Developing Essential Management Competencies in Public-Private Partnerships

Daniel J. West Jr., Ph.D.

Bernardo Ramirez, M.D., M.B.A

Cherie Lynn Ramirez, Ph.D.

Michael M. Costello, J.D., M.B.A., FACHE

Stephen J. Szydlowski, D.H.A.

Robert Spinelli, D.B.A., M.P.H.

GHIC 2019: Global Health & Innovation

Conference April 13-14, 2019

Yale University, New Haven, CT

Contact Information: Daniel.West@scranton.edu

Learning Objectives

Analyze public-private partnership models used by hospitals and healthcare organizations to enhance clinical outcomes and design sustainable ventures in countries outside the United States.

Understand the development of the International Hospital Federation (IHF) competency model and what specific management competencies are needed to implement public-private partnerships.

Agenda

I. Introduction

II. Public-Private Partnerships in Health Care: Mexico, Georgia, Slovakia, and other countries.

III. Competency-Based Approach to Health Management Education and Professionalization

IV. Future Considerations

Introduction

Globalization & HME

Competency Models

IHF, Professionalization & Global Leadership

Public-Private Partnerships

Need for Competent Managers and Leaders

Educational Venues

Global Accreditation

Competency Directory Derived from the Healthcare Leadership Alliance Model

Leadership competencies for health services managers (2015) International Hospital Federation. Retrieved from:

https://www.ihf-fih.org/resources/pdf/Leadership_Competencies_for_Healthcare_Services_Managers.pdf .

Competency Models

Cascading Competency Model

Globalization and HME

Commission on Accreditation of Healthcare Management Education (CAHME)

Phase I Study (2010-2011) – 16 Countries

Phase II Study (2011-2012) – 6 Countries

Phase III – Application of Criteria

Phase IV – Public-Private Partnerships & Competencies

Phase V – Global Accreditation

West, D., Filerman, G., Ramirez, B., & Steinkogler, J. (2011) and Phase II (2012) CAHME International Healthcare Management Education. Washington, D. C. Retrieved July 26, 2018 from the CAHME

website: https://cahme.org/files/CAHME-I-Final-Report-International.pdf & https://cahme.org/files/CAHME-II-Report_FINAL_7-5-12.pdf Executive Summary at: https://cahme.org/files/ARAMARK-International-

Study-Executive-Summary.pdf

West, D. & Stanowski, A. (2017) Global Accreditation in Health Management Education: Concept Paper. CAHME-Commission on Accreditation of Healthcare Management Education. Retrieved July 26,

2018 from the CAHME website: https://cahme.org/files/heath_care_organization_resources/Global_Accreditation_Concept_Paper_v2_2017_11_08.pdf

Countries Examined

Examples & Functions of Healthcare PPPs Around the World

Data from: West, D., Filerman, G., Ramirez, B., & Steinkogler, J. (2012) CAHME International Healthcare Management Education. Washington, D. C. Retrieved July 26, 2018 from

the CAHME website: https://cahme.org/files/CAHME-II-Report_FINAL_7-5-12.pdf

Mexico Case Study: Challenges

Mexico Case Study: Pilot Study

At one of the PPP high specialty hospitals in Mexico, we piloted a questionnaire with 8 middle and high level managers representing the 3 partnership model actors.

Questions related to: How long have you participated in this PPP?

What is your previous experience in similar projects?

Most important benefits of the new PPPs identified by interviewees

Most frequent problems they face (structure, process and outcomes)

In your view, how can these identified problems be resolved?

Interactions from PPP partners to achieve common goals

Are high and middle level managers prepared to perform functions?

How familiar are you with the PPP contract?

What recommendations would you offer to improve impact of PPP?

Mexico Case Study: Key Findings

Benefits of PPPs are consistent with each one of the 3 actors:

Client: Ability to concentrate on essential; availability of services; quality of infrastructure and cutting edge medical technology; potential for innovation and explore new areas.

Investor: Efficient services; quality of services and equipment; availability of specialists.

Operator: Facilities provide excellent services; Quality high and cost at the low level of baseline socioeconomic study; medical personal only need to worry about patients; better cost control.

Mexico Case Study: Key Findings

Recommendations included:Developing training and

curricular plans with academic organizations

Online training and toolkitsMore time to develop and

implement strategic plans & mentoring

Common vision and mission and planning, organizing and implementing together.

Competency Development Key Areas

Improve healthcare outcomes and operations by optimizing the synergy of partnership models.

Leverage the different perspectives (cultural, organizational) and skills of public/private organizations.

Competency Development Key Areas

Use the Triple Aim model to address escalating healthcare costs, errors, and waste in healthcare.

Build stronger relationships between healthcare providers, healthcare market, accrediting bodies, and academia.

Emphasize values that cultivate positive engagement, encourage teamwork, continuous communication, and sustainability of effort.

Public-Private Partnership Efforts In Georgia & Slovakia

Public-private sector modelsPartnering up with Universities & MOHUnique focus on the marketManagement training & competenciesFocus on quality & patient outcomesLeadership & governanceInsurance companies & contractingSpecialized hospital servicesAmbulatory care

Slovakia Model

A. Development of the Private Sector• Bratislava• Market Competition

B. Ministry of Health • Reduce costs• Increase quality • Improve access to care

C. Catholic Health System

Slovakia ModelD. St. Elizabeth University

• Mission & vision • 50+ global projects• Low resource areas• Healthcare Management

Faculty

Adult Hospital

Pharmacy Clinic

Pediatric Emergency

Georgia ModelA. MediClubGeorgia, Ltd. (April 1999)

• South Caucuses (Azerbaijan & Georgia)• Tbilisi- Hospital location • Acute Care Hospital (25+ beds, semi-

private)• Full Service • Laboratory Research Center• Advanced Trauma Life Support• Physician Ownership

B. Ministry of HealthC. Petroleum Industry• Pipeline from Caspian Sea to

Black Sea

Georgia ModelD. University of Georgia • Partnership with U of S Health

Management Department

E. EU & USA• Geo-political interests• Caucuses region

Performance Continuum

Learning Resources

Textbooks

Articles

Development of national or regional journals

Management training materials by

development agencies and foundations

Internet resources

Future Directions and Conclusions

Scaling up our pilot study of hospital and healthcare PPPs in two ways:Expanding the study within Mexico by including other

high specialty, general hospitals that are already in operation and new ambulatory services or primary care/population-based health services currently in development.

Expanding the study to additional countries by including other Latin American (Colombia, Brazil) Other European and Middle Eastern countries (Czech Republic, Italy and Mediterranean, Dubai & Oman to take advantage of our existing academic and health services partnerships.

Future Directions and Conclusions

Diversifying our research methods beyond qualitative surveys of middle and high level healthcare managers to include measurements that more objectively reflect management performance such as:Patient satisfaction

Wait times in hospital admittance and inside hospital services

Financial efficiency indicators such as bed occupation rates

Performing a more detailed analysis of competencies, learning methods and venues required to improve the effectiveness and efficiency of PPPs as well as studying the most appropriate teaching/learning methods and venues to cultivate these in academic programs trainees and professionals.

These Photos by Unknown Authors are licensed under CC

Questions & Comments