Strategic Planning In Healthcare Research Articles

TEMPORAL TRENDS AND REGIONAL VARIATION OF HIP ARTHROSCOPY AND PELVIC OSTEOTOMY IN ENGLAND FROM 2010 TO 2023

Hip arthroscopy (HA) and pelvic osteotomy (PO) are surgical procedures used to treat a variety of hip pathology affecting young adults, including femoroacetabular impingement and hip dysplasia respectively. This study aimed to investigate the trends and regional variation in the provision of HA and PO across England from 2010 to 2023 to inform healthcare resource allocation.We analysed the National Hospital Episode Statistics database for all HA and PO procedures in NHS England using specific OPCS-4 codes: HA: ‘W83+Z843’ or ‘W84+Z843’; PO: ‘X222+Z75’. We collected patient demographics, age, sex, and region of treatment. We performed descriptive and regression analyses to evaluate temporal trends in PO volume, age, sex and regional variation.22,401 HAs and 1,348 POs were recorded between 2010 and 2023. The annual number of HAs declined by 28.4%, whilst the number of POs increased by 64% (p<0.001). Significantly more females underwent PO vs HA (90% vs 61.3%) and were older than males undergoing the same procedure (PO: 29.0±8.7 vs 25.8±9.2 years; HA: 36.8±12.0 years vs 35.8±11.2 years, p<0.001). For HA, the mean age of both sexes decreased by 3.3 and 2.9 years respectively (p<0.001), whereas the age of PO patients did not change significantly over the study period. There were significant regional variations with a mean incidence of 1.60/100,00 for HA (ranging from 0.70–2.66 per 100,000) and 0.43/100,000 for PO (ranging from 0.08–2.07 per 100,000).We have observed a decline in HA volume in England, likely due to improved patient selection and the impact of COVID-19, whilst PO volume has significantly increased, with regional variation persisting for both procedures. These trends highlight the need for equitable HA and PO access to improve patient outcomes and call for strategic healthcare planning and resource allocation to reduce disparities and improve training opportunities.

РОЛЬ ШТУЧНОГО ІНТЕЛЕКТУ ПРИ СТРАТЕГІЧНОМУ ПЛАНУВАННІ ДІЯЛЬНОСТІ ЗАКЛАДІВ ОХОРОНИ ЗДОРОВ'Я

Artificial intelligence (AI) has the potential to revolutionize the healthcare industry, including strategic planning. A key aspect of strategic management is that businesses in the same environment can have different levels of success, depending on their strategic decisions. In healthcare, it is also important for managers to develop strategic thinking in their employees. This will help them use strategic principles, methods, and tools to improve their performance. AI can be used to teach employees the basics of strategic planning. However, there are challenges and limitations to using AI in this context. Modern transformations in the healthcare sector require the implementation of strategic planning in management, as an important prerequisite for the successful functioning of a healthcare facility. AI is a tool that can be used to generate profit, as it can improve the economic performance of economies. This research has demonstrated the potential of AI to improve efficiency, effectiveness, and quality of care. AI can be used to analyze large amounts of data, identify trends, and predict future needs. This can help healthcare organizations develop more effective strategies that provide quality care at an affordable price. The article aims to define the features and potential of strategic planning in the management of healthcare facilities in the modern world using artificial intelligence to improve efficiency. This article explores the potential of AI in strategic management of healthcare organizations. It is argued that AI is a valuable tool for strategic planning in healthcare management. The article defines the concepts of "artificial intelligence" and "strategic planning in healthcare." It analyzes the areas of strategic planning where the use of AI is feasible. It proposes ways to use AI in healthcare management. The analysis and logical generalization of the research made it possible to determine the further direction and problems of using AI. The practical value of the article lies in the fact that it introduces readers to the possibility of using AI in strategic management in healthcare.

Arabic version of the Palliative Care Self-Efficacy Scale: Translation, adaptation, and validation.

