance of using an evidence-based competency assessment process to identify the competency gaps and learning needs of the health service management workforce drawing on data from the 360º management competency assessment with middle to senior level health service managers.
Methods: The MCAP Competency Assessment program completed the following steps: systematic literature review, document analysis, focus group discussion (n=35), online survey, managers’ survey (n=108) and 360°competency assessment (n=103).
Results: Eight core management competencies were identified for middle to senior level health service managers working in both community and hospital settings. As a result a Leadership and management competency framework and assessment tool were developed and validated. The assessment process confirmed the ability of the 360º management competency assessment to identify the competency level of health service managers and determine their learning and professional development needs.
Conclusion: An evidence-based leadership and management competency and assessment process is critical to confirming the competency gaps and setting the overall directions of educational activities and development for HSM.

Presentation 3

Strengthening the District health system management – challenging facing Thailand and Thai managers
Phudit Tejativaddhana1, Zhanming Liang2, Peter Howard2, David Briggs3, Kamolnat Muangyim4
1 Naresuan University, Thailand
2 La Trobe University and Naresuan University
3 Naresuan University
4 Sirindhorn College of Public Health, Chonburi, Ministry of Public Health, Thailand
Corresponding author: A/Prof Phudit Tejativaddhana
phuteja@gmail.com; phuditt@nu.ac.th Key words: Thai health system, district management, health managers, workforce development
Abstract
Objectives: The purpose of the paper is to discuss the key challenges facing the Thai health system’s sustainability and the importance of strengthening the management capacity in particular the competence of the health service managiers in the Thai health system
Methods: A review of the literature on health system strengthening in developing countries and analysis of Thai policy documents was conducted. The literature was searched from ProQuest-Central and a number of health policy journals directly.
Results: A total of 38 papers were sourced exploring the health services workforce in Thailand. The following four key challenges that threaten the sustainability of the Thai health system were identified: 1) Workforce shortage; 2) Bureaucratic management style; 3) Unclear responsibility and authority between different the regional, provincial and district level in terms of quality and efficiency of care provision and monitoring; 3) Increasing demand for increase of volume of health services with unclear grow of health funds; 4) Unclear roles of competency requirements for senior health manager.
Five key areas for improvement efforts were identified as critical in strengthening the district health service management in Thailand.
Conclusion: The Thai district health system requires strengthening for the sustainability of meeting the universal healthcare needs of the Thai population. A framework linking the international literature and experience of management workforce development is required in the Thai context for developing and evaluating the management workforce competence.

Presentation 4

Chinese health service managers in CHC and Hospitals: characteristics and responsibilities
Zhijun Zhang1, Zhanming Liang2, Felicity Blackstock3, George Liu2 et al.
1 Puyuhuang Community Health Centre;
2 La Trobe University;
3 University of Western Sydney
Corresponding author: Dr Zhanming Liang MBBS MSc PhD FCHSM
z.liang@latrobe.edu.au Key words: Chinese health managers, hospital management, community health service, management training
Abstract
Objective: Studies in human resource management (HRM) and management competency in the Chinese context are very limited, with only one published systematic review identifying 21 papers, of which no data was describing the healthcare sector. Therefore, the purpose of this paper is to answer the following three questions:
What are characteristics, educational background and core responsibilities of senior managers working in the community health and hospital sectors in China?
Is there a difference between the characteristics, educational background, and core responsibilities of senior managers working in the community health and hospital sectors in China?
What are the levels of commitment to continued professional development and continuous education of senior managers working in community health and hospitals in China?
Methods: The study design was a cross-sectional cohort paper-based survey conducted with senior managers (the top three levels) working in all (n=13) community health centres (CHC) in the Fengtai District, Beijing, and all (n=4) level 3 teaching hospitals associating with the Harbin Medical University. Questionnaire survey packages were distributed directly to, and collected from, the participants through postal collection. A total of 608 surveys were sent to potential participants across the two sectors and the different management levels. Quantitative data was analysed using standard frequencies and distributions, with significance set at p<0.05. Qualitative data were grouped according to themes through content analysis.
Results: The study had a response rate of 94% and 80% respectively for the CHC and Hospital sites and found that the higher the management level, the higher the percentage of postgraduate qualifications being possessed by managers. However, the majority of the postgraduate qualifications were not management related.
Conclusions: There are differences in the educational backgrounds between managers at different management levels and managers working in different sectors (CHC vs Hospitals) – a phenomenon to be further studied which is important to guide the formulation of management training and support to managers working in these two different sectors.

