The final task of the panel members was to break out of the traditional
hospital paradigm and generate ideas for addressing some of the major problems.
They were challenged to think "outside the box" and approach the problems
from a new direction, including using the earlier mentioned guiding principles.
The technique used for this task was to work with some "what if" scenarios.
The panel chose to work on three of these scenarios. Through a brainstorming
process, they generated ideas for addressing the problems implied in the
scenarios.
"What If" Scenario #1
The first "what if" scenario is expressed by the following question:
"What if competition diminishes the viability of Christian hospitals, including
new government services that were not previously available?" The following
recommendations were made:
1. Conduct an across-the-board review to gear hospitals to primary
health care; leave tertiary care for others; provide limited secondary
care; make sure services meet community needs.
2. Include community participation at all levels -- board, management,
and health services.
3. Work at obtaining management efficiency; include staff reduction
if needed; be transparent and present monthly financial reports that compare
months for the current and previous year.
4. Develop new niches for hospitals; provide services that no
one else provides; become knowledgeable and effective in areas such as
quality of care, speed in patient care, preventive services, etc.
5. Reorganize hospitals, specializing in services such as outpatient
care, maternity care, spiritual care, and psychological services for chronically
or terminally ill patients.
6. Attract investments from pharmaceutical and equipment companies;
offer to conduct clinical trials and test new equipment.
7. Consolidate hospitals that are in the same region or area;
combine services.
8. Set up affordable fees for services; conduct market studies
to balance the cost of services with ability to pay; market/open services
such as lab, x-ray, and sonogram services to outsiders.
9. Adapt technology; make own IV fluid; use solar energy; use
the Internet to find low-cost technological innovations that fit existing
infrastructure; use mission and international contacts to develop relationships
with inventors and appropriate technology organizations, and partner with
them in making technological innovations.
10. Improve income-generating capacity of communities; partner
with income-generating development agencies (develop partner-ships with
selected Christian development agencies in this area).
11. Set up local health insurance systems.
What
if competition diminishes
the viability of Christian
hospitals?
"What If" Scenario #2
The second "what if" scenario is represented by the following question:
"What if a Christian hospital's resources are dwindling and it is threatened
with closure?" For this scenario, the following recommendations were made:
1. Work with the community to assess health needs from their perspective
(note that it is critical that the needs be assessed from the community's
perspective, not the hospital's); the hospital must be willing to up-grade
or downsize to address the needs.
2. Present the situation to local community leaders and come to
an agreement about services and how these will be financed.
3. The hospital must be willing to assess its performance in relation
to the needs on a continuing basis; it must make itself accountable to
the community as part of the partnership agreement.
4. The hospital should then change its objectives and mission
to meet community needs that can be performed by existing staff.
5. Conduct annual celebration and orientation festivals with the
community on vision, philosophy, and mandate for health services.
6. The hospital should consider cutting down its services to match
its staffing capacity.
7. Replace expatriate staff with local staff; insist that a timetable
is set and local staff is trained to accomplish this.
8. Use local, competent, committed Christian volunteers in full-time
service elsewhere, to donate regular time to the health ministry.
9. Similarly, use willing, competent, committed Christian health
providers from abroad to periodically donate consistent short-term services
to the health ministry; some of these services could be specialized services
that generate income for the hospital.
10. Set up rotation of staff from a committed private practice
abroad or a local group.
11. Seek selective external support for local individuals in ministry;
for example, a Christian medical practice in an industrialized country
could provide support for a local epidemiologist, who, among other duties,
would provide data on the success of the hospital in achieving outcomes
and make sure that community needs are being met.
12. Get local staff to raise support from "foreign" sister churches.
13. Involve the community in making recommendations for recruitment.
14. The hospital could obtain help in designing effective training
programs for its staff and leaders (many Christian development agencies
have the capability to help in this area; ask them).
15. Structure fees using creative ways to pay for services without
making people feel indebted; find ways to be creatively involved in paying
for this service (e.g., "work for service").
16. Seek national volunteers who are motivated by call and vision;
weekend contributions; weekly or monthly contributions.
What
if a Christian hospital's
resources are dwindling
and
it is threatened with closure?
"What If" Scenario #3
The third "what if" scenario is represented by the following question:
"What if, in the communities it serves, the hospital has no impact on the
health and the spiritual lives of people and has mission objectives that
are no longer relevant to the needs of people?"
There are numerous actions that the hospital needs to take in reexamining
its mission and how it can impact people in the communities it serves;
but the first action needs to be a self-examination, taking into consideration
the stated mission of the hospital and the attitudes, relationships, and
motivations of all staff. This internal assessment needs to include the
following processes:
1. The participation of all staff in reviewing, developing, and
discussing the mission of the hospital in an open, non-threatening, interactive
dialogue.
2. The use of outside resources in examining the hospital's mission
and staff relationships; these can include people from the communities
the hospital serves, professional outside facilitators, or consultants.
3. An interdisciplinary review of the situation from various professionals
"on the edge" of the hospital's mission; these would likely include people
not directly involved in Christian medical or spiritual ministry.
4. Assessment tools such as the Comprehensive Quality Assurance
Program used by the EHA.
5. Christian medical management tools such as those found at the
www.healthdevelopment.org website.
This internal assessment should focus on individual staff development
needs as much as on corporate development needs (mission, vision, leadership)
of the hospital. It should also look at the style and effectiveness of
leadership demonstrated by the chief executive officer of the hospital
and how it is shaping the organizational culture. Is staff motivated and
affirmed? Do they understand the vision and mission of the hospital? Do
they demonstrate core values such as openness, love, respect, trust, and
integrity?
What
if the hospital has no
impact on the health and
the
spiritual lives of people?
