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Paper Topic:

DILEMMA OF HEALTHCARE INDUSTRY:HOW TO RECRUIT, IMPROVE AND RETAIN GOOD EMPLOYEES IN TODAYS` COMPETITIVE MARKET

Introduction

Health care professionals are the heart and soul of the health care industry . Aside from providing the expertise of the profession they also represent the humanity of the profession . The great demand in health care services is most apparent in the demand for health care professionals and their educational and development necessities

The industry itself is trying to find its footing with the new developments in society , technology and opinions on heath and wellness Developing the necessary competencies has been the most urgent priority in the industry particularly in organizational

and personal development in the field (Woolman et al , 2002 . It is not only the patients and the health needs that are driving the need but it is also the realization of the professional and personal challenges faced by health care workers themselves

Recent global health crises are prompting the institution to create a global disaster response system . The Asian Development Bank together with the United Nations is creating the necessary response measures and leaderships to be lead by WHO , UNICEF , UNESCO and UN Peace Corps in the event of these health crises . The motivation is their realization is that the health care industry is becoming more globalized than any other field faster than anyone has expected . Disease prevalence in one region can easily spread through ease of transportation and contact among regions via people and indirect exposure that technology ahs afforded us (World Watch Institute , 2005

Significance of the Study

The need to obtain , maintain and develop manpower in the healthcare industry is directly related to the quality of healthcare service that is rendered . Therefore , the attention given to the recruitment retention and development of employees in the industry translates to competitiveness and competence . At the same time , greater awareness among the public about the health industry is making them demand for well-trained health vary providers to ensure their well being

Thus , the establishment of development programs should become a priority of every institution that aims to be a viable health care provider much more to lead the industry . The study aims to be able to identify what is the demand for health care professionals : the perception of patients and the current educational and training requirements . Identifying these factors provides health care institutions with programs that need to be included into their programs for their employees answering not only professional and productivity requirements but also ensuring the health of employees as well (Buchanan , 1994

Considering the manpower crisis in the industry today , institutions need to become more aggressive in being able to have the manpower they need (Massey et al , 1998 . Europe and North America have had to source a great deal of health care professionals from Asia to augment their respective country 's industries . The competition that also exists between institutions is one of the factors why developmental programs are needed . Increasing the competence of health professionals within the institution can contribute to their overall job satisfaction and longevity (Leatherman , 2001 . This is the motivation for creating programs that enrich the profession and the personal development of health professionals otherwise , they will be unable to meet the challenges of the most recent developments in health care today

Background of the Study

According to the World Watch Institute (2005 , one of the most urgent issues that have to be addressed today is the concern that pertains to health and wellness . The study points out that the concern should not be limited to the field of expertise or the countries health institutions are based in but because of the nature of human traffic , transportation and interaction today should adopt a wider perspective . A significant fact of acknowledging these issues is the training of professionals to address both medical and non-medical concerns of patients

For example , in treating communicable diseases that have epidemic consequences , localized knowledge or experience is not enough . As seen in the recent bird flu scares , the reality is that health professionals play a vital role in detecting and controlling the spread of the virus but are given very little training to deal with the situation before hand . Another case in point is in the incidence of malaria . Whereas before the affliction was considered a concern generally for tropical climates , there has been an increase in incidence in colder climes because of the increase in people form these regions vacationing in tropical countries . Thus , there has been a need to review the various approaches to the disease considering the manner of affliction and the spread (Dawson et al , 2005

In 2001 , the World Health Organization (WHO ) has made efforts to reorganize different health requirements both for institutions and professionals . The effort is primarily motivated to recognize the various demographical and social developments that health care professional encounter today . Another motivation of the project is to identify the key priorities of development in the industry . In the course of the study , technology and manpower were identified as the key drivers of development in health institutions . Particular focus has been given to the manpower because it has lesser economic constraints . Though it is not saying that the cost of developing the professional competencies is not costly , it is saying that manpower has a greater impact based on cost on improving services and patient satisfaction

