Casemix Information, ABF Funding Model, And Healthcare Management

The ABF Funding Model in Australian Public Health Services

1. Skills and attributes for contemporary health management and major challenges faced by managers

In order to provide an effective healthcare the following skills as well as attributes are needed in healthcare administrators or managers

• Appropriate academic training and previous work experience

Possessing a degree from an accredited university demonstrate effective theoretical knowledge about healthcare management. Moreover, previous work experience in the field makes it easier for manager to face adverse situation due to knowledge gathered from previous experience (Ricci, 2013).

• Excellent communication skills:

Excellent written as well as oral communication skills are highly required to manage the healthcare system efficiently. As a manager, it is highly crucial to communicate with the colleagues, subordinates as well as superiors effortlessly in order to avoid confusion.

• Adaptability, flexibility and good organizational fit

In order to fit well in the organization as well as to fit in with the goals and objectives of the same it is highly crucial for managers to be flexible and adaptable. Moreover, in case of change management, managers should be the first one to good for organizational fit (Cherry & Jacob, 2016).

• Efficient professional judgment, strong character and dependability

Enough maturity along with the decision making capability in order to make decisions is a highly crucial skill that a healthcare manager must possess. Along with that good moral compass that enables honest and ethical business decisions is highly required to enhance the efficiently of the organization.

One of the major challenges of the contemporary healthcare system is ethical challenges related to the confidentially of the patients which has the potential to lead to fatal coincidence. The professional judgment skill along with effective communication skills of manager helps the same to solve these types of issue effectively.

1. Aspects of human resource in healthcare development and challenges associated with them

Majority of the healthcare organizations in Australia operates in a constantly changing business environment. In order to handle such situation and provide the health care service users with high quality treatment, both resourcing as well as funding is required.  One of the major challenges faced by the contemporary health care system includes too many health worker in some occupation and very few in others. This type of issue bears the potential to distort the healthcare system, reduce the performance and productivity of the healthcare service users and thus results in low morale (Flynn, 2013). In order to solve the issue, it has been found that the management chiefly focuses on providing training to the already existing healthcare service providers. However, instead of that that recruitment of more professionals and providing them with effective training is needed to solve the issue from core.

Another major healthcare issue associated with resourcing and funding includes inappropriate training provided to the healthcare service users resulting in lo quality healthcare. Not only has that, Small 2 armies of poorly trained and supervised support personnel reduced the productivity of the whole system. In order to deal with such situation the management of several healthcare organizations has undergone HRH planning. However, due to lack of support from strategic planning in general along with limited sustained support for planning, the HRH planning lacks success (Riva et al., 2012).

Main Uses of Casemix Information in a Hospital Setting

The Activity Based Funding is a Rudd hospital reform plan. According to the mentioned model, providers are funded based on the activity they undertake. Considering the fact that majority of the healthcare home activity involves treating patients or cases, the term casemix funding is used. Casemix information informs the ABF funding model about the healthcare service users and related procedures into groups based on the type as well as mix of the patients treated (Desselle, Zgarrick & Alston, 2012). Along with that, it provides the ABF Model detailed description of the injuries and diseases.

The ABF was introduced in order to ensure that healthcare organizations that treat greater number of patients and patients with more complex diseases are receiving more funding compared to that of the organizations that treats lesser number of patients. Earlier, the entire healthcare home used to receive similar funding. This in turn, used to hamper the quality of service provided by the healthcare home with greater number of patients. Thus the rationale of ABF funding is to enhance and maintain the quality of services provide by the healthcare homes to the healthcare service users of Australia.

Casemix information helps the management of the hospital to access the degree of variety odd patients who are being treated by the health care professions. This in turn not only help the managers to plan the amount of recourses need to provide quality services to the patients but also helps the same to plan the budget for effective healthcare service provision ( Hupp, Tucker & Ellis, 2013).

Considering the fact that change management in business is considered to be a complicated issue, the following factors are highly crucial to employ change in a healthcare organization.

