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MNG91220 Strategic Health Management

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MNG91220 Strategic Health Management

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Course Code: MNG91220
University: Southern Cross University

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Country: Australia

Identify and describe in detail remedial actions to address/solve the strategic issue (considering the attributes of effective healthcare manager as well as principles of justice and equity).
It is possible to incorporate a combination of different strategic management frameworks/models/theories to address the issue identified. However, different frameworks need to be integrated in a meaningful way. They can be implemented sequentially or simultaneously (e.g. identifying SWOT could be an appropriate start for planning).
Provide a critical discussion and justification for planning, implementing and evaluating the framework.
Provide detailed information about the ways in which you believe your approach/strategic model is likely to address the various aspects of the problem you have identified. Justify your approach using relevant theoretical literature/approaches which has informed your thinking.

The service sector associated with health care or hospital industry particularly depends on the availability of the adequate highly efficient health professionals in various health care field and improved medical technologies (Al-Sawai & Al-Shishtawy, 2015). It has been identified in the previous assignments that the health care sector suffers from high employee turnover, especially the rural health sector lacks skilled health professionals, thus, it has become difficult to provide adequate and effective care to the rural population, as a result various health issues have led to the consequence of high mortality rate (Ognyanova, Plotnikova & Busse, 2014). One of the main reason of such high employee turnover in health care sector is the lack of effective strategies for employee retention in rural settings. It has been identified that lack of motivation in the health workforce is one of the important factors that affect the health workforce. There are other factors as well for example, poor infrastructure, remuneration issue, poor incentive structure, lack of health and safety factor in the workplace, excessive workload, stress and others (Russell et al., 2017).  Such poor management leads to high turnover of skilled and highly efficient health professionals in the health care sectors, especially in rural settings.
The health workforce turnover has been identified as the global issue in health care sector by the World health Organization. According to WHO, the performance and productivity of a health care organization relies on the quality of care, composition of health workforce and appropriate distribution of health workers (WHO., 2014). It has been demonstrated that half of the global population especially the people residing in rustic areas face difficulties in accessing adequate and effective health service and one of the most significant reason of such poor health service is the shortage of health workforce (Crisp & Chen, 2014). The health care sector of Australia heavily depends upon the skilled health professionals and the statistics have indicated that the country would suffer from 2700 doctors and 109,500 nurses by the year 2025 (). The workforce of health sector is aging which causes reduction in the working hours. The geographic distribution of health workforce has indicated poor and unequal distribution of health workers. Such condition may resulted in poor health service, reduction in productivity, medical errors and reduction in the reputation of health care organizations (ahha.asn.au, 2018). Thus, it is important to introduce effective employee retention strategies in order to retain the skilled health professionals and address the issue of high turnover. In this regards the assignment aims to provide effective remedial framework that could help to resolve the issue of health workforce shortage and improve the health service in an effective manner.
Remedial framework:
Identification and selection of strategic management approach:
In order to introduce effective management strategies it is required to understand the health workforce and select the appropriate management approaches that could help to decrease the turnover of highly qualified and skilled health professionals and resolve the issue of workforce shortage in health care sector. In this regards the process of SWOT analysis would be beneficial as it helps to identify the strength, weakness, opportunity and threat of the health workforce, thus could facilitate the way of introducing management strategies while considering the above mentioned factors (Hill, Jones & Schilling, 2014).
SWOT analysis of health workforce:
Strengths: The health workforce contains highly skilled staffs and health professionals which can be considered as the biggest strength. On the other hand there is effective training and clinical practice session that helps the nursing students in order to understand the way of providing adequate and effective care to the people with need (Duffield et al., 2014). In addition, it has been found that there are some health professionals that are interested in working with community health care service which could increase the availability of health service (Newman, Ye & Leep, 2014). Furthermore, it has been found that there is scope for inter professional practice in the health care sector that allows the health professionals to understand the responsibilities of each other and collaborate in an effective manner in order to provide quality service (Pourshaban,  Basurto-Dávila & Shih, 2015). Thus, it is required to introduce strategies in order to improve such strengths and retain the skilled health professionals in the health sector.