A lack of confidence among oncology nurses might be problematic when providing palliative care. No valid and reliable tool is currently available in Saudi Arabia to assess oncology nurses' confidence in providing palliative care. This study aims to explain the process of translation, adaptation, and validation of the Palliative Care Self-Efficacy Scale (PCSS) to support its use in the Saudi context. This was a methodological study of translation, cultural adaptation, and content validation of PCSS. The process of translation and adaptation was conducted according to the World Health Organization guidelines, including forward and backward translations, an expert panel review, and pretesting and cognitive interviewing, resulting in a final version. Two independent bilingual oncology nurses familiar with palliative care terminology translated the PCSS from English to Modern Standard Arabic. Next, the concise PCSS translation developed from the 2 translations was back-translated to English by 2 English-speaking translators and then compared to the original PCSS. The Arabic version PCSS was evaluated by Saudi professionals (N=5) in oncology and palliative care nursing using a Likert scale for essentiality, relevance, clarity, and appropriateness. The content validity was examined using the calculation of the content validity ratio, item-level content validity index (I-CVI), and modified kappa statistics. The thinking aloud method was also used to interview Saudi oncology nurses (N=8) who had palliative care experience. The relevance, clarity, and appropriateness of the first Arabic version PCSS were validated. It had a level of content validity index of 1.00 for all items after improvements were made based on the recommendations of experts and oncology nurses. The PCSS demonstrated face and content validity in the assessment of oncology nurses' confidence in providing palliative care. The PCSS is suitable for use in palliative cancer care units in Saudi Arabia to identify the educational needs of nurses to promote their confidence and improve the quality of care. Additional reliable and valid language versions of the PCSS allow for international and national comparisons, which may be useful for oncology nursing administrators or managers who are accountable for the quality of palliative care during the strategic health-care planning process in cancer services.

From Survey Results to a Decision-Making Matrix for Strategic Planning in Healthcare: The Case of Clinical Pathways.

Background: It is a well-known fact that the information obtained from a survey can be used in a healthcare organizational analysis; however, it is very difficult to compare the different results found in the literature to each other, even through the use of metanalysis, as the methodology is often not consistent. Methods: Data from a survey analyzing the organizational and managerial responses adopted in pathology-specific clinical pathways (CPs) during the first two waves of the COVID-19 pandemic were used for constructing a decisional matrix, a tool called SPRIS system, consisting of four different sheets. The first sheet reports the results of the survey and, using a streetlight color system, identifies strengths and weaknesses; the second one, by assigning a priority score, establishes the priority of intervention on each of the strengths and weaknesses identified; the third sheet reports the subjective items of the questionnaire in order to identify threats and opportunities and their probability of happening; in the last sheet, a SWOT Analysis is used to calculate the performance index of the whole organization. Results: The SPRIS system, applied to data concerning the adaptation of four CPs to the COVID-19 pandemic, showed that, whereas all the CPs had a good performance index, some concerns remained unsolved and need be addressed. Conclusions: The SPRIS system showed to be an easily constructed tool that is able to give an overview of the organization analyzed by the survey and to produce an index that can be used in a direct quality comparison between different services or organizations.

A System Dynamics Approach to Strategic Planning and Performance in Healthcare: Dynamic Balanced Scorecard Leveraged with Corporate Social Responsibility

The balance scorecard (herein after called BSC) is a powerful concept for performance measurement. However, it suffers from some drawbacks regarding quality of the BSC. System dynamics overcomes these shortcomings with a Dynamic Balanced scorecard (DBS). In this article we elaborate how a Dynamic Balanced scorecard can be used in the healthcare sector including its connectivity with Corporate Social Responsibility as a strategy in the changed regulatory regime in India particularly after enactment of Companies Act 2013, and section 135 and schedule VII in particular. The pandemic of 2020 has challenged us to look into CSR not only for a facelift for the stock market but to make the core of organizations strong. Healthcare specially will be the center of focus for coming days and reason why our article has special focus on this sector. Sustainability measures have been researched by scholars and it has been found that companies who factor in sustainability measures in their performance do better (Nidumoli, 2013) than those who do not. The DBS technique is a powerful tool to capture the CSR and sustainability measures. Our article aims at presenting a framework to implement this in organizations in health care.