• Appropriate planning: Having a clear as well as valid reason for the change process is highly crucial. In order to successfully implement a change, effective planning of each and every steps that would be taken in order to re-freeze the change should be conducted.
• Effective communication:  The most important factor for ensuring an effective change management includes communicating the change to the key stake holders of the healthcare home that includes employees, shareholders as well as consumers through various external and internal communication tools like social media platforms and intranet (Ross et al., 2014). Effective communication helps the management to provide the stake holders with better understanding of the changes.
• Integration: Considering the fact that the healthcare service provides directly communicate with the patients and have greater knowledge about their specific needs it is crucial to integrate the change with for consultation with the stakeholder group (Ayo 2012)

Change is crucial for the healthcare home since it allows the same to adapt to its environment and improve its market position by offering up to date facilities to the healthcare service users. This in turn helps the organization to gain competitive advantage over the competitor and enhance its yearly profit.

• The term strategic management can be defined as an organizational wide activity where the operations sales are concerned from the bottom level of the organization to the top level. In contrary, operational management is concerned about operations as in the production function of a company at the manufacturing floor level of the organization (Amin, 2014).
• Strategic management is considered to be a long term process where the long term desired level of the performance are identified and are tried to achieve. In contrary, operational management is defined to be a short term process that ensures that the day to day activities are focused as well as handled effectively.
• While the strategic management include a non-reutilized tasks which is ambiguous and dynamic in nature, the operational management includes day to day activities which is highly routinized and mechanical. The later does not involve ambiguity.

In order to ensure an effective development of strategies for a healthcare organization, the following factors needs to be considered:

• Supportive visionary leadership: Considering the fact that the quality of leadership and management impose ample impact on the satisfaction as well as motivation of the employees, it is highly crucial for the organization to train the leaders effectively (Holton et al., 2015).
• Education and training of the employees: In order to deliver efficient service to the healthcare service users, the healthcare staffs needs to be provided with effective training and education amount hygiene and others.
• Availability of resources: Working with low quality material is bound to reduce the effectiveness of the service provided to the patients. Hence, it is crucial to ensure that the health care home have enough high quality medical resources so that the best of the care can be delivered to the healthcare service users.

Integrated governance is highly important for healthcare management since it ensure effective public services as well as improved social outcomes. Efficient governance of hospitals requires responsible as well as effective use of funds, professional management and competent governing structures. Some of the important assets of good governance include establishing as well as maintaining public trust, awareness of the resources of the community and ensuring high quality care (Daly, Speedy & Jackson, 2015).

Employing Change Management

The major accountabilities, systems and processes need for good governance are as follows:

• Role and responsibilities: There should be clarity regarding organizational expectation, individual responsibilities and role of each steering committee and executives.
• Risk management:  executive committees can help enhance the likelihood by putting in place a proper system of risk oversight as well as internal controls. Proper rik management will enable the organization to ensure a risk free workplace
• Transparency: Transparency should be there in the flow of the information. Processes, institutions as well as information should be directly accessible to only those individuals concerned with them, and enough information is provided to understand and monitor them.
• Accountability: It should be kept in mind that all the decision makers are accountability to the consumers as well as to the institutional stakeholders. However, the accountability differs depending on the healthcare home and if the decision is external or internal to an organization.
• Equity
  both male as well as female employees should be provided with the opportunity to improve or maintain their well-being.

You have been asked to manage the accreditation process for your facility, what are the key elements in any quality system? You see the need for new resources in this area, how do you pitch your request for more funding to the board/Area CEO

The 5 key elements of a quality healthcare system are as follows:

• Safety: All the healthcare service users are secure and no harm to the health of the patients from the care provided by the organization that is intended to help them has place (Holton et al., 2016).
• Effectiveness: The service provided to the patients is based on the scientific knowledge to all who could get benefited as well as refrain from providing services to those not likely to get benefited.  
• Patient-centered: The care provided to the patient is respectful as well as responsive to the preferences, requirements as well as values of each healthcare service users, it should also be checked that all the patients follows as well a values  the guideline of the rules and regulations off the healthcare home (Leung et al., 2018).
• Timely: Timely approachreduces the waiting time and harmful delays for both the healthcare service users as well as providers.
• Efficient: Organization is avoiding unnecessary wastage of equipments, supplies, energy and ideas.
• Equitable: Organization is providing a care with invariable equity due to gender, ethnicity and other factors.

