HONG KONG HOSPITAL
LEADERSHIP CONVENTION
Dr Terence Carter
National Department of Health
South Africa
May 2016
Dr. Terance Carter Deputy Director General:
Hospitals, Tertiary Services and HRD
Management Challenges
– High GDP spend with sub-optimal health outcomes and competing demands on fiscus
– Burden of disease and health system transition requirements
• UHC, NHI
– Leadership and management are critical components of strong health systems, but ….
• Previous interventions did not address requirements satisfactorily
• Lack of systematic link with health system requirements; generic and often externally driven; not grounded in HR strategy and human development for sustainability
0%
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80%
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77% 74%
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93% 96%
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Performance of the Central /University Hospitals
78%
54%
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68% 65% 66%
59%
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64% 61%
78%
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76% 75%
82% 82%
76%
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40%
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Performance of the Tertiary Hospitals
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wc
Moss
el B
ay H
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wc
Som
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t H
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40%
73%
62%
73%
59%
62%
86%
75%
61%
80%
70%
86%
72%
58%
53%
73%
69%
57%
81%
66%
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58%
82%
67%
50%
63% 62% 61%
67%
58%
74%
55%
68%
85%
57%
65%
Performance of the Regional Hospitals
0%
10%
20%
30%
40%
50%
60%
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90%
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Ap
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heid
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heid
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81% 78%
80%
66%
71%
79%
61%
45%
55%
87%
63%
68% 71%
49%
55%
50% 54%
52%
66%
50%
70% 70%
Perfomance of District Hospitals in KwaZulu Natal
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
fs B
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ati
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ati
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arys
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ital
57%
41%
72%
55% 56%
47%
62%
90%
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57%
62% 61%
52%
Perfomance of District Hospitals in Free State
0%
10%
20%
30%
40%
50%
60%
70%
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lim
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58%
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56% 54% 55%
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43%
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Perfomance of District Hospitals in Limpopo
0%
10%
20%
30%
40%
50%
60%
70%
ec G
rey
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rey
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oly
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om
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itu
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49% 49%
43%
60%
43%
65%
49%
37%
41% 38%
48% 46%
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Perfomance of District Hospitals in Eastern Cape
0%
10%
20%
30%
40%
50%
60%
70%
lp E
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ital
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58%
65%
60%
51%
56% 54% 55%
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43%
64%
38%
Perfomance of District Hospitals in Limpopo
0%
10%
20%
30%
40%
50%
60%
70%
80%
mp
Ber
nic
e S
am
uel
s H
osp
ita
l
mp
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bh
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ni
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mp
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nd
er
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kw
an
a H
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ital
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del
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ital
mp
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del
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ital
mp
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ak
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ital
mp
Pie
t R
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ita
l
mp
Pie
t R
etie
f H
osp
ita
l
mp
Sta
nd
erto
n H
osp
ital
44% 45%
57%
43%
64%
50%
61%
48% 44%
72%
Perfomance of District Hospitals in Mpumalanga
0%
10%
20%
30%
40%
50%
60%
nc
De
Aa
r (C
entr
al
Ka
roo)
Ho
spit
al
nc
De
Aa
r (C
entr
al
Ka
roo)
Ho
spit
al
nc
Ha
rtsw
ate
r (C
on
nie
Vo
rste
r)
Hosp
ital
nc
Ha
rtsw
ate
r (C
on
nie
Vo
rste
r)
Hosp
ital
nc
Ha
rtsw
ate
r (C
on
nie
Vo
rste
r)
Hosp
ital
nc
Ku
rum
an
Hosp
ital
nc
Man
ne D
ipic
o (
Cole
sberg
) H
osp
ital
nc
Man
ne D
ipic
o (
Cole
sberg
) H
osp
ital
nc
Man
ne D
ipic
o (
Cole
sbu
rg)
Hosp
ital
nc
Pri
esk
a (
Bil
l P
ick
ard
) H
osp
ital
nc
Tsh
warag
an
o H
osp
ital
nc
Tsh
warag
an
o H
osp
ital
53%
37%
29%
25%
49%
40%
50%
44%
39% 42%
32%
48%
Perfomance of District Hospitals in Northern Cape
Evidence for doing better
• International experience
• Move to more sustainable systemic approaches
• beyond defining programme content and practice improvements
• Focusing on multiple elements for cohesion
• Importance of individual & team effectiveness and system performance
• Health L and M is a specialist field demanding transdisciplinarity
• Public service values, public health principles, evidence-based management, systems strengthening, quality improvement, resource management etc.