Novel coronavirus disease 2019: predicting prognosis with a computed tomography-based disease severity score and clinical laboratory data.

Currently, there are known contributing factors but no comprehensive methods for predicting the mortality risk or intensive care unit (ICU) admission in patients with novel coronavirus disease 2019 (COVID‑19). The aim of this study was to explore risk factors for mortality and ICU admission in patients with COVID‑19, using computed tomography (CT) combined with clinical laboratory data. Patients with polymerase chain reaction-confirmed COVID‑19 (n = 63) from university hospitals in Tehran, Iran, were included. All patients underwent CT examination. Subsequently, a total CT score and the number of involved lung lobes were calculated and compared against collected laboratory and clinical characteristics. Univariable and multivariable proportional hazard analyses were used to determine the association among CT, laboratory and clinical data, ICU admission, and in‑hospital death. By univariable analysis, in‑hospital mortality was higher in patients with lower oxygen saturation on admission (below 88%), higher CT scores, and a higher number of lung lobes (more than 4) involved with a diffuse parenchymal pattern. By multivariable analysis, in‑hospital mortality was higher in those with oxygen saturation below 88% on admission and a higher number of lung lobes involved with a diffuse parenchymal pattern. The risk of ICU admission was higher in patients with comorbidities (hypertension and ischemic heart disease), arterial oxygen saturation below 88%, and pericardial effusion. We can identify factors affecting in‑hospital death and ICU admission in COVID-19. This can help clinicians to determine which patients are likely to require ICU admission and to inform strategic healthcare planning in critical conditions such as the COVID‑19 pandemic.

The Association of Health Literacy Level with Self-Care Behaviors and Glycemic Control in a Low Education Population with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Iran.

IntroductionPromoting Health Literacy (HL) can be a priority in strategic healthcare planning of the countries. Low HL is prevalent in some societies which make barriers to successful self-care of diseases. The aim of this study was to examine the association of HL with self-care behaviors and glycemic control in a low education population with type 2 diabetes mellitus.MethodsThis cross-sectional study was conducted in Sarab city, Iran. The 192 participants were patients diagnosed as type 2 diabetes and with low level of education. Convenient sampling method was applied and the participants were chosen by their medical records in health-care centers. To collect data a valid and reliable tool was used based on HL dimensions and self-care behaviors. Using hierarchical logistic regression, the possible association of variables with self-care behaviors and glycemic control was assessed.ResultsThe mean age of study participants was 58.12 (±11.83) years. A 28.8% of the variation in the self-care behaviors is explained by the HL and the demographic variables (R= 0.288%; p-value<0.05). Furthermore, decision-making was the strongest predictor of self-care behaviors (β= 0.451). Approximately 80% of the variation in the HbA1c is explained by the HL, self-care behaviors, and the demographic variables (R= 0.804%; p-value<0.05).ConclusionThis study revealed that the HL dimensions predicted approximately one-fourth of self-care behaviors and the self-care behaviors and HL dimensions about eight-tenths of HbA1c in this population. These findings call for the need for interventional programs on HL to improve the self-care behaviors and HbA1c control.

Literature Review of Quality Management and Strategic Planning in Healthcare

The health care industry operates in a complex environment that is influenced by various factors located in the internal and external environment. For this reason, top management needs to develop unique skills necessary to predict potential threats and implement actions to lead providers of care to accomplish their goals. It is expected that the accomplishment of such goals (that are in line with the institutions’ mission) will result into a quality product. The incorporation of management tools is a key element to identify not only an institution’s performance, but also its external environment. Also, tools that enable an organization to assess and develop critical actions adopted to improve operations, overcome threats, and participate of existing opportunities.

