Mongolia: HRH Support of a Private Hospital
Client: European Bank for Reconstruction and Development
HCA is the HR part of a small consultancy team that includes expertise on clinical pathways, best practice and management information systems supporting the growth plans of a Mongolian private hospital, Gurvan Gal. HCA’s input is to link the desired improvements in clinical capability and quality with HR performance management systems that help drive and sustain change. At a less strategic level, HCA has helped the hospital HR function develop better process for job description, performance appraisal, needs assessment and to develop and implement more equitable and competitive salary structure.
Egypt: Strategic HR Support for Family Owned Hospital
Client: European Bank for Reconstruction and Development
HCA, as part of an EBRD team, has helped a family owned hoispital in Cairo refocus its specialist strategic HR structures to align more faithfully with its emerging business objectives (expanded footprint and commitment to quality services). This has required work on the organisation structure, the salary structure, development of the HR information system, and linking of performance management to better specified competencies and appropriate and meaningful performance indicators. Other strategic work on planning the nursing workforce and more operational work on job descriptions, job evaluation, and training needs assessment were undertaken.
Solomon Islands: Medical practitioner remuneration review
After many years of continued payment of doctors and dentists in the Solomon Islands under a Scheme of Service negotiated and consummated in 2005, a review of the Scheme of Services was long overdue. In 2017 the Solomon Islands Medical Association (SIMA) had petitioned the Ministry of Health and Medical Services (MHMS) to conduct a review otherwise they would engage in trade union action. Under WHO funding, the MHMS urgently sought the support of an independent consultant for this review as part of its support for change management.
During a visit to the Solomon Islands in November 2017 HCA Principal, Lee Ridoutt, conducted broad and inclusive dialogue with Solomon Islands Government stakeholders, associations and presented initial observations.
Identifying major concerns with the structure of the current Scheme of Service and its tenuous relationship with the Unified Salary Structure (USS) an important pillar of public service remuneration, it was decided to create an Options Paper that would identify possible solutions to medical practitioner pay and performance, and suggest a way forward, including the development of a new Scheme of Service divorced from a structural connection with the USS. This Options Paper is now being considered as a basis for longer term structural change while trade union action is resolved I the short term.
Solomon Islands: Leadership and Management Training
HRDA, HCA’s ‘sister’ company, has been contracted by WHO to design a Postgraduate Certificate in Health Leadership and Management to be provided through the Solomon Islands National University (SINU). It will be the first postgraduate course ever at SINU, so it is an extremely exciting project.
The course is planned to commence in the second semester of 2018. The development of the Health Leadership and Management course is in response to complex management issues that constrain health service delivery within the structural, resourcing and cultural environments of the Solomon Islands. HRDA is working with key officers from the Solomon Islands Ministry of Health and Medical Services (MHMS), SINU and the Ministry of Public Service (MPS) and its key partner in Australia the Australasian College of Health Service Management (ACHSM).
An exciting course structure, building on Pacific Island indigenous cultural concepts, and based on an agreed set of internationally recognized leadership and management competencies has been developed from the ACHSM Master Health Service Management Competency Framework. An initial course proposal has been submitted to the SINU Academic Council. The proposal outlines the course approach to credit points, level of qualification, the status of the course, purpose, proposed course structure and target student groups.
Ireland: Health Information Systems
HCA Team members Lee Ridoutt and Victoria Hirst completed a project in Ireland critical to that country’s future health financing as they move to a ‘Money follows the patient’ process of service payment – more widely understood as activity based funding (ABF).
The project overall, managed by a HCA partner Pavilion Health, had many components aimed at ensuring that when Ireland transitions fully to an ABF basis for funding hospital services the coded casemix data on which funding is based will be as precise and timely as possible, and accurately reflect each hospital in Ireland’s real level of activity in terms of number and complexity of episodes of care. HCA’s team members worked primarily on the HR and work organisation aspects, in particular on three components:
1. An analysis of the management of clinical coding services with the view to finding ways services can be managed, staffed and resourced to best practice levels.
2. An analysis of the training needs of the clinical coding workforce in terms of both numbers (new coders to be trained) and
3. The content of current and future courses to ensure the workforce is competent to deliver quality coded data.
The work in Ireland could have much wider application in Europe, but also many Asian countries already experimenting with ABF or attempting to base more decision making on quality casemix data. A series of journal articles related more narrowly to the HR components of the project are due to be published in the near future.
Ukraine: Building HRH Capacity
HCA’s principal, Lee Ridoutt, completed a project funded by the European Bank for Reconstruction and Development (EBRD). The project involved supporting the growth ambitions of a Ukrainian private sector health services company called Mamin Dom (Mom’s House), which started with a small shop in the centre of Kharkiv (the second largest city in Ukraine on the Eastern border) in 1999 providing families with new-born babies and children under 6 necessary goods (from cloths to strollers). In 2006 a pediatric clinic called Raduga (Rainbow) was established by the same company, but until recently it has operated as a separate business structure.
The HCA component of this project related primarily to HRH capacity. Working with a very competent HR Officer and some of her staff and several senior line manager colleagues.
HCA was able to review and improve all aspects of HR functioning but particularly introduce new thinking on worker (especially the health professionals) selection, training, remuneration, performance management, deployment, recruitment strategy and support changes in organisational structure and work descriptions — and tying this up in improved HR information processes.
Kazakhstan: Ministry of Health Project
The project was a study tour / training program organised in conjunction with HCA’s New Zealand partners, Training and Technology Transfer. The program was designed and delivered for delegates of the Kazakhstan Ministry of Health (KazHealth). The purpose of the program was to assist the Ministry to build capacity prior to the initiation of a Human Resources in Health (HRH) Observatory in Kazakhstan. The tour program had the following key learning objectives areas in mind:
Lee Ridoutt and Kazakhstan Study Tour Delegates – 2015
- HRH data collection and analysis and monitoring of HR capacity;
- Understanding IT options of HRH information systems;
- Methodology and application of HRH data for planning, labour market analysis and capacity building;
- Understanding stakeholders in HRH planning; and,
- Understanding the structure and function of HRH Observatories
Scoping study on population ageing and its implication for human resources for health policy and planning
The main objective of the study was to produce a regional analysis of specific needs and gaps with regard to the implications of population ageing for health workforce policy, planning and implementation, and identify current policies and practices that could inform policy options and priority actions of particular relevance to low and middle-income countries in the Western Pacific Region. A draft report has been provided outlining the types of health services that are likely to be pursued and the workforce required to deliver these services. Significant re-direction of workforce development, deployment and management is envisaged.
Malaysia: Training in Health Workforce Planning
A study tour was designed and delivered to a key Ministry of Health workforce planning officer that included visits to relevant Australian government organisations and departments and private sector companies involved in health workforce data collection, data analysis and use of data for a variety of human resource research functions. Individual tuition was also provided to the officer in strategic workforce planning activities, particularly the application of HCA’s workforce demand and supply estimation methodology.