Considering this , it can be seen that the people factor in health institutions can augment other resources that may not be as easy to develop . As reported by UK Centre for the Measurement of Government Activity (2006 , public health is an essential service the state has to provide to be able to serve society and improve its competencies . Health professionals are given the task of not only being able to do their functions within the confines of health institutions but are now being asked to extend their services in community settings . This development has become more in demand as it becomes apparent that patients are showing better results by having social rehabilitation (Bouguet , 2002

Review of Related Literature

Most of the traditional literature that focuses on development in the health care industries is focused on the development of institutions rather than individuals . However , recent studies particularly those done in the last three years have shown the growing evidence that it is the professionals themselves who should be the focus of development

Studies done by Democratic Health Network (2006 ) indicate that there is direct correlation to the health of patients to the health of health service providers . Bracken and Thomas (2006 ) reported that new developments instituted for care in post-psychiatry have had significant success in improving patients . The new care programs have been done through training of health professionals in the combination of clinical and community-based care as recommended by their respective health services . In so doing , health care professional are tasked not only to treat and rehabilitate patients but also to take a more active role in socialization and productivity of patients

History

Health is a prevailing concern of all societies . This is because of health directly affects the productivity and the success of society Historically , health care is closely related to cultural and religious beliefs but once it was considered a scientific discipline , health and medical science started to become universal and methodological in approach . The establishment of health care institutions is a perennial state institution or concern , though socialized health programs only became institutionalized in the 20th century (Blank , 2002 . These efforts have had the function of defining the modern concept of the health care industry by establishing the standards of practice and treatment for diseases

The health care industry as we know it today has private and public elements into it similar to the traditional form . The distinct difference however is in the institution of the practices and the extent of state control over the industry which is designed to endure quality and accessibility of the service . There has become greater access to health services , both public and private , primarily because of socialized health programs and health assurance programs

Socialized health programs were developed after World War II to aid the restoration efforts . The programs were first designed in England by William Beveridge but since have been adopted and modified by all other countries (Ries et al , 2004 . Health care assurance developed together with the development of the insurance industry . It started out in industrial settings but soon was adapted to the consumer markets Initially , the service coverage only included standard medical services but now most contracts include non-medical or non-essential services for enhancement or cosmetic purposes (Manfredi Maioni , 2002

The increased variation on the range of health and medical services has prompted the development of professional and developmental aims in the industry . Further distinctions in training and function of professionals has been done to specialize necessary skills delineating the professional sector as a distinct element of the industry separate form medical and health services . The industry has always been a good indicator of the status and success of any society . Though there has been emphasis on its importance , it often does not receive the attention due it

Today , there is a more substantial understanding in the importance of health care in developing competencies for globalization . At the same time , the realization of health in the global perspective has increased cooperation of many health institutions

The Healthcare Industry

The health industry has role that extends beyond its function to include social and economic implications . The health industry today is one of the most affected by technology and social developments because it follows closely the life of people and their needs . Because of the increasing cost of keeping that health care current , there is an opinion that the industry may have to turn to privatization to stay current and to alleviate the demand on government for the services (Blank , 2002 However , this is feared to have the potential of diminishing the accessibility of health care since it is similar to liberalizing the industry

Though the industry is a free enterprise , the government is still the major provider of health care . In recent years , there has been a significant increase in the number of health institutions that have been put up by private enterprises offering specialized and wellness services . However , very few of these institutions are covered by socialized care so there is no decrease in the demand of health services in government institutions . The demand for health care is the main reason for the increasing cost of providing and accessing health care , a development that has limited access to quality health particularly in poorer countries and has also become a factor that further aggravates disparities between socio-economic levels

Another factor that is increasing in prominence in the industry is the health complications brought in by substance abuse and the lifestyle in today 's societies . According to Bowen and Beresford (2002 , the lifestyle of people today is one of the major factors that the industry is trying to cope with . Recognition of the impact of individuals lifestyles has made a great impact particularly in the wellness industry . Efforts have been made to improve lifestyle : the Food and Agricultural Organization (2003 ) has prompted international efforts in improving nutrition among children while the research of Bowen and Beresford (2002 ) have emphasize on the need to emphasize dietary health .At the same time , the WHO has raised alerts on the world wide increase of drug and alcohol related conditions (Dantzer et al , 2006 . According to studies , substance abuse and related conditions should be earmarked as one of the most urgent focus in the health care industry since it has significant economic and crime repercussions . Similarly , efforts have been made to develop global standards for mental health care emphasizing patient rights (Edd et al , 2005 . These developments indicate that there has been focus in recognizing patient or a shifting to a patient-centered system of health care