GLOBAL AND RUSSIAN TENDENCIES IN THE HUMAN RESOURCE MANAGEMENTIN HEALTH CARE

The article analyses the main directions of development of human resource management in the health sector, both in Russia and abroad. Through the example of the Russian and foreign health care service it shows that the main problem is the deficit of nurses and physicians. The world experience in solving this problem is analysed in the article. The research shows the current classification of availability of medical personnel and characterises system of training of medical personnel in Russia. In conclusion the prospects of development of human resources policy and medical personnel management on the basis of strategic planning in health care are given.

Successful Strategic Planning for a Reformed Delivery System

Hospitals and health systems continue to consolidate and purchase physician practices; payment reform and quality initiatives are kicking into high gear; 123 new accountable care organizations are being rolled out; and workforce supply issues are emerging or reemerging. These are just a few of the challenges that call into question the enduring value of strategic planning in an environment characterized by increased uncertainty and greater and faster change. Can-or should-we try to plan for three to five years into the future when we do not know how healthcare reform will really affect the field? Shouldn't we be completely focused on immediate needs and initiatives?While addressing the most pressing and immediate concerns and hot spots tends to be a natural response, leading organizations recognize that strategic planning, and the focus and prioritizing that it calls for, is more important now than ever before for several reasons:* Increasingly scarce resources require shortand long-term allocation perspectives.* The larger, more diverse, and more geographically dispersed organizations currently being formed benefit greatly from the alignment that results from strategic planning.* Uncertainty and fast-paced change call for adaptability, which research demonstrates is greater when there is a dear direction, strategy, and alignment among organizational leaders.To maximize the yield from strategic planning in these turbulent times, the strategic planning process is being adapted to be more relevant to contemporary organizations. Healthcare leaders are advancing strategic planning from a periodic exercise to a more continuous and integrated (with other key management functions) strategic management process (see Figures 1 and 2). This type of process is dynamic and increases an organization's capacity to deal with curveballs, emerging developments and threats, and change in general.ADDRESSING HEALTHCARE REFORM AND OTHER ENVIRONMENTAL CHALLENGESA framework that identifies and describes key attributes of major environmental challenges affecting nearly all healthcare providers today is shown in Figure 3. Healthcare reform challenges are significant and complex, with major direct and indirect financial implications, particularly as commercial insurers follow the lead of the federal government in payment reform. In all likelihood, future reimbursement rate increases will lag health cost inflation by at least a few percentage points. This factor alone forces providers to significantly reduce costs while upping their competitiveness to try to maintain or increase revenues-a twofold challenge.While historically strategic planning in healthcare has focused nearly exclusively on growth through increasing share and enlarging the market, strategic planning today includes five new imperatives (see Figure 4):1. Sufficient scale and scope or niche play: Organizations will need to scale up or focus in order to survive in the future. For most, scaling up will involve inorganic growth through mergers, acquisitions, and new partnerships. In major metropolitan areas, a limited number of consolidated organizations will emerge, probably with annual revenues in excess of $2 billion. These organizations will be the ones that can meet the integration, alignment, and value challenges that result from healthcare reform. …

Planning in the Irish healthcare system: Legislative strategy or administrative control?

Although strategic planning in healthcare has been in evidence in many OECD countries since the 1970s, it did not emerge in Ireland until the advent of legislatively mandated service planning in the 1990s. This occurred in the context of significant managerial, organisational and environmental change. One of the central mechanisms of the Strategic Management Initiative is the devolution of accountability and responsibility from the centre to the periphery. Service planning in the health sector in Ireland is seen as part of this strategic planning ethos. This paper reports on part of a wider study that examined both the intent and the consequences of this legislatively mandated service planning and looked at the process of its implementation in Irish healthcare. This has important implications for Irish health policy due to the continuing budget overruns, the embargo on recruitment of frontline staff and the reported lack of strategic planning. This paper posits explanations for the difficulty in aligning strategy and planning after nearly a decade of service planning.

