major stakeholder of health care delivery system
TRANSCRIPT
CLASS PRESENTATION
ON MAJOR STAKEHOLDERS IN
HEALTH CARE DELIVERY SYSTEM
PRESENTER:
Christian Jenet Daniel
M.Sc.1st Year
Roll no. 1
1
The health care system intended to
provide services and resources for better
health. This system includes hospitals,
clinics, health centers, nursing homes and
special health programme in school,
industry and community. Health system
operates in the context of socioeconomic
and political framework of the country.
2
DEFINITION
A stakeholder is
a party that can
affect or can be
affected by the
actions of the
business as a
whole.
3
DEFINITION
Stakeholder is a
person, group,
organization or
system who
affects and can be
affected by an
organizational
action.
4
Stakeholders are
those entities in the
organization’s
environment that
play a role in an
organization’s
health and
performance or that
are affected by an
organizational
action.
DEFINITION
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TYPES OF STAKEHOLDERS
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TYPES OF STAKEHOLDERSAccording to involvement
People who will be
affected by an enterprise
& can influence it but
who are not directly
involved with doing the
work. In private sector,
people who are affected
by any action taken by
any organization or
group. Example parents,
children, customers,
owners and suppliers’
people that are related or
located nearby. 7
According to availability
Primary Stakeholders:
The primary
stakeholders are those
that are engaged in
economic
transactions with the
business. Examples:
stockholders,
customers &
employers.
8
Contd…..Secondary Stakeholders:
The secondary
stakeholders are those
who are although do
not engage in direct
economic exchange
business but are
affected by or can
affect. Example
general public,
communities, activist,
business support
groups & media. 9
According to position/work
According to position or work the stakeholders
can be divided into three and these are:
• External stakeholders
• Interface stakeholders
• Internal stakeholders
10
External Stakeholders:
They fall into three
categories in their
relationships to the
organization:-
• Those that provide
inputs to organization.
• Those that compete
with it.
• Those that have
particular special
interest.
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Those that provide inputs to organization:
The first category includessuppliers, patients andfinancial community. Therelationships between theorganization and theseexternal stakeholders are asymbiotic one, asorganization depends onthem for its survival. Inturn these stakeholdersdepend on the organizationto take their outputs. Therelationships between theorganization and thestakeholders are one ofmutual dependence.
12
Those that compete with it:
The competitor stakeholder seeks to attract the
focal organization dependents. The competitor
may be direct competitor for patients (e.g.
other hospital) or they may be competing for
skilled personnel.
13
Those that have particular special interest:
External stakeholders in third category are
special interest group. These are the
government regulatory agencies, private
accrediting association, professional
associations, labor union, the media and
political action group. Because of special
interest conflict most often occur. Compromise
and, in some cases, overt collaboration
generally resolves the conflicts.
14
Interface Stakeholders:Some stakeholders functionon the interface between theorganization and itsenvironment. The majorcategories of interfacestakeholders include themedical staff, the hospitalboard of trustees. Theorganization must providesufficient inducements tocontinue to makeappropriate contribution.The organization may offerprofessional autonomy,institutional prestige orpolitical contacts, specialservices and benefits etc.
15
Internal Stakeholders
Internal stakeholders almost entirely within theorganization and typically includemanagement, professional and nonprofessional staff. Management attempts toprovide internal stakeholders with sufficientinducements to gain continual contributionfrom them. The stakeholders determinewhether the inducements are sufficient for thecontribution that they are required to makepartly on the basis of alternative contributionoffer received from competitors.
16
STAKEHOLDERS IN HEALTH CARE SYSTEM
• GOVERNMENT
• PUBLIC
• PROVIDERS
• HOSPITAL ADMINISTRATOR AND
GOVERNING BOARDS
• NON GOVERNMENTAL
17
GOVERNMENT
Many federalgovernment health careefforts are headed by acabinet-level officer,the secretary for healthand human services,who runs thedepartment of healthand human services.The federal governmentmakes budget andother planning relatedto expenditure in healthcare. 18
At central level:Stakeholders at central level are Cabinet minister &
Secretary for Health & Human services who runs
the Department of health & Human services.
The functions are:
• Ensuring high levels of executive management
performance.
• Ensuring quality of patient care.
• Ensuring financial health of the organization.