The health industry today has opened more venues for discussion for non-mainstream treatment methods particularly those that have had recent scientific support like Tai Chi , herbal medicines and other traditional healing therapies . The move is in recognition of non-Western medicine at the same time the need for exploring new alternative for health that can prove to be cost effective and without side effects . The effort is part of the international initiative of the WHO to be able to increase global health research and knowledge (WHO , 2001

Mission and Vision

The basic objective of the industry is to provide health care services prevent and control diseases and to improve the quality of life in terms of health . The health care industry is based on the principle of providing the means of health and wellness for people to be able to affect social health and wellness (Casalino et al , 2003 . From the oaths taken of the different health professionals , the common theme is the need for an industry that protects the quality of life through providing professional medical and health care to the public

According to Blank (2002 , it should be the objective of every health institution not only to provide not only health but also the tools to ensure health . It should be the vision of the health institutes not only to create healthy individuals but individuals who are able to maintain health and take control of it . The development of a society that recognizes health as an important element to their productivity and success is another objective of the industry (Haider Solong , 2004

The Working Force

The health industry is detailed in Figure 1 . As shown , it is made up of health sector service providers and management and support as well as other sectors that support service providers and various other sectors This shows that health services needs the combination of many sectors to be come effective and comprehensive

Developed countries have significant advantage over the number and the expertise of the health professionals . Aside from economic reasons , they also provide the most opportunities for growth and development . However the deterioration of health in a far off poor country still has implications on developed particularly considering viruses and other epidemiological pathogens . As seen in Figure 2 , there is greater concentration of health care workers in Europe and the Americas though the incidence of disease is the lowest

A developing role of professionals in the health industry today has been in the development of various out-patient care and support systems that aim to increase rehabilitation and treatment effectiveness . With more literature concluding the positive influence of community and family to patient recovery , nurses and doctors find themselves out in the field to provide information and insight to ordinary people to support related efforts . According to the Australian Government Productivity Commission (2005 , this emphasizes the need for the redevelopment of health care competencies not only in response to technical skills but to social and community needs as well

Health professionals ' continuing education is one of the most urgent priority to keep at pace with technological and research developments Authorities in the field judge that there is a need to appraise model for continuing professional development not just to ensure that patients get the best care but also to afford career enrichment for professionals . Studies have indicated that most health professionals are given very little opportunity , motivation or alternatives for professional development which has limited the professional development and skills (Bouch , 2003

Development programs for health care professional should make available for options that may not essentially be related to the practice of the health professionals . Studies have shown that a high degree of professionals in the health industry today suffer from work-related stress , feeling isolated and desensitized . Thus optimum continuing education programs include academics or professional developments well as orientation and training for emerging alternatives . This will enable professionals in the field to expand the prospects of their practice as well as evaluating their alternatives (Leatherman , 2001 . So far , there have been a number of significant studies highlighting the contribution of continuing education among health professionals in enhancing productivity and efficiency (Ries et al , 2004

The Rising Concerns of the Healthcare Industry

The major developments that have been the center of concern in recent years is the migration of health care professionals form third world countries to Europe and America and the increasing stress of keeping pace with technology . These developments have been raising the costs of health care and are seen as indicative of the professional crisis and the drain on the health professionals in economically challenged countries (United Nations Population Division [UNPD] , 2000

The need to bridge professional and non-professional health care is not only essential as part of the practice of the profession but also can contribute in promoting public awareness and health . To create truly effective health care systems , there should be a prevailing effort to be aware of the changing society . Stereotyping in care work does not only lead to decline of service quality but also diminishes the value of health care and welfare professionals . It should be recognized that these professionals have to deal with not just health of welfare issues but must tackle societal ills as a whole