Our proposed approach
Elements of the approach:
– Developing an appropriate health competency model
– Aligning formal recognition to Leadership and Management interventions with health system requirements
– Sign post for health managers to access relevant and directed education, training, resources, mentoring, coaching and other support through KNOWLEDGE HUB
– Moving towards professionalisation
– Supporting the development and transformation of healthcare management practice with partners
Operational Overview
Competencies for practice
Applying a national
competency model and
framework for leadership and management in
healthcare
Education, Training and developiment
Provide access to education, training
and personal development
resources via a Knowledge Hub
Credentialing and registration
Assessing candidates using specific standards
of practice for registration under
the Academy
Transformation and practice development
Conduct activities to improve and
transform practice
improved performance of the health system
improved effectiveness of health managers and management teams
ethics
and
values
Standardised Competency Model
Rolesp
ecific
CompetencyFram
ework
TransversalCompetencyModel
RoleProfile
education,traininganddevelopmentprogrammes
major
activities
selfassessment
performancemanagement
knowledgehubplatform
measurement
performanceassessment
EntrustableProfessionalActivities
assesslearning
competency
directory
Knowledge Hub Functions
Administration
• User Profile
• Data exchange
Assessment, analysis and reporting
• Of individual, team and organisational competency
Connect to resources
• Face-to-face
• Online
• Peers/ groups
Improvement process Support
• Drive improvement
• Links in system performance data
standardised competency model
Competency Reporting
Self-
assessment
Testing
Monitoring
User Profile
User Relationships
Similar role Team Mentor/ Coach Buddy Organization
Individual, team, organization effectiveness
Improved service delivery
Development Opportunities
Short courses/ workshops/qualifications
Mentoring/ coaching
Self-directed
Service Provider Profile
Credentialing (curate content and service)
Specific Competency Framework
Entrusted Professional Activities
Indicators of Health System Performance
Role Profile
Competency tools linked to service delivery imperatives
Entrusted Professional
Activities (EPAs)
Competency tool
Application
in the Academy
Competency Frameworks
Education,
training and
personal development
Competency Models
Service
delivery driver
Guidelines and
quality standards for
practice
Programme evaluation
and leaner assessment
Functional capacity
required of occupation or
group
Systems improvement
requirement to achieve
strategic goals
Individual outcomes
Programme design
core principles
Peer-based entry assessment
and continuous development
evaluation
Requirements for
credentialing into specific
occupation
Requirements for
credentialing
Manager is effective in the
workplace
Manager is effective in
occupation and team
Manager is effective in the
system
Expected result PM
JD/
RS
PM: Performance management and personal development
JD: Generic job descriptions
RS: Recruitment and selection
Improving practice using the Knowledge Hub for education, training and personal development
Formal
learning (qualification)
Informal
learning (assessed)
Self directed
learning
Learning
opportunities Practice
Resources
Mentors and
coaches
Other
managers
and peers
Documents,
policies,
guidelines,
standards,
how-to’s etc
Assessment
Self-
assesment
tools
Credentialing
tools
Providers of
psychometric
assessments
easy access to relevant knowledge, people and services
Academy approval/
review process to
ensure quality and
alignment of content
and services
National
Competency Model
and Frameworks for
Healthcare Managers
unique profile
specific and relevant resources
competency
Who am I Where am I
What I need
Where I can get help Who I can help
Linking management practice to the Hub
key indicators
data
management tool (mobile app/ dashboard)
deviation
access resources (knowledge hub)
change
priorities
reflects in
NHIRD (DHIS)
improvement (PDSA)
standardised management proccess
norms, standards, targets
strategic objectives
Health Information Systems strengthening
comptency model/ frameworks/ activities
associate
manager
entry for managers
professional degree/ diploma and
registration with professional
body
short-courses, certificates or
other learning relevant to
leadership and management
portfolio and
entry assessment by peers
registered
manager
full registration
professional degree/ diploma and
registration with professional
body
post-graduate diploma or masters
degree in health management*
portfolio and
entry assessment by peers
Fellow
of the
Academy
Advanced registration
professional degree and
registration with professional
body
full registration with masters or
doctorate* in health management;
and seen by peers as an
exceptional contributor to the
practice of leadership and
management
nomination
and peer review
potential to
articulate
potential to
articulate
Existing management
qualifications will be grandfathered
for a period of time. *
Recognition and Registration
Societal Advancement
universal access to healthcare
Organisational Transformation
Team Performance
Leadership Research and Resources ALMH
Individual Development
Adapted from the Crentre for Creative Leadership approach
THANK YOU
Dr. Terance Carter Deputy Director General:
Hospitals, Tertiary Services and HRD