Weaknesses: There are some significant weaknesses of the health workforce for example, most of the skilled professionals avoid working in the rural settings they provide service mostly in the metropolitan cities. Such condition leads to inadequate health service in rural settings (Duffield et al., 2014). On the other and the lack of motivation, poor incentive structure, poor infrastructure and lack of health and safety in the workplace also play an important role in demotivating the health workforce (Newman, Ye & Leep, 2014). In addition due to workforce shortage most of the health professionals or nurses has to take care of many patients, which lead to poor nurse-patient ratio that affect the quality of care as well (Liu et al., 2012). Thus it is important to implement effective management strategies while considering such weaknesses of the health workforce in order to address them in an effective manner.
Opportunities: Beside the strength and weaknesses there are several opportunities for the health workforce that could be utilized in order to resolve the issue of workforce shortage or retain the efficient health workers. One of such opportunity is the introduction of effective policies to improve the incentive structure and set some rules and regulation for the health professionals to provide service in the rural settings (Duffield et al., 2014). On the other hand, there is opportunity to encourage and appreciate the health workers for their contribution in order to motivate them to continue their quality service. Further, the health care organizations could consider the health and safety factors for the health workers and improve the infrastructure to reduce the rate of occupational death of health workers in the workplace (Bertman, 2016). In addition the improved training process and scope of practice for the nursing students could help to attract the students to join the health workforce (Newman, Ye & Leep, 2014). Utilizing such opportunities could be helpful to resolve the issue of high turnover in health care sector.
Threats: In order to implement adequate management strategies it is essential to analyze the various threats and implement effective strategies to reduce the threats and manage the condition in an effective manner. In this regards it has been found that the migration of health professionals could be one of the biggest threat for health care organization. Due to lack of opportunity many health workers in the rural or poorly developed places are migrating to developed areas for better career opportunity (Pourshaban,  Basurto-Dávila & Shih, 2015). Thus, it is important to improve the retention plan in health care sector in order to reduce the prevalence of migration of health workers.
Effective management strategies:
The above discussion has identified potential strengths, weaknesses, opportunities and threats for health workforce. Based on such identification the following strategies could be implemented in order to retain the skilled health professionals and attract new health professionals in the health sector in order to address the issue of health workforce shortage.
The first remedial strategy should be introducing new policies and developing existing policies in order to improve the incentive structure to retain the skilled health workers and attract the new graduate students to join health workforce (Bryant & Allen, 2013).
Secondly, it is required to improve the health and safety factors in the hospitals. In this regards improvement in the infrastructures is important in order to provide adequate measures during emergency (Al-Sawai & Al-Shishtawy, 2015).
The third strategy should be introducing some rules and regulations for the health professionals in order to encourage them to provide service in the rural areas which could increase the availability of health service in such areas (Russell et al., 2017).
Fourth, it is required to improve the training process of nursing students and introduce effective learning approaches that could motivate the nursing students in order to provide quality service and join the health workforce. Effective training could help the students to learn the essential skill and use them in the clinical practice in order to become efficient health professional (Al-Sawai & Al-Shishtawy, 2015).
Lastly, it is required to introduce some appreciation for the contribution of the health professionals in order to motivate them to provide consistent performance with high quality (Bryant & Allen, 2013).
According to the current situation Russell et al., (2017) have demonstrated that future demand for health service will be increase due to high prevalence of various communicable and non-communicable diseases, aging of the population and changes in the expectations of the consumers. Thus, it is important to implement such strategies in order to retain the skilled health professionals and attract the new health workers to mitigate the health workforce shortage in an effective manner (Al-Sawai & Al-Shishtawy, 2015).
Critical argument around remedial framework:
While critically analyzing the strategies for healthcare employee retention and their development in the rural settings, it should be mentioned that these strategies are useful for each kind of organization as all of these are inclusive of different concepts and theories of workplace. These concepts are ethical consideration, social responsibility, teamwork, leadership as well as humanistic management using which organizations can understand the strategies using which the employee retention could be achieved.
The first strategy used for this aspect was associated to employee benefits which is given in the form of incentives. Further, the strategy also mentioned about creating a policy or improving an existing system so that the helathcare employee who are leaving the rural healthcare setting due to excessive work and less amount of pay can be compensated. As per the research of Sinha and Sinha (2012), incentive system is an important system to motivate employees to include their extra efforts for the benefit of the organization and in return they are provided with a specific monetary reward. The researcher also mentioned the best aspect of this policy and strategy as it can be implemented in any organization with a large work force and a better policy related to incentives are always accepted by the workforce as they are being paid for their extra effect they made for the betterment of their organizations well as for themselves (Lowe, 2012).