Cost, Effectiveness, and Cost-Effectiveness

Pluck the goose so as to obtain the most feathers with the least hissing . — —Jean-Baptiste Colbert, Minister of Finance to King Louis XIV of France Incremental or marginal cost-effectiveness ratios are founded on a number of assumptions that weaken their suitability as a way to balance competing economic and clinical priorities. We therefore propose a more relevant and responsible way to gauge the impact of clinical management strategies based on “consumer protection” principles—explicit disclosure of (1) the total magnitude of expected benefit in the target population (in life-years or quality-adjusted life-years), (2) the total monetary cost (in per capita inflation-adjusted dollars), and (3) a formal plan by which the added costs would be paid. Health policy decisions should therefore be based on the inherent trade-offs in the component measures of cost and effectiveness and not on a simple ratio of the two. Cost-effectiveness ratios are thereby rendered superfluous. Incremental or marginal cost-effectiveness ratios are widely viewed as rational ways to balance competing clinical and economic priorities that arise as a consequence of the inevitable disconnect between an individual’s wants and the society’s willingness to pay for those wants.1–5 The purpose of this essay is to question the practical relevance of these ratios with respect to strategic planning in health care, and offer a suitable alternative. In doing so, we will focus on the more pragmatic issues underlying cost-effectiveness analysis, and gloss over a variety of technical details such as the difference between a privately financed free market and the publicly financed healthcare market, between costs and charges, and between unadjusted and quality-adjusted outcomes. Our pragmatic perspective is not likely to be welcomed by orthodox experts in cost-effectiveness analysis. We believe, however, that any such criticisms can be blunted by recognizing the important distinctions between regulatory and clinical …

Planning in the Irish healthcare system: Legislative strategy or administrative control?

Although strategic planning in healthcare has been in evidence in many OECD countries since the 1970s, it did not emerge in Ireland until the advent of legislatively mandated service planning in the 1990s. This occurred in the context of significant managerial, organisational and environmental change. One of the central mechanisms of the Strategic Management Initiative is the devolution of accountability and responsibility from the centre to the periphery. Service planning in the health sector in Ireland is seen as part of this strategic planning ethos. This paper reports on part of a wider study that examined both the intent and the consequences of this legislatively mandated service planning and looked at the process of its implementation in Irish healthcare. This has important implications for Irish health policy due to the continuing budget overruns, the embargo on recruitment of frontline staff and the reported lack of strategic planning. This paper posits explanations for the difficulty in aligning strategy and planning after nearly a decade of service planning.

Databases for assessing the outcomes of the treatment of patients with congenital and paediatric cardiac disease – the perspective of critical care

The development of databases to track the outcomes of children with cardiovascular disease has been ongoing for much of the last two decades, paralleled by the rise of databases in the intensive care unit. While the breadth of data available in national, regional and local databases has grown exponentially, the ability to identify meaningful measurements of outcomes for patients with cardiovascular disease is still in its early stages. In the United States of America, the Virtual Pediatric Intensive Care Unit Performance System (VPS) is a clinically based database system for the paediatric intensive care unit that provides standardized high quality, comparative data to its participants [https://portal.myvps.org/]. All participants collect information on multiple parameters: (1) patients and their stay in the hospital, (2) diagnoses, (3) interventions, (4) discharge, (5) various measures of outcome, (6) organ donation, and (7) paediatric severity of illness scores. Because of the standards of quality within the database, through customizable interfaces, the database can also be used for several applications: (1) administrative purposes, such as assessing the utilization of resources and strategic planning, (2) multi-institutional research studies, and (3) additional internal projects of quality improvement or research.In the United Kingdom, The Paediatric Intensive Care Audit Network is a database established in 2002 to record details of the treatment of all critically ill children in paediatric intensive care units of the National Health Service in England, Wales and Scotland. The Paediatric Intensive Care Audit Network was designed to develop and maintain a secure and confidential high quality clinical database of pediatric intensive care activity in order to meet the following objectives: (1) identify best clinical practice, (2) monitor supply and demand, (3) monitor and review outcomes of treatment episodes, (4) facilitate strategic healthcare planning, (5) quantify resource requirements, and (6) study the epidemiology of critical illness in children.Two distinct physiologic risk adjustment methodologies are the Pediatric Risk of Mortality Scoring System (PRISM), and the Paediatric Index of Mortality Scoring System 2 (PIM 2). Both Pediatric Risk of Mortality (PRISM 2) and Pediatric Risk of Mortality (PRISM 3) are comprised of clinical variables that include physiological and laboratory measurements that are weighted on a logistic scale. The raw Pediatric Risk of Mortality (PRISM) score provides quantitative measures of severity of illness. The Pediatric Risk of Mortality (PRISM) score when used in a logistic regression model provides a probability of the predicted risk of mortality. This predicted risk of mortality can then be used along with the rates of observed mortality to provide a quantitative measurement of the Standardized Mortality Ratio (SMR). Similar to the Pediatric Risk of Mortality (PRISM) scoring system, the Paediatric Index of Mortality (PIM) score is comprised of physiological and laboratory values and provides a quantitative measurement to estimate the probability of death using a logistic regression model.The primary use of national and international databases of patients with congenital cardiac disease should be to improve the quality of care for these patients. The utilization of common nomenclature and datasets by the various regional subspecialty databases will facilitate the eventual linking of these databases and the creation of a comprehensive database that spans conventional geographic and subspecialty boundaries.