This is to inform you that XYZ Organization is suffering from shortage of resources. For instance the whole organization has only one monometer. This in turn is hampering their quality of services provided to the healthcare service user. I will be highly obliged if you grant the request to enhance the funding of the organization.

1. Separating individual from the issue: Considering the fact that communicating, emotion as well as perception can cloud the issue that needs to be negotiated, during I will ensure to avoid anger or fear and negotiate putting my self in the position of my opponent party.
2. Focusing on the Interests: In order to ensure an effective negotiation I will ensure to identify the specific interest of both the parties involved, instead of focusing on the position of the subject (Mitchell & Beales, 2015).
3. Generating opinions: Being a leader, it is crucial for me to generate a good number of alternative options. I will also ensure not to judge the ideas given by my opponents. The generation of ideas should involve shifting the thinking among the tasks of stating the problem, analyzing it, taking general approaches, and considering specific actions.
4. Using objective Criterion: I will ensure that both the parties are using objective criteria in present of the opponent. Objective criteria that include legal percent, industry statistics and scientific studies will be developed.
5. Dealing with issues one by one: As a negotiator, I will try to deal with each of the issues presented by the opponent one by one instead of looking at the negation as a single entity. Making concession on one issue will ensure goodwill which in turn will impose a positive impact while solving the next one.

Reference List

Amin, S. (2014). Capitalism in the age of globalization: The management of contemporary society. Zed Books Ltd.

Ayo, N. (2012). Understanding health promotion in a neoliberal climate and the making of health conscious citizens. Critical public health, 22(1), 99-105.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Daly, J., Speedy, S., & Jackson, D. (2015). Leadership and Nursing: Contemporary Perspectives. Elsevier Health Sciences.

Desselle, S. P., Zgarrick, D. P., & Alston, G. (2012). Pharmacy management. McGraw-Hill Publishing.

Flynn, R. (2012). Structures of control in health management. Routledge.

Holton, S., Rowe, H., Kirkman, M., Jordan, L., McNamee, K., Bayly, C., … & Fisher, J. (2015). Erratum: Long-acting reversible contraception: Findings from the Understanding Fertility Management in Contemporary Australia survey (European Journal of Contraception and Reproductive Health Care). European Journal of Contraception and Reproductive Health Care, 20(5), 409-409.

Holton, S., Rowe, H., Kirkman, M., Jordan, L., McNamee, K., Bayly, C., … & Fisher, J. (2016). Barriers to managing fertility: findings from the Understanding Fertility Management in Contemporary Australia Facebook discussion group. Interactive journal of medical research, 5(1).

Hupp, J. R., Tucker, M. R., & Ellis, E. (2013). Contemporary Oral and Maxillofacial Surgery-E-Book. Elsevier Health Sciences.

Leung, G., Ho, E. Y., Chi, H. L., Huang, S., Ting, I. K., Chan, D., … & Seligman, H. K. (2018). “We (Tong) Chinese”: Contemporary identity positioning through health management among Cantonese Chinese Americans. Journal of International and Intercultural Communication, 1-15.

Mitchell, T., & Beales, D. (2015). Knowledge and Use of The ‘Clinical Framework For the Delivery of Health Services’ in Western Australia: Summary report of a survey of Workers’ Compensation stakeholders.

Ricci, S. S. (2013). Essentials of maternity, newborn, & women’s health nursing. Wolters Kluwer Health| Lippincott Williams & Wilkins.

Riva, S., Monti, M., Iannello, P., & Antonietti, A. (2012). The representation of risk in routine medical experience: what actions for contemporary health policy?. PLoS One, 7(11), e48297.

Ross, A. C., Caballero, B., Cousins, R. J., Tucker, K. L., & Ziegler, T. R. (2014). Modern nutrition in health and disease(No. Ed. 11). Lippincott Williams & Wilkins.