MAJOR STAKEHOLDERS IN HEALTH.pptx

Advance nursing practice

1. INTRODUCTION The health care delivery system is intended to provide services and resources for better health. This system includes hospitals, clinics, health centers, nursing homes and special health programs in school, industry and community. Stake holders encompasses a wide sector of society. They include consumer or patient, community health care professionals, hospital health care professionals, pharmacists, supplier etc.

2. Definition of Stake holders: Stake holder is a person, group, organization or system who affect and can be affected by an organizational action. 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.

3. TYPES OF STAKEHOLDERS: External stakeholders Interface stakeholders Internal stakeholders

4. 1. External stakeholders: A health care organization must respond to large number of 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.

5. THOSE THAT PROVIDE INPUTS TO ORGANIZATION: The first category includes suppliers, patients and financial community. There is symbiotic relationship between organization and external stake holders as organization depends upon them for their survival. In turn stakeholders depends on organization for output.

6. 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.

7. 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.

8. 2. Interface stakeholders: Some stakeholders function on the interface between the organizations and its environment. The major categories of interface stakeholders include the hospital board of trustees. The organization must provide sufficient inducements to continue to make appropriate contribution. The organization may offer professional autonomy, special services and benefits etc.

9. 3. Internal stakeholders: Internal stakeholders almost entirely within the organization and typically include management, professional and non-professional staff. Management attempts to provide internal stakeholders with sufficient inducements to gain continual contribution from them. The stakeholders determine whether the inducements are sufficient for the contribution that they are required to make partly on the basis of alternative contribution offer received from competitors.

10. Stakeholder in health care delivery system Government Public Providers Hospital administrator and governing boards Non-governmental

11. 1. Government: Many federal government health care efforts are headed by a cabinet-level officer, the secretary for health and human services, who runs the department of health and human services. The federal government makes budget and other planning related to expenditure in health care. Therefore, hospital have a great incentive to comply with regulations promulgated by federal government, because they can be fined or decertified a provider of care to Medicare clients if they do not.

12. At central level: Stakeholders at central level are cabinet minister & secretary for health & human services who runs the department of health & human services.

13. The functions are: Ensuring high levels of executive management performance. Ensuring quality of patient care. Ensuring financial health of the organization. Formulating policy to guide decision making and action.

14. 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. Availability of medical facilities. Plan health programmes & drawing policies in providing health care. Provision of medicines.

15. AT DISTRICT LEVEL: The district level stakeholder in health care delivery system is deputy commissioner, MLAs of the area, civil surgeons, senior medical officers and district public health nurse.

16. 2. THE PUBLIC: The public has a stake in health care from several perspectives. As consumers of health care services or as patients, the public is concerned with quality, cost and access to care. They expect an employer to offer a wide variety of option for health coverage that can be customized to their specific needs. They also look for the employs to fund the majority of cost of health insurance. People are interested in receiving quality care at a reasonable cost.

17. 3. THE PROVIDERS: Community health care professional Hospital health care professional

18. Community health care professional Nurses Health workers Doctors of community health center Dias Anganwadi workers

19. Hospital health care professional: PHYSICIANS: Physicians provide direct medical services to clients in variety of settings, including offices, clinics, hospitals and freestanding centers. In addition, physician control 60% to 70% of hospital costs through their decisions regarding the use of resources. Physicians decide which client to admit, where to admit, the length of stay, whether to perform surgery, when to initiate and to discontinue treatment regimens, and which medications to prescribe.

20. CONT.. NURSES: An individual who provides care to clients. The extent of participation varies from simple patient care tasks to the most expert professional technique necessary in acute life- threatening situations. The ability of nurse to function independently and making self-directed judgment will depends on his or her professional development. PHARMACIST:

21. 4. HOSPITAL ADMINISTRATORS AND GOVERNING BOARDS The chief executive officer, chief financial officer, chief nursing officer, and governing boards of hospitals strongly influence health care delivery in their institutions. The responsibilities are: Decision maker Leader Manager Executor Communicator

22. 5. NON-GOVERNMENTAL STAKEHOLDERS: 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.

23. 1. 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: Milk and medical supplies Maternal and child welfare services Family planning Blood bank and first aid

24. 2. 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 includes 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.

25. 3. INDIAN COUNCIL FOR CHILD WELFARE: It was established 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.

26. 4. 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.

27. 5. BHARAT SEVAK SAMAJ: The Bharat sevak samaj which is non-political and nonofficial organization was formed in 1952. One of the prime objectives 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.

28. 6. THE KASTUBRA MEMORIAL FUND: Created in the memory of Kasturba 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.

29. 7. 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.

30. STEPS IN THE MANAGEMENT OF STAKEHOLDERS 1. Identify type of stakeholder: I dentify the major stakeholder and recognizes the function depicted to them.

31. 2. Diagnose each stakeholder relationship: Stakeholder potential for threat: These threats may focus on obtaining inducements from the organization that may or may not be provided. Stakeholder power and its relevance for any particular cause confronting the organization manager determine the stakeholder potential for threat. Stakeholder potential for co-operation: Generally the most dependent stakeholder on the organization, the higher the potential for the co- operation.

32. CONT.. 3. Classify each stakeholder relationship: Mixed blessing stakeholder relationship: In this, health care executive faces a situation in which potential both threat and co-operation rank for stakeholder. E.g. physician and hospital relationship Supportive stakeholder relationship: In this type there is low potential threat and high co-operation. E.g. relationship of hospital with its trustees, its manager. Non-supportive stakeholder relationship: T here is high potential threat and low co-operation. E.g. competing hospitals, employee union. Marginal stakeholder relationship: There is neither co- operation nor threat. E.g. employees, volunteer groups in community etc.

33. 4. Formulate strategies to reduce stakeholder’s potential to threat: Collaborate cautiously in the mixed blessing relationship. Involve trustingly in the supportive relationship. Defend pro-actively in the non-supportive relationship. Monitor efficiently in marginal relationships.

34. 5.Implementation of strategies and evaluation: The fifth step of stakeholder relationship is implementation of planned and articulated strategies. With conscious, consistent relationship and implementation of strategies, a quite fully organized heath care system can be developed.

35. Thank you