Linkage of Hospital and Death Records Increased Identification of Dementia Cases and Death Rate Estimates

Background/Aim: To use health record data linkage to improve case ascertainment and death rate estimates of deaths with dementia. Methods: Retrospective population study. Western Australians older than 20 years who died between 1990 and 2005 with a dementia diagnosis in Western Australian hospitals and/or death records using the Western Australian Data Linkage System were classed as having a lifetime history of dementia. Cases with dementia documented on death certificates were classified as having dementia as a contributory cause of death (COD). Age-standardized death rates (ASDR) were estimated. Results: 29,884 decedents were identified with a lifetime history of dementia. 88.2% had hospital records and 55.9% had death records indicating dementia. The ASDRs for dementia as a contributory COD increased from 50 to 81 per 100,000 person-years from 1990 to 2005. ASDR for lifetime history of dementia increased from 80 to 140 per 100,000 person-years over the same time period. In 2005, 50.1% (95% confidence interval: 47.2–53.1) of all females and 39.2% (35.8–42.7) of all males aged 85+ years died with dementia. Conclusion: Data linkage nearly doubled case ascertainment of deaths with dementia because people hospitalized with dementia often lacked dementia documentation at death. These results have important implications for strategic healthcare planning. Data linkage methodology could improve studies of hospitalisation trends in dementia.

Strategic Planning in Healthcare: The Experience of the University of Wisconsin Hospital and Clinics

In 1999, after 25 years of stable leadership from a single CEO, the University of Wisconsin Hospital and Clinics (UWHC) Authority Board named a new CEO. The 471-bed academic medical center had recently experienced significant change and challenges. In 1996, it had emerged as a public authority, a statutory designation by the state of Wisconsin that moved the hospital and clinics from the University of Wisconsin and the state of Wisconsin, and created it as a quasi-public entity with its own board. In 1999, when the new CEO was named, the hospital was experiencing a loss of revenue and market share, operating deficits, a 22 percent nurse vacancy rate, and patient satisfaction scores below the 40th percentile. The first task assigned to the new CEO by the board was the development of a new strategic plan that would reverse these trends and position UWHC as a premier academic hospital. The CEO began a strategic planning process that involved leaders, physicians, and staff from throughout the hospital and clinics, its affiliated medical school, and the physician practice plan. This article describes the collaborative, integrative, and communicative strategic planning process UWHC used; details the organization of the process; describes the results achieved by UWHC; and lists the lessons learned along the way.

