Health care governance structures and policy frameworks

Health Care Governance

Overview of the Health Care Organization and the Interviewees

The two stakeholders that I interviewed belong to a medium-size health care organization, particularly a community hospital. The organization has around 20 to 30 medical staffs including the doctors, nurses, and medical assistants. The community hospital, which started its operation 2 decades ago, houses 30 rooms for in-patients. Generally, it mostly provides its health care service to people residing within the area of its location as well as to people in the nearby communities. On average, the hospital receives around 5 to 10 in-patients in a day, making its 30 rooms almost always occupied. Currently, among the plans and projects that hospital is trying to pursue is to build a hospital extension to accommodate more patients and maintain a healthy environment for the patients.

A conducted an interview with two stakeholders belonging to different levels within the organization. One is a doctor and the other is a nurse. The doctor interviewee is a general physician and performs his duty in the community hospital for 8 hours, 3 days a week. He doesn't serve regular number of days in the community hospital because he also provides his medical responsibilities in a public city hospital as well as in a small clinic that he put up within his residence. The doctor has been in the practice of medicine for 15 years now and focuses in general healthcare in which his major responsibility is to provide comprehensive healthcare and further assistance in finding the right health personnel that can help an individual who seeks medical service (Bentzen, et.al., 1991). He has been serving his duties to the community hospital for 2 years now. He has a nurse staff in the community hospital that assists him in all his medical service.

The nurse, on the other hand, has been in the field of nursing for 7 years now and has already worked in two hospitals since she started her career in the medical service. The first hospital that she had worked for was a private hospital located in another state. She served that hospital for two years. After which, she transferred to a community hospital where she currently works at and has been providing her nursing expertise almost 5 years. Within this span of time, she has become familiar in the management procedures of the organization. One proof is that from time to time, she is participating in the planning and development of different management strategies that specifically relate to the improvement of assisting medical doctors in the provision of health care services to patients.

How Each Interview Influences Governance within the Scope of their Organization's Management Plan

The Doctor

The doctor has been with the community hospital for 2 years now but has already shared knowledge and skills in terms of managing the organization. Every month, the community hospital holds a meeting with all its staffs and the doctor participates in the discussion of management ideas especially in those related to the field of medicine, particularly on how to provide accurate and always-available medical service to patients.

The doctor influences governance within the scope of their organization's management plan through sharing of management ideas that he particularly learned from the different hospitals where he worked at in the past 15 years. Moreover, gathering from his experience as one of the board members in a private hospital where he served his medical services for 7 years, he influences governance in the community hospital by integrating the hospital's current organization policies with good policies that he learned from his health care service experiences.

One instance where the doctor had influenced governance in the community hospital's organization plan was when the hospital had been unable to accommodate the increasing number of patients. Because most of the health care staffs in the hospital are similarly providing their medical service in other hospitals, as with the doctor, there was not enough time for the organization to plan to work on the improvement of the management planning. But, for our doctor interviewee who has a commitment in the delivery of good health care service, he volunteered to organize the management planning and improvement of the organization's structure. However, the doctor did not just individually govern the management planning. Instead, he promoted shared governance within the organization wherein everyone was able to contribute in the improvement of the framework and structure of the community hospital. A body of model employees and staffs were formed to exercise the authority of implementing the management procedures that have been decided. As described by Laura Caramanica (2004), in her article Shared Governance: Hartford Hospital's Experience,

Shared Governance is the administration and deployment of the organization's services through a partnership model of managers and staff. A system is said to "live" where it provides service. In a health care organization this is the point of service known as the patient care unit.

The Nurse

Our next interviewee, the nurse, is also influencing in the governance of the community hospital. In fact, she is among the model hospital staff that helped our doctor interviewee in the planning of management procedures to improve the hospital community. As with our doctor interviewee who applied in the community hospital the good management governance that he saw and experienced from the hospitals where he worked at in the past, the nurse also shared her past work's experiences to the community hospital, as well as the good management structures and frameworks that she witnessed from the private hospital where she worked at before.