1. How readily can the concepts of ‘evidence-based decision making’ be applied in the strategic decision making of health service management executives? Justify your arguments.
2. What leadership style(s) is/are most suitable to manage strategic changes in health care? Justify your answer which includes providing examples of strategic health changes.
1. Evidence based decision making process can be implemented with the strategic decision making in a health care organisation, with objective of maintaining work continuity and achieving effectiveness in care delivery (Légaré, 2014). Health care executives, administrators and professionals uses the evidence from various researches to implement their opinion, knowledge, and perspectives within their decision-making process of routine care delivery. This concept of clinical services has become an integral part of health care centres all over the world, owing to the fact of proven efficacies in care outcomes, which has been further explained with an example, that can provide clear understanding.
Use of evidence-based decision making helps the managers to make strategic planning about how to organise, deliver and operate the health services (Légaré, 2014). For instance, the Australian government uses demographic information, population dynamics, incidence of diseases, and effectiveness of medication (post-marketing surveillance) within the pharmaceutical companies, which allows easy access of the prescribed medicines for community. The measure is also effective in terms that it makes the medication production, cost effective (due to presumed market demand) (Alonso-Coello, 2016). Another example illustrates Australian childhood immunization register which uses the evidence based vaccination policy. According to their earlier statistics, the estimated cost for the vaccination for childhood immunization was supposed to increase from $6 million annually to around $60 million. Here in this case population based observational information was used in determining the increased profit, in conjunction to the expanded vaccination policy (Barry & Edgman-Levitan, 2012). The above-mentioned example thus illustrates how the evidence based decision making process renders cost effective solution to manage the health requirement of Australian community, thereby also offering access to medication and immunisation requirements.
Similarly, in another case of Australian medical care related to optometrists, the above technique of evidence-based decision making has been used. This clinical practice here includes the diagnosis, analysis, and supervision of dry eye. The Australian optometrists mostly used the phenol red test and tear osmolality test based on the research evidence data of dry eye (Alonso-Coello, 2016). These primary sources of evidence further helped the optometrist practitioners in their routine clinical services that in turn is reflective with optimal standards in managing care delivery of commonwealth. A statistical analysis was done on Australian women suffering from polycystic ovary syndrome (PCOS) based on the evidence based guidelines, which was subsidized by the Government of Australia (Department of health and ageing). According to the evidence, about 21% of the Australian reproductive-age are facing PCOS, and mostly who are weighty. Thus, in the year 2003, a conclusion was made on PCOS by the Rotterdam consensus workshop based on the guideline and according to it, ultrasound of either oligo or anovulation and polycystic ovaries is implemented as an effective diagnostic tool. Similarly, another such instance was seen in the year 2003, where the national health and research council of Australia provided the evidence based guidelines for the acute low back pain (LBP) to every Australian practitioner. According to the evidence the practitioners supported either of the two methods, that is conducting x-ray if fracture is detected and another is providing appropriate treatment. While it should be noted that practitioners should not implement these evidences blindly, rather they should do proper research and study before implementation in routine services (Melnyk, Gallagher?Ford, Long & Fineout?Overholt, 2014). Thus, these examples, explain how the evidence-based decision making is helpful in managing the standards of care delivery and managing customer satisfaction.
2. Change is the key to success for every organisation, especially the health care organisation, where strategic changes have potential to manage the effectiveness and brings positive outcomes. The change can be in the form of structure of the health care departments or in the selection of the treatment procedure, or in the treatment instruments. In this regard, it is noteworthy to mention that the implementation of the change or the innovation might not work properly, because of the wrong implementation procedure (Daly, Jackson, Mannix & Hutchinson, 2014). Thus, in a health care organisation proper management and implementation of the change is a matter of key concern which needs to be handled effectively by the medical leaders. For a successful strategic health change management, the medical leader has to properly evaluate, plan and implement the necessary actions and strategies needed. Additionally, the proper coordination of medical leaders and other health care staffs is requisite to implement the change successfully. The various leadership qualities needed for efficient strategic change management are:
Charismatic leadership- In a health care management, a medical leader should be charismatic in order to drive transformation among the medical staffs to successfully implement change in the department. They give new strategic view and preview its positive outcomes to gain maximum support from the staffs (Fulop & Mark, 2013). They identify their staffs needs, which includes doctors, nurses, technicians, pharmacists and other employees and bring the change accordingly. Notably, in some cases the patients also disagree to implement the change in the health care system to avoid the risk factor. Thus, a charismatic leader can only direct them towards the change with the use of communication, mentor relationship, and visionary for long term benefits.
Visionary leadership- A visionary medical leader has the potential to change the vision of implementation into reality. This leadership style helps in proper evaluation, analysis of the outcomes, and manages the results from the change implementation into visionary objective. Notably, the visionary leader has characteristics of making use of evidences in strategic change plans and also have effective communication skills to convince others (Hurley & Hutchinson, 2013).
Transformational leadership- The transformational medical leader will always try to initiate change in the health care system by virtue of their perspectives, wisdom, evidence, and justified rationale. They motivate the medical staffs, the senior management and the patients to follow and implement the change in the medical procedure, which in turn is always effective in managing the standards of outcomes (Sebastian, 2014). They use challenging steps to get the higher result in course of time, which marks their attitude of strategic decision making distinct from other leaders.
Strategic leadership- A strategic leader within health care settings is generally the head of the organisation, who is always willing to provide change in the research, procedures and medicines. The leaders should provide proper medical training to the doctors and nurses to adopt the new procedures. Note that strategic leader always make use of evidence in the process of strategic planning (Hurley & Hutchinson, 2013). Likewise, they also put emphasis on the training and education related framework to bring optimal competency level in their employees. Correspondingly, they also make rationalised usage of evaluation and monitoring framework to achieve efficacy in their implemented strategic changes.
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Alonso-Coello, P., Oxman, A. D., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., & Guyatt, G. H. (2016). GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines. bmj, 353, i2089.
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