The health care profession itself is being challenged to develop better methods and professionals that are responsive to social and economic developments (Lowell Findlay , 2002 . Efforts to increase health awareness and creating preventive care are seen as the most effective means of ensuring future medical crises are avoided but this entails greater coordination with other government agencies and the communities which may not be available for most settings (Bowen Beresford , 2002

One of the key issues that has yet to be fully addressed is the issue of health coverage for home care . To alleviate the cost of home care , many opt to get services privately which has raised the concern for medical risk and insufficient training . Home care should be viable profession in health care if it is developed as a sector in the health industry if the increasing demand for the service is to be met . The quality and realism services dictate the success of the community . Health care and welfare providers must be responsive and able to change as society does otherwise they fail their role as an institution (Democratic Health Network , 2006 . The increasing demands because on existing health because of either developing demographics is not just about funding but also entails the more important issue of effective management (Blank 2002

Professional migration is expected to continue however it is also expected to ease within the next ten years due to free labor market movements , balancing the distribution of health professional or the very least easing the impact of the trend . It should be realized that developed countries can not rely on foreign professionals for long and abandoning efforts to develop the profession and foreign professionals can not continue to migrate without their home countries suffering stagnation because of the lack of experts (United Nations Population Division , 2000

There is a realization that better health care for one country does not necessarily ensure health security . The threat of global epidemics is underlining the need to develop health care in a global perspective (Democratic Health Network , 2006 . As the demand for health care professional continues to increase worldwide , it can be expected that incentives will try to become more competitive . This will undoubtedly mean also greater demands on the profession . However , this may also translate to higher prices of health care because of increased labor costs

The World Health Organizations believes that providing the basic health care to the poorest countries can affect better results to improving the social conditions (WHO , 2001 . In line with this , the organization is concentrating of establish networks for the health industry to cooperate regarding global health issues . With many related literature suggesting the health concerns should be viewed in greater global perspective health industries are being asked not only to share their knowledge but their competencies as well

Objectives of the Study

The survey will provide the data for the quantitative evaluation and Focus Group Discussions (FGDs ) will represent the qualitative discussion of the . The main objective of the study is to be able to construct a study of the perception on the current skills of health care professionals and the programs that are needed to maintain and enhance the manpower in health care institutions . At the same time , the study aims to define the skills that are perceived to be important from the perspective of patients and compare it to the existing skills of health care professionals and the skills that are to be developed by developmental programs designed for them (Bouch , 2003 . The information gathered will be presented quantitatively and qualitatively

The second element of the study is conducting the FGDs is to discuss the discussed issues affecting health care professionals and to validate the result of the surveys . There will be three set of FGDs each composing equal numbers of health sector service providers and management and support as well as other sectors that support service providers and various other sectors and patients both under in-patient and out-patient programs

In so doing , the research aims to be able to establish the skills perceived to be essential by institutions and patients alike and whether there is a difference between them . The study aims to evaluate these variations and investigate the causes and implications of this information . In the course of the surveys , the research aims to be able to identify the key elements that will increase the ability of health institutions to recruit , maintain and develop their health professionals

Time and Date of the Study

The first part of the study will involve the survey and since this entails greater amount of time in terms of collection , collation and summarization , it will be the first task to be tackled . The survey will be done in the span of a week , from Monday to Friday starting at 10 :00 am to 2 :00 pm . Workdays will be the days to conduct the survey to ensure the availability of targeted respondents . The time frame selected is chosen since it is the common time for the target respondents . The survey is to be conducted in as limited time as possible to be able to avoid contamination of responses . Considering that the surveys act as spot review of prevailing opinions , it is essential to be able to gather the opinions with as little time differential as possible

The interviews that are t be conducted via the FGDs will be done on the Saturday of the week the surveys are to be conducted . The FGDs will be utilized as a form of interview to be able to maximize the number of opinions gathered and to serve as verification of the prevalence of the opinion . There will be three sessions : morning , late morning and early afternoon . As in the case of the surveys , the FGDs will be conducted closely together to avoid contamination of information and opinions among the group of respondents . The time schedules are also aimed to afford respondents and the research flexibility in organizing the composition of the respondents

Material and Methods

To be able to conduct successful surveys and interviews , the research will modify the questions to suit the levels of the respondents that will range form medical experts , support personnel and patients . In designing the materials and methodologies of the research , consideration will be given to the nature of the office and condition of professionals and patients respectively