Moving Toward Strategic Planning Unique To Healthcare

THE TWO FEATURE ARTICLES in this issue present the state of the art in and the application of strategic healthcare planning. THE TEN BEST PRACTICES AND FOUR STAGES OF SOPHISTICATION In examining the state of the art, Alan Zuckerman identifies ten best practices. Apparently, performing well on the first nine of the ten positions an organization at stage two in his four-stage model of strategic planning sophistication. Performing well on number ten-managing strategically-vaults an organization into stage three. To achieve the highest level of sophistication (stage four), Zuckerman proposes that the organization needs to employ an additional five practices drawn from companies outside of healthcare. Zuckerman asks, What should healthcare organizations do to increase the rigor and sophistication of their strategic planning practices? One might argue, Nothing! If planners and executives are in agreement and pleased with the results (as reported in his study), perhaps making strategic planning complicated and time consuming (rigorous and sophisticated) may not be such a great idea. His assumption seems to be that more advanced will mean effective in the long run, but at the margin, the time or cost required or the degree of effectiveness gained may not be worth the effort. Zuckermaris best practices are separated into five that are related to the product and five that address the process of strategic planning. Only the fifth practice, achieve real benefits, is actually a product; all the rest are processes-the means and not ends in themselves. Furthermore, all ten best practices are not created equal, but rather several serve as inputs to others. In addition, the five practices (planning characteristics) outlined by Zuckerman and drawn from pathbreaking companies outside of the healthcare sector are actually characteristics or qualities for performing the ten best practices. STAGE-FOUR STRATEGIC PLANNING FOR HEALTHCARE For years we have advocated that healthcare organizations should adopt strategic management practices developed in the business sector-especially considering the relatively long history of strategic planning in business and the relatively short history of its use in healthcare. Certainly, in the late 19805 and 19905 many healthcare organizations had much to learn from pathbreaking companies. It appears that this approach has, for the most part, worked pretty well. As a result, healthcare organizations have come a long way in installing strategic planning and management practices since their cost-plus protective covering was ripped away in the mid-1980s. Transferability Practices from pathbreaking companies outside of healthcare for strategic planning, however, may not transfer to healthcare. It is not that increased rigor and sophistication of strategic planning practices (stage-four strategic planning) is not an appropriate goal for healthcare organizations or that the pathbreaking company's planning models do not provide some useful insights, but rather that an entirely different type of stage-four planning may be required-one that acknowledges healthcare's unique organizational and market characteristics. Coarse grain (stage one) strategic planning practices may be applied to any industry. Fine grain (stage four) practices may or may not apply. Healthcare needs to define its own stage-four strategic planning qualities. Unique considerations might include the following. 1. Some strategic alternatives available to non-healthcare organizations may not be realistic for many healthcare organizations. For example, unrelated diversification or vertical integration may not be viable, as organizations with a single dominant core business that is both capital intensive and human intensive have considerable difficulty operating successfully outside of that core. Further, service area limitations restrict market expansion (market development) for many services. …

Strategic Planning in Healthcare: Building a Quality-Based Plan Step by Step

Strategic Planning in Healthcare: Building a Quality-Based Plan Step by Step

Economics and mental health

Health economics has important contributions to make to both strategic health care planning and clinical decision-making. To date, its influence in the mental health field has been modest. However, there has been clear growth in the volume of economics research in this field and marked improvements in quality. This review examines recent developments in relation to resource allocation, cost of illness, cost-effectiveness evaluations and markets.

From directive expert to non-directive partner: a study of facilitating change in the occupational self-perceptions of health visitors and school nurses

Abstract A group of health professionals participated in a ten-week course in counselling skills for working with families whose children have special needs. A comparison group received no such training. Occupational self-perceptions were measured during training and at one-month follow-up. Significant shifts were found in perceptions of self as ‘expert’ to self as therapeutic ‘partner’. In particular, training produced positive changes in self-perceived counselling skills, internal locus of control, and self-esteem. It was concluded that training conceived along interdisciplinary lines can promote a belief amongst health-care professionals in the efficacy of working in partnership with families; that such an effect provides further support for working in such a way; and that appropriate provision of similar courses therefore should be incorporated into strategic health-care planning.