• Assuming responsibility for itself (for its efficient and
effective performance).
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Contd....•Formulating policy to guide decision making
and action.
•Making decisions, either by retaining authority
with respect to its responsibilities or by
delegating this authority to others.
•Performing oversight by monitoring decisions
and actions to make sure they are in compliance
with policies.
20
At state level:At state level, state health directorate is responsible for
administering health care services & regulating the health care
delivery system.
The functions are:
Integrating health care services.
During integration the state level administrators may have to overcome
many of barriers in integration of health services such as insufficient
understanding about changing environment and issues affecting health
care organizations , ambiguity about roles, responsibilities, relationships,
accountabilities, lack of readiness for change etc.
Availability of medical facilities.
Plan health programmes & drawing policies in providing health care.
Provision of medicines.
21
At district level:
The district level stakeholder in health care
delivery system is deputy commissioner,
MLAs of the area, civil surgeons, senior
medical officers & district public health nurse.
22
THE PUBLIC
The public has a stake in health care fromseveral perspectives. As consumers of health careservices or as patients, the public is concernedwith quality, cost and access to care.
They expect an employer to offer a widevariety of option for health coverage that can becustomized to their specific needs. They also lookfor the employs to fund the majority of cost ofhealth insurance. People are interested inreceiving quality care at a reasonable cost.
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THE PROVIDERS
• Community health care professional
• Hospital health care professional
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HOSPITAL HEALTH CARE
PROFESSIONAL:
Physicians:Physicians provide direct medicalservices to clients in variety ofsettings, including offices, clinics,hospitals and freestanding centers. Inaddition, physician control 60% to70% of hospital costs through theirdecisions regarding the use ofresources. Physicians decide whichclient to admit, where to admit, thelength of stay, the ancillary services,whether to perform surgery, when toinitiate and to discontinue treatmentregimens, and which medications toprescribe.
25
An individual whoprovides care to clients.The extent of participationvaries from simple patientcare tasks to the mostexpert professionaltechnique necessary inacute life threateningsituations. The ability ofnurse to functionindependently and makingself directed judgment willdepends on his or herprofessional development.Nurses provide a uniqueperspective on the healthcare system.
Nurses:
26
HOSPITAL ADMINISTRATORS AND GOVERNING BOARDS:
The chief executive,
chief financial officer,
chief nursing officer,
and governing boards
of hospitals strongly
influence health care
delivery in their
institutions.
27
NON GOVERNMENTAL
STAKEHOLDERSThe voluntary agencies occupy an important place in community
health care system. These organizations directly or indirectly act as
stakeholder. These organizations are administered by autonomous
boards which hold meetings, collect funds from private sources and
spend money for providing health services and health education to
individual, family and Community. There are many NGO’S in India
which serves to society. Some of these organizations are given below:
Indian Red Cross Society: It was established in 1920 and has over
400 branches all over India. It has been executing programme for
the prevention of diseases and promotion of health. Its activities are:
• Relief work
• Milk and medical supplies
• Armed forces
• Maternal and child welfare services
• Family planning
• Blood bank and first aid28
• Hindu Kusht Nivaran Sangh: It was founded in 1950 with
its headquarters in New Delhi. Its precursor was the Indian
council of British Empire Leprosy Relief Association
(B.E.L.R.A) which was dissolved in 1950. The work of the
Sangh include rendering of financial assistance to various
leprosy homes and clinics, health education, training of
medical worker and physiotherapists conducting research
and field investigation. The Sangh has branches all over India
and work in close cooperation with the Government and
other voluntary agencies.
• Indian council for child welfare: It was establish in 1952. It
is affiliated with international union for child welfare. The
services of I.C.C.W are devoted to secure for Indian children
those “opportunities and facilities, by law and other means”
which are necessary to enable them to develop physically,
mentally, morally, spiritually and socially in a healthy and
normal manner and in conditions of freedom and dignity.
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• Tuberculosis Association of India: It was formed in 1939. It
has branches in all states of India. The activities of this
association comprise organizing T.B campaign every year to
raise funds, training of doctors, health visitors and social
workers in anti tuberculosis work, promotion of health
education conferences.