The questions and procedures for the research will refer to existing to studies related to the development of competencies for the health care industry and industry developments as well . The research references will serve as a point of origin for the direction of the questions however there will be no limitation as to the s that can be covered in the course of the data gathering particularly in the FGD . This is to recognize the limitation of the reference research versus the results of discussions or respondent 's opinions

The Questionnaires

There are two wets of questions for the use of the research . The first set of questions will serve as the prescription for the questions to be used in the survey forms while the next of questions will be sued as guides during the discussion in the FGDs

Survey Questionnaire

Health Care Professional Study

Survey

Personal Information

Name of Respondent (Optional

Age

Sex

Occupation

Background Information (Answer the questions by choosing yes or no

Yes

No

Are you aware of the most recent development in health care

Do you have access to health periodicals or other literature

Do you have close friend or family members who are health care professionals

Are you concerned about your current state of health

Have you seen a doctor or sought medical treatment in the last three months

Were you satisfied with the care you received

Did you feel your physicians were able to treat your condition

Did you feel that the nursing staffs were able to do their duties well

Did you feel the health professionals you encountered had adequate training

Perceptions of Health Care Professionals (Rate the importance of the factor mentioned with 4 being the highest

1

2

3

4

Recruitment of health professionals

Exposure of health professionals to foreign diseases management

Exposure of health professionals to non-traditional health programs

Exposure of health professionals to technological innovations in the health industry

Exposure of health professionals to other cultures and traditions

Level of education attained , experience or other professional training

Competence in non-medical health settings like community programs or out-patient treatment

Retention and training programs for health professionals

Amiable character and approachableness

Ability to translate medical information to layman 's terms

Communication skills (e .g . multi-lingual or sign language

Presentability , image or persona

Camaraderie with other professionals and patients

Stress management and personal development

Are there any other traits you believe are essential to health professionals

Thank You and Good DayFGD Guide Questions

Background Information

What do you believe are the most important developments in health care today

Do you believe that there is greater awareness of health issues today

Do you think that people within and outside the health care industry are more proactive regarding issues

What is the content of most publication today regarding health care and health care professionals

What are the social implications of health institutions being able to recruit and retain adequate trained health professionals

What are your expectations of the industry

Perceptions of Health Care Professionals

What do health care professionals expect from the institutions they work for ? Are these fair expectations

How can current programs be rated by health professionals

What do you believe are the most important factors to be considered in the recruitment of health professionals

What is the cost of establishing these programs in terms of money manpower or resources

Among the following competencies , what do you believe are essential or not and why : exposure to foreign disease care and management , exposure to technological developments , exposure to medical alternatives cultural exposure , education and training and years of experience in the profession

Are non-medical training or development programs important to health care professionals ? If so , to what degree

What programs do you believe should every institution have for health care professionals

What should developmental programs focus on

Who is the most responsible sector in the development of programs that encourage professionals to stay in field of health

What is the nature of programs that should be developed

What is the extent of the programs that have to be developed

How will the effectivity of the formulated programs be measured ? What is range of effectivity

Is there of standardization of the programs or will it be better to encourage competition of programs in the industry

What can be expected as a result of the programs

Distribution of Questionnaires

The survey questionnaires will be distributed according to the target respondents . Prior to the distribution of the questionnaire to he respondent , a brief summary regarding the issues concerning the development of programs to recruit , retain and develop health professionals will be given . The role of the survey results in the assessment for the study will also be divulged . The respondent will also be assured that any information they give in the survey will be used for the purpose of the research alone and will be treated with confidentiality

At the beginning of the FGD , the guide questions will be distributed to the participants to give them an idea of what direction the discussion is expected to cover . Like in the distribution of survey questionnaires the participants of the FGD will be also informed of purpose of the study , the role that the FGD will play in the research and the confidentiality of the information elicited during the discussion . In addition , they will be informed that notes will be taken down in the course of the discussion to serve as reference for the research