On the other hand, the second strategy discussed about one of the major factors due to which majority of the healthcare professionals are leaving their job and the reason is occupational health and safety. There are several incidences has been registered and discussed in the research articles that majority of the critical infections the healthcare professions acquire, occurs due to the helathcare hazards and lack of safety policies in the healthcare facility (Huang, You & Tsai, 2012). Therefore, the strategy mentions that healthcare organization should implement strategy using which enforcing helathcare occupational health and safety could be implemented and followed. This is the ethical responsibility of the employer to include this aspect in the helathcare facility as there are evidences that indicated to the fact that lack of educational health and safety is an important aspect for majority of the healthcare professionals job quitting. Therefore, implementing health and safety policies in the organization should be used as one of the strategy for employee retention in the rural healthcare settings.
Further as per Lowe (2012), training is the process using which a large number of workforce can be provided with education and skill training and those knowledge persist in their memory for a longer time as audio visual mode of resources are used in the process. Therefore, it is an important aspect for the growth and development of the employees of the healthcare department (Aguenza & Som, 2012). There are instances when the employees of rural healthcare settings cannot complete their training period and due to burnout they quit their job to move to other cities or metropolitans (Lowe, 2012). Therefore, it is the responsibility of the helathcare facilities to take care of the helathcare professionals and their knowledge and understanding about the care facility in the primary days so that while working in the helathcare facility or attending training processes in their primary days they can understand the need of their retention and their value in the healthcare facility (Aguenza & Som, 2012).
Another strategy which was involved in the helathcare facility for the involvement and retention of helathcare professionals in the rural settings was creating rules and regulation for the people as well as for the employee in the helathcare facility (Huang, You & Tsai, 2012). This is an important aspect as majority of the helathcare employees chosen metropolitan cities for their occupation and in the course, the rural helathcare facilities and their nurse to patient ratio increases drastically (Mosadeghrad, 2013). Therefore, it is the duty of the local as well as national government to make regulations and policies so that while going through the process, they can provide ample taskforce to the rural helathcare facility (Aguenza & Som, 2012). As the researchers mentioned that making policies and regulations will be able to make changes in the healthcare policy and number of workforce in the rural healthcare facility can be increased (Huang, You & Tsai, 2012).
The introduction of rewards and recognition have been reported to prevent employee attrition in organizations effectively (Dobre, 2013). It has been seen that employee turnover rate can be controlled to a significant extent with the introduction of motivation strategies. Studies have further revealed that money is not the only motivation factor that could successfully prevent employee turnover rate (Muogbo, 2013). Rewards such as the introduction of the incentive scheme can help in the promotion of motivation. Rewards could also be in the form of a token of appreciation or a gift card that could be an equivalent for an appreciation of a good work. Further, inclusion of awards on the basis of performance can help in motivating other employees. Recognizing the good performance of an employee can also help in appreciation and at the same time inspire other employees to engage in a healthy competition (Sajuyigbe et al., 2013). It has been significantly observed by researchers that employees perform better on being exposed to a healthy competitive environment.
The recognition and reward policies could comprise of aspects such as giving away promotional materials or in case of exceptional performance awarding a short trip. In addition to this publication of the success stories of top performers can help in shedding light on the efforts put in by the people and the obstacles encountered. Rewards might not be in the form of gift cards or promotional material always, it can also be other benefits such as granting an extra leave that could be availed by the employee for working post the shift timing in order to uphold the value of client commitment. It should also be critically mentioned here that the rewards and recognition scheme should be based upon the evaluation made by the key performance indicator tools (Sajuyigbe et al., 2013). The KPI tool could engage and cover a multitude of aspects such as performance, attendance, client satisfaction and communication (Njoroge & Yazdanifard, 2014). For each category it is advised that there should be a separate range of rewards in order to inspire employees to perform to the best of their ability. It would not only help in the prevention of employee turnover but also attract other professionals from different areas.
Hence to conclude, it can be said that employee turnover is a serious issue that leads to the negative promotion of the brand name of an organization. It is important to understand the fact the employees are the most valuable asset of an organization and the employee-organization relationship is broadly based upon demand and expectation. Therefore. The organization must take into consideration the employee needs and accordingly reform the existing policies so as to promote a healthier and positive environment. The most important factor that determines employee motivation is the flexibility in terms of organizational policies and improves employee benefit schemes. The inclusion of benefit schemes such as better leave policy, improved incentive structure, medical benefits and recognition can help in maximising employee satisfaction to a great level.
In order to prevent the employee retention in the concerned organization it is suggested that the Organization must adhere to the following strategies:

Reform the organization policies and involve the employees equally while undertaking a critical decision for the organization
Inclusion of training and workshops in order to equip the nursing professionals with better opportunities so as to enhance their skills while dispensing service delivery
Improvisation of the organizational infrastructure and inclusion of upgraded instruments so as to engage the professionals in advanced learning
Inclusion of an incentive plan, better leave policies, bonus schemes, reward and recognition and recreation therapies can help in inducing motivation among the workers
Inclusion of a risk safety environment and counselling sessions for employees can help in mitigating work related stress and promote a positive work environment that would facilitate better work output.

ahha.asn.au (2018). Retrieved from https://ahha.asn.au/sites/default/files/docs/policy-issue/ahha_position_statement_-_health_workforce_3.pdf
Al-Sawai, A., & Al-Shishtawy, M. M. (2015). Health Workforce Planning: An overview and suggested approach in Oman. Sultan Qaboos University Medical Journal, 15(1), e27.
Bertman, S. L. (2016). Facing death: images, insights, and interventions: a handbook for educators, healthcare professionals, and counselors. Taylor & Francis. pp. 4-197
Bryant, P.C. & Allen, D.G., (2013). Compensation, benefits and employee turnover: HR strategies for retaining top talent. Compensation & Benefits Review, 45(3), pp.171-175.
Crisp, N., & Chen, L. (2014). Global supply of health professionals. New England Journal of Medicine, 370(10), 950-957.
Dobre, O. I. (2013). Employee motivation and organizational performance. Review of Applied Socio-Economic Research, 5(1).
Duffield, C. M., Roche, M. A., Homer, C., Buchan, J., & Dimitrelis, S. (2014). A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing, 70(12), 2703-2712.
Hill, C. W., Jones, G. R., & Schilling, M. A. (2014). Strategic management: theory: an integrated approach. Cengage Learning. 11th edition. pp. 43-395.
Liu, L. F., Lee, S., Chia, P. F., Chi, S. C., & Yin, Y. C. (2012). Exploring the association between nurse workload and nurse-sensitive patient safety outcome indicators. Journal of nursing research, 20(4), 300-309.
Muogbo, U. S. (2013). The impact of employee motivation on organisational performance (a study of some selected firms in anambra state nigeria). The international journal of engineering and science, 2(7), 70-80.
Newman, S. J., Ye, J., & Leep, C. J. (2014). Workforce turnover at local health departments: nature, characteristics, and implications. American journal of preventive medicine, 47(5), S337-S343.
Njoroge, C. N., & Yazdanifard, R. (2014). The impact of social and emotional intelligence on employee motivation in a multigenerational workplace. Global Journal of Management And Business Research.
Ognyanova, D., Plotnikova, E., & Busse, R. (2014). The unfinished workforce agenda: Europe as a test-bed for policy effectiveness. Health professional mobility in a changing Europe, 269.
Pourshaban, D., Basurto-Dávila, R., & Shih, M. (2015). Building and sustaining strong public health agencies: determinants of workforce turnover. Journal of Public Health Management and Practice, 21, S80-S90.
Russell, D.J., Zhao, Y., Guthridge, S., Ramjan, M., Jones, M.P., Humphreys, J.S. & Wakerman, J., (2017). Patterns of resident health workforce turnover and retention in remote communities of the Northern Territory of Australia, 2013–2015. Human resources for health, 15(1), p.52.
Sajuyigbe, A. S., Olaoye, B. O., & Adeyemi, M. A. (2013). Impact of reward on employees performance in a selected manufacturing companies in Ibadan, Oyo state, Nigeria. International Journal of Arts and Commerce, 2(2), 27-32.
WHO., 2014- Global health workforce shortage to reach 12.9 million in coming decades, News Release, https://www.who.int/mediacentre/news/releases/2013/health-workforce-shortage/en/, downloaded on 3/20/2015.

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