• Bharat Sevak Samaj: The Bharat Sevak Samaj which is non-
political and nonofficial organization was formed in 1952.One of
the prime objective of the Bharat Sevak is to help people to
achieve health by their own actions and efforts. The B.S.S. has
branches in all the states and nearly all the districts.
Improvement of sanitation in villages is one of the important
activities of the B.S.S.
• The Kastubra Memorial Fund: Created in the memory of
Kastubra Gandhi, after her death in 1994, the fund was raised
with the main objective of improving the status of women,
especially in the villages, through gram-savikas. The trust has
nearly one crore of rupees and is actively engaged in various
welfare projects in the country.30
• All India Women’s Conference: It is the only women’s
voluntary welfare organization in the country. Established
in 1962, it has now branches all over the country. Most of
branches running M.C.H. clinics, Medical centers, and
adult education centers, milk centers and family planning
clinics.
• The All India Blind Relief Society: It was established in
1946 with a view to coordinate different institutions
working for the blind. It organizes eye relief camps and
other measures for the relief of the blind.
• Professional Bodies: The Indian Medical Association, All
India Dental Association, The Trained Nurses Association
Of India of all men and women who are qualified in their
respective specialties and possess registerable
qualifications. These professional bodies conduct annual
conferences, publish journals, arrange exhibitions, foster
research, set up standards of professional education and
organize relief camps during periods of natural calamities.31
• Central Social Welfare Board: This is an autonomous organization
under the general administrative control of the Ministry of education. It
was set up by the Government of India in August 1953. The functions of
the Board are:
• Surveying the needs and requirements of voluntary welfare
organizations in the country.
• Promoting and setting up of social welfare organizations.
• Family and Child Welfare Services in rural areas for the welfare of
women and children. The activities of these projects comprise
teaching of craft, social education, literacy classes, maternity aid
for women, and distribution of milk, balwadis, and organization of
play centers for children.
• Family Planning Association of India: The Family Planning
Association of India was formed in 1949 (Head quarters in Mumbai). It
has done pioneering work in propagating family planning in India. These
Branches are running family planning clinics with grant –in-aid from the
Government. The Association has trained several hundred doctors,
health visitors, and social workers.
32
1. World Health Organization:
WHO Is a specialized, non political
health agency of the United Nations,
has head quarters in Geneva
Switzerland. The constitution came in
to force on 7th April, 1946. This day is
celebrated as “World Health Day”. A
world health theme is chosen every
year to focus attention on specific
aspect of public health.
33
Function of WHO:
• Prevention and control of specific diseases
• epidemiological surveillance of communicable
disease problems
• Immunization against common disease
• Development of comprehensive health services
• Family Health
• Environmental Health
• Health Statistics
• Bio-medical Research
• Health literature and Information
• Cooperation with other Organizations34
Other United Nations
Agencies
UNICEF (United Nations International
Children’s’ Emergency Fund):
It believes that future of of mankind
depends on the well being of our children. Its
slogan is –“the child of today for the world of
tomorrow” UNICEF is now called as United
Nation’s Children Fund”. It works with close
collaboration with WHO and other
specialized agencies for the welfare of
children and mothers. 35
36
• United Nations Development Program (UNDP):
Established in 1966. The basic objective of the UNDP
is to help poorer nations develop their human and
natural resources more fully. The UNDP projects cover
virtually every economic and social sector i.e.
agriculture, industry, education and science, health
social welfare etc.
• United Nation’s Fund for Population Activities
(UNDPA): has been providing assistance to India
since 1974. In addition to funding national level
schemes, area projects for intensive development of
health and family welfare infrastructure and
improvement in the availability of services in the rural
areas have been under implementation in eleven
districts of Rajasthan.
Food and Agricultural Organization (FAO):
Formed on 1945, Head quarters in the Rome. It was the first
United Nation’s Organization specialized agency created to look
after several areas of world cooperation. The aims of FAOs are:
a. To help nations raise living standards.
b. To improve nutrition of the people of all countries.
c. To increase the efficiency of farming, forestry and fisheries.
d. To better the condition of the rural people and, through all
these means, to widen the opportunity of all people
productive work.
e. FAO’s prime concern is towards ensuring that the food is
consumed by the people who need it. Insufficient quantities
and in right proportions, to develop and maintain a better
state of nutrition throughout the world.
