Management of any concept or organization can't be fulfilled without a balance between different components that make up the whole. The same applies to the management of a population's health. More accurately, it could be said that the delivery of healthcare within a given community or population is managed to more precisely help those patients located within. The balance is found in the focus from which the care is predicated.
In the healthcare industry, many different systems are functioning parts of a whole organization. These are divided into three high-level classifications:
The Content System: evidence, knowledge and evaluations
The Deployment System: team structured, defined roles and implementation
The Measurement System: priorities, calculations and data visualizations
In all truth, these systems have many overlapping characteristics within them, but there are defining aspects to each section. Within the Content System resides the more academic ideas, but may be lacking in real-world usability. To have content, you must first collect and store information. In an industry as data-intensive as healthcare, storing that data isn't as simple as having an open computer or even a good size server. The amount of information being produced with basic facts, medical records, doctor's notations, prescriptions, and images (x-rays, MRI, digital photos, etc.) would quickly eat through most basic data storage. Many healthcare organizations have turned to an Enterprise Data Warehouses (EDW) to not only store information, but to have a centralized platform from which that information can be accessed and analyzed. This opens the door for more data-driven decisions, ability to set realistic goals and to remove waste and overages within the organization.
The Deployment System can be defined as the action and organization portion of the whole. As teams or departments are established, as roles are clearly defined and as requirements are mandated, full implementation can take place. At this point, the structure created is quite rigid because no accumulative data supports changes. Mapping out projects to better organize the created structure can be formed as a way to become more efficient and effective. Accuracy is a key ingredient to employ throughout the system, and should be part of the standards integrated into daily operations of everyone working within.
One thing that is lacking in the deployment is measuring or comparing results found when assessing current procedures and results against the instituted goals. The Measuring System moves from the real-world actions to a more IT-centric realm. This area within the system is dedicated to streamlining much of what is required, requested and practiced out on the floor, so to speak. Taking the stored data, goals, and expectations and turning them into quantifiable end results is the specialty of this arm. Measurements are presented in a number of different forms. The most popular utilized is a visual tools, such as dashboards, which translates results into a more quickly understood method of interpreting compared data onto a screen or printout. Quality and satisfaction are evaluated, changes are recommended, and comparisons are always weighed to ensure progress is being made. An all-encompassing questions that belongs in this category would be: What can we do to make it better?
Just as balance is an essential tool within our lives, careful balance is required when applying these systems together. Becoming too heavily centered on one or two of the systems will begin to negate the beneficial characteristics of the other or others. Without a doubt, there will be more favoritism or emphasis placed in a section of the system, but a healthcare organization fundamentally depends upon nurturing all areas, finding the people to represent them, and working to find the equilibrium to allow progress to happen and evolution to be a part of the whole body of work.
top image courtesy of freedigitalphotos.net/StuartMiles,
bottom image courtesy of freedigitalphotos.net/VichayaKiatying-Angsulee