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Trends in Global Health: Expanding Programming in Hospital Administration and Management

In the first installment of Trends in Global Health, Louise C. Myers, MSW, Post-Master’s Health Care Administration outlines the need for increased training in hospital management and administration in resource-scarce settings, and identifies some of the challenges HVO must overcome as we expand into this new program area.

“Well-run hospital systems are an essential component of quality patient care. Through decades of first-hand experience, HVO recognizes and understands the importance of sound structures and effective systems to the delivery of quality health care.  As we expand our efforts to build and strengthen the health care workforce, we will also focus on the development of a new program area aimed at hospital administrators and managers.” – Excerpt from the HVO Bulletin – Expanding Our Global Reach

Throughout its 30 year history HVO has been a leader in health care education, training and professional development of the health workforce in resource-scarce countries. HVO continues this tradition as the organization looks to expand its programming to include training in hospital management and administration. With the addition of this new program area, HVO will be at the forefront of scholars and practitioners who are finally recognizing that hospitals are complex institutions that need to be led by skilled, trained managers, not, as has been the tradition, a senior physician with little or no background in health care finance, logistics, human resources management or strategic planning.

As part of its effort to define and organize this new program initiative, HVO asked me to travel to the National Referral Hospital in Thimphu, Bhutan, an institution that HVO has partnered with for more than two decades. I collaborated with the president of the hospital, Lhab Dorji, on an assessment of potential HVO administration and management volunteer opportunities that would best meet the needs of that institution.  I met with senior management team members and department managers; I joined clinical rounds and observed operating room procedures; I studied an Organization Development Report completed in 2015, which was supplemented with a management self-assessment survey.  I also spent hours inspecting mechanical rooms, the laundry, medical records, the pharmacy and a host of other important departments and spaces.  At the end of my month in Bhutan, President Dorji and I jointly identified areas that might be strengthened by an HVO volunteer skilled in administration and management.

This work in Bhutan highlighted what may be the largest challenge for HVO as it expands its volunteer program activity to include administration and management.  If a hospital’s most significant need is training and mentoring of the executive management team, a mature volunteer with institutional experience at the CEO, COO, or CFO-level will be needed.  If, however, mid-level managers are the hospital staff most in need of training and support, volunteers with experience as department leaders with applicable specialty knowledge, such as hospital pharmacy directors, hospital human resources managers, or infection control program managers, will need to be recruited.  Each institution will have a unique set of administration and management challenges.  HVO’s response will be to expand its recruitment and networking efforts to find both executive level professionals and department and program leaders from multiple specialty areas with relevant administration and management experience.

In 2003, a professor at Georgetown University wrote in Human Resources for Health, “The success of any organized health program depends upon effective management, but health systems worldwide face a lack of competent management at all levels.”  Only in the past few years has this work begun in earnest around the world, and HVO once again will be at the forefront of matching need with the large and growing talented pool of mature, skilled professional health care managers interested in volunteering to improve global health.