37
International Labor Organization (ILO): Soon after world
war, it was recognized that problems of industry, like
disease, know no frontiers. In 1919 the International
Organization established in as an affiliate of the League of
Nations to improve the working conditions of the working
population all over the world.
World Bank: is a specialized agency of the United Nations.
Established with the purpose of helping less developed
countries to raise their living standards.
The Colombo Plan: At a meeting of common wealth
foreign minister at Colombo in January 1950, a program
was drawn up for cooperative economic development in
South and South East Asia.The All India Institutes of Medical
Science at New Delhi was established with the financial
assistance of New Zealand.
38
The Swedish International Development
Agency (SIDA): This agency assisting in the
National Tuberculosis Control Program since
1979.
The Government of Denmark(DANID A):
Is providing assistance for the development of
services under National Blindness Control
Program since 1978.
39
OTHER AGENCIES1. Rockefeller Foundation: This foundation is a philanthropic
organization chartered in 1913 and endowed by Mr. John D.
Rockefeller.Its purpose is to promote the well being of mankind
throughout the world.
2. Ford Foundation: Where as Rockefeller Foundation earlier
concentrated most of its assistance on the universities and post
graduate institutions. On professional education and on research,
the Ford Foundation has been active in the development of rural
health services and family planning.
3. Co-operative for Assistance and Relief Everywhere): was founded
in North America in the wake up of world war in the year 1945.
CARE is one of world’s largest non-profit, non-sectarian,
international relief and development organization. CARE provides
emergency aid and long term development assistance.
4. International Red Cross: It is a non-political, non official
international Humanitarian organization devoted to the services of
mankind in peace and war.40
BUSINESS & INDUSTRY:As health care costs increased
in mid of 1990, the influence
of business industry increased
as well. Health insurance
programmes are launched
mainly through benefit
programme. As the cost of
health care increases,
insurances costs increases as
well, forcing business to
assume greater financial
burden to insure employee &
their dependents as well. Cost
for product increases
accordingly.41
TYPES OF STAKEHOLDER
RELATIONSHIP
• Mixed blessing stakeholder relationship
• Supportive stakeholder relationship
• Non supportive stakeholder relationship
• Marginal stakeholder relationship
42
Mixed blessing stakeholder
relationship:
With the mixed blessing stakeholder relationship’s thehealth care executive faces a situation in which thestakeholder rank high on both type of potential: threatand co-operation. Physicians-hospital relationshipsprobably are the clear example of this type ofrelationship. Although physicians can and do providemany services that benefit hospitals, physicians alsocan threaten hospital because of their general controlover admissions, the utilization and provision ofdifferent services, and the quality of care.
43
Supportive stakeholder
relationship:
The ideal stakeholder relationship is one that supports
the organization’s goals and actions. Managers wish
all their relationships were of this type, such a
stakeholder is low on potential threat but high on
potential co-operation for e.g. the relationships of
well managed hospital with its board of trustees, its
manager, its staff employees, local community and
nursing homes.
44
Non supportive stakeholder
relationship:
The most distressing stakeholderrelationship for an organization and itsmanager’s are non supportive ones. Theyare high on potential for threat but lowon potential for co-operation. Typicalnon supportive relationships forhospitals include competing hospitals,employee unions, the federalgovernment, other govt. regulatoryagencies the news media.
45
Marginal stakeholder
relationship:
The marginal stakeholder relationships are high
on neither threatening nor co-operative
potential. This type of relationships include
professional associations for employees,
volunteer groups in community etc, for a well
run hospital.
46
STEPS IN THE MANAGEMENT OF
STAKEHOLDERS:
diagnose each stakeholder
classify each stakeholder relationship
formulate generic
strategies
implement strategies and
evaluate
identify type of stakeholder
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Introduction and meaning of stakeholders,
Definition,
Major stakeholders in health care system of
stakeholders,
The types of stakeholders,
Different stakeholders in health care delivery system,
Hospital administrators and governing bodies,
The non-governmental stakeholders,
International health agencies,
Steps in the management of stakeholders,
Business and industry,
Types of stakeholders’ relationship,
Other agencies
• ASSIGNMENT:
WRITE DOWN ROLE OF MAJORSTAKEHOLDER IN HEALTH
CARE DELIVERY
• SUBMITTED ON
10TH JAN.2017
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