Presentation 5

Developing the competence of Chinese health managers – self-perception and roles of education and training
Hongkun Ma1, Kongdong Zhu2, Zhanming Liang3, Felicity Blackstock4, Peter Howard3, George Liu2 et al.
1 Dongbei Agriculture University
2 Harbin Medical University
3 La Trobe University
4 University of Western Sydney
Corresponding author: A/Prof Peter Howard M
p.howard@latrobe.edu.au Key words: management competency, health service management, Chinese health system, medical training
Abstract
Objectives: Formal education and continuous professional development is used to improve health service managers’ competence. However, to design professional development activities, an understanding of the perceived and real level of competency is needed. No literature currently available has examined the perceived level of competency in China. The purpose of this paper is to report on the perceived management competence and gaps amongst different senior management levels in both Community health centres (CHC) and hospitals and the differing educational and development needs.
Methods: The study design was a cross-sectional cohort paper-based survey conducted with senior managers (the top three management levels) working in all of the 13 community health centres (CHC) in the Fengtai District, Beijing and all four level 3 teaching hospitals associating with the Harbin Medical University. Questionnaire survey packages were distributed directly to and collected from the participants through postal collection. A total of 608 surveys were sent to potential participants across the two sectors and the different management levels. Quantitative data was analysed using standard frequencies and distributions, with significance set at p<0.05. Qualitative data were grouped according to themes through content analysis.
Results: The survey results confirm that the higher the management levels, the higher the perceived competency amongst managers in both CHC and hospitals. However, managers working in hospitals generally perceived their competence level higher than those working CHC. The data also confirmed a positive correlation between management training and competency level. A number of competency gaps amongst managers in hospitals and CHC have also been identified.
Conclusions: Chinese HSM have perceived gaps in competency and learning needs, suggesting a review of educational activities is warranted. Considering the very specific postgraduate educational pathway for Chinese managers, innovation in undergraduate training and medical internship for development of management competency should be considered.

Presentation 6

Designing a Competency Based Undergraduate Health Services Management Programme in Hong Kong in a Rapidly Aging Context
Simon TY Cheung and Peter P Yuen
College of Professional & Continuing Education, The Hong Kong Polytechnic University Key words: competency, health services management, leadership, education, Undergraduate, Hong Kong
Abstract
Background: The Hong Kong health system is facing challenges including an increasing demand for health services driven by factors such as over-dependence on secondary and tertiary health care, changing patient culture and a rapidly ageing population. With a foreseeable reduction in public funding due to a rising dependency ratio compounded by a narrow tax base, the sustainability of the Hong Kong health system is called into question. The adequate supply well-trained health care management professionals appropriate for the Hong Kong context in the near term is of vital importance. The majority of the training programs for health care professionals in Hong Kong tend to be very much acute-centric and inpatient focus.
Methods: Local supply and demand for undergraduate programs in health services management (HSM) is assessed. Students’ aspirations and community need are both taken into consideration. A HSM competency framework for undergraduate program is developed based on the analysis of relevant HSM job vacancies in Hong Kong and interviews with key employers. Core competencies and employability skills desired by potential employers are determined. Appropriate learning outcomes, specific subjects for an undergraduate HSM programs are then constructed based on the results of the analyses.
Results: Work experience, communication skills, and language skills are amongst the top generic employability skills perceived by employers in general in Hong Kong. Holistic health, community based care, long term care, knowledge of the health care system and basic medical knowledge are identified as important components by health care providers. A two-year top-up degree program, targeting Associate Degree/High Diploma (sub-degree) graduates, is proposed. The curriculum, consisting of foundation subjects, core business subjects, core health services management subjects, and electives, provides different pathways for candidates with health care and business background to acquire the required skills and competencies identified in the study.