Collection of Data

The answered survey forms will be main method of data collection for the survey while the notes on the FGD discussion will be utilizes as the data collected . The survey information will be collated to define the mean of responses and to identify the standard variances of the responses . In the case of the FGD , the information gathered will be treated qualitatively and be analyzed for the consistency of information and opinions

Survey

The survey will be tabulated and statistically analyzed to define the standards of response . The responses will indicate the degree of importance of the various factors . This will indicate what the respondents consider the most important factor to consider in creating the programs that have to be developed . Another study that will be done to regarding the correlated or hold significance against each other

The data will be also analyses by sector . Responses will be grouped according to the classification of the respondent and summarized . The information from each question will then be analyzed in comparison to other sectors . This is to be able to find out if there is a difference in the opinion or prioritization of those surveyed

Interviews

From the notes taken from the FGD , the most common answers for each of the guide question will serve as the primary data gathered . The incidence of the responses able is recorded to indicate their prevalence and importance . The results will be then catalogued and compared to the noted . If there are inconsistencies to the response , there will be a needed to theorize as to the source of the discrepancy either by review of the discussion or by consultation with the participants of the FGD as needed

The responses will again be classified according to the classification of the respondent . The responses will also summarize and then will be compared to the similar categorized summary done with the survey respondents . A similar comparison will be done to see similarities of differences in the responses . Analysis will be done whether the variance in respondent category is the source of the variation in opinions , if any

Parameters

Standardized parameter for all respondents will included their ability to express their opinions either through verbalization or in writing personally . The respondents , particularly those who have been in in-patient or out-patient care for the last three months were not admitted because of any mental health condition or have resulting diminished mental faculties either because of the health condition or due to their treatment or medication

Considering the differences in health needs for geriatric patients and adults or adolescents , additional questions specific to these age groups will be to both survey and FGD according to the age group of respondents . In the case of FGD , if there is any present corresponding to the separate questions , then they can be both utilized Senior Citizens

Senior citizen respondents should not be bed ridden or in any form of isolation limiting their awareness or participation in their medical treatments . The primary targets for the respondents are senior citizens who are still relatively active either in their community or among close associates regardless of age . Whenever possible , respondents should be individuals who have interest in the research or have opinions regarding the health industry in general

In the case of lack of respondents within the 60-65 years of age , the age range can be beyond the upper limit . However , the mentioned parameters should still apply . For the respondents in the category , the supplementary questions

Do you believe that there sufficient programs to address the need to increase the quality of life of geriatric patients

Do you believe that there is adequate training of health professionals for geriatric care

What skills do you believe should health professionals further develop to be able to deliver services for senior patients

Are you willing to bear the burden of training professionals via increased cost of medical services

Who do you believe should be responsible for the training and development in the health industry

Are there any measures or methods that you would suggest

Do you believe that it is possible for the health professionals to gain needed competencies for the field in the next five years

Adults and Adolescent (Below 65

Respondents should also be individuals who have interest in the research or have opinions regarding the health industry in general . The main target age range is between those aged 30 's to 40 's . Whenever possible there should be preference to respondents who are versed in health industry issues either nationally of internationally . Respondents should have health options and not limited to socialized care or programs

In the event of a lack of respondents , the research can expand the parameters to include those that may be dependent on federal or nationally instituted health care programs by virtue of employment or privilege . For the respondents in the category , the supplementary questions

Do you believe that health care professionals are aware of the current trends in lifestyle and challenges of working , family and social life

Do you believe that health care professional have the needed competencies to effect optimum care and health

What are the traits that are needed to develop better health care professionals

Is there a need for institutions to sponsor developmental programs and initiatives that target health care professionals ? How should these be conducted

Are you willing to bear the burden of training professionals via increased cost of medical services

Who do you believe should be responsible for the training and development in the health industry

Are there any measures or methods that you would suggest

Do you believe that it is possible for the health professionals to gain needed competencies for the field in the next ten years

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The concentration is greatest in the North American region while the South American region has a concentration similar to that of the Western Pacific region (WHO , 2001

Dilemma of Healthcare Industry PAGE 1

Figure 2 . Classification of Health Professionals (WHO

Figure 1 . Distribution of Health Workers by Level of Health Expenditure and Burden of Disease (WHO ...

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