On the whole, leadership is the art of motivating a group of individuals to act toward a common goal. Management, in particular, is a social discipline concerned with the actions of the people and the institutions of a human. In general terms, Leadership is about inspiring and management is about planning. In fact, the most dynamic element of a company is the manager. Furthermore, without him/her, the resources of production remain as resources without output. Moreover, Public health is a vital community medicine speciality which integrates an individual’s concepts of public health.
Good management and leadership are required to tackle the health issue so that the problem can be resolved appropriately and most productively. Particularly, this can be done by evaluating service delivery, service efficiency and resource utilization. So, Public health is about protecting and strengthening communities through the prevention, care, and policy advancement of injury or disease. In addition, there are two key aspects a health-care organization wants to achieve:
To enhance the health condition of the population
To provide the healthcare services to the community
Healthcare systems consist of a large number of professionals, groups of complex units and specialities. For example, Doctors and administrators in hospitals are not always in perfect relationships. Due to the demands in the healthcare world, it’s common for the doctors to get overwhelmed and lose sight of what matters most to the administrators. Besides, these two groups tend to have different focus areas. Doctors concentrate on patient care while administrators concentrate more on the organizational aspects of operating the company. Situations like these help in the emergence of a leader and according to Huston CJ, the following characteristics are seen in a leader:
Envisioning the desired future
Fostering Innovation and Change
Building Effective Teams
Creating positive work cultures
ENVISIONING THE DESIRED FUTURE
A critical part of leadership is having a vision for the optimal work environment. Followers become more inspired to act when leaders promote a strong vision that many people identify with and want to be part of. Vision offers guidance for a team and lets people concentrate on doing what it takes to get a job done well. Vision also helps encourage and offers a clear view of how the management plans to accomplish those targets for those concerned.
FOSTERING INNOVATION AND CHANGE
Some of the driving forces for change in contemporary health care include raising prices, diminishing reimbursement, shortages in the workforce, new technology, and a growing elderly population. Healthcare leaders today are challenged to think in new ways, adjust to change, and lead that change while creating new care models and dealing with rapid change effectively while leading more complex organizations. Meeting this challenge was also seen as being an important part of leadership skills. The ability of the change agent is what often differentiates a successful change effort from an unsuccessful one.
A leader who is skilled in organized change theory and execution to cope effectively with contradictory human emotions and to connect and balance all facets of the company that will be impacted by the transition. Leaders will also ensure that anyone impacted by a transition can be included in the preparation for the transition. The agents of reform and the system’s “elements” need to build goals and plans together freely.
BUILDING EFFECTIVE TEAMS
Teambuilding, which includes a shared mission and vision of all stakeholders, is critical to achieving organizational objectives. The role of the leader is fundamental in building that team. In team building, the leader must recognize all team members’ skills and capabilities and empower them to work to the fullest potential. The most efficient teams include talented people who have complementary areas of expertise and are comfortable to express their opinions. Leaders will trust and encourage their team members with new learning opportunities. The leaders and their teams should be able to show a high degree of emotional intelligence and the confidence to make the right decisions for the company when tough decisions are needed. Leaders will also inspire team members to collaborate collaboratively, so they can work together effectively and learn from each other.
CREATING POSITIVE WORK CULTURES
Leaders need to set a good example because, after the leaders of the organization, workers often model their attitudes. Besides, a leader who ‘shows honesty and integrity in all activities, for example, can serve as a role model for team members to ensure they act similarly. A leader who ‘admits a mistake and takes ownership of the situation can demonstrate the importance of acting responsibly to the rest of the team. Organisational leaders are the most powerful force in changing the culture of an organization and doing away with intimidating behaviour. True leaders do so by talking to the employees of the company; by modelling desired behaviour (“walking the talk”); and by formulating policies that promote, enable and reward desired improvements in attitudes and actions around the company.
Healthcare leadership aims at influencing practitioners towards achieving the shared goal of quality patient care. The demands put on leaders in the hospital sector have become more complex, and the need for different types of leadership is becoming increasingly obvious. The intensive reorganization has taken place to derive cost-efficiency and improve productivity.
As a result of these changes, there has been increasing recognition that certain assumptions of traditional leadership models are not well suited to bringing about change at the point of care or to ensuring expanded participation of clinicians and patients in decision-making. Accordingly, calls have been made for a transition to a new phase of hospital leadership, one that puts the clinical frontline and clinicians at the top.
The Transformation theory demands that leaders express their vision in a meaningful, exciting way which creates cohesion and unification collective purpose; the dedicated manager has a vision and is capable of inspiring others as transformational King. The transformative leaders will inspire success the capacity to affect behaviours beyond expectations. Transformation leaders seek to accomplish greater goals within an organization by encouraging other community members to express their dream for the organization. Transformation leaders are motivating and raising their follower’s morality and helping them reach their fullest potential. The leaders of transformation are Mohandas Karamchand Gandhi and Nelson Mandela
Collaborative partnerships in today’s dynamic and competitive healthcare environment allow organizations to achieve improved results by gaining expertise, skills, technologies or other vital resources that a single entity cannot provide on its own. Collaborative collaborations put together people who have very different bases of expertise, behaviours and expectations. Each partner has unique knowledge and competencies that can benefit others. They build learning opportunities for themselves and each other as partners coordinate, prepare plans and move forward. Stanfield says factors like moral values and honesty play a role in successful leadership. Communication is a two-way path, so being an effective communicator requires proper listening and virtuous speech. So, Effective leaders in health care need professional skills. Some of the skills are as follows:
Listening and Learning
Planning and Vision
Build open channels of Communication
Competence refers to the process which allows individuals, particularly leaders and managers, to express the competencies required to complete the task. To sum up, it has been found that the atmosphere at healthcare organizations is dynamic that the skilled and knowledgeable leaders and administrators are in desperate need of handling the social health issues. Competent leaders have the ability, skills and knowledge to handle a given situation in the best possible efficient way. So, It is a crucial dimension, which needs tremendous attention.
The Health Care Manager will demonstrate the following particular behaviours to facilitate collaborative problem-solving among stakeholders:
Trust that the goals and aims are achievable.
The capacity to act as an active listener.
The capacity to share information and power with the employees
The ability to evaluate and manage varying risk levels in decision making and implementation.
Although collaborative leadership has much in common with theories of transformational leadership and servant leadership, there are also many differences. Among the many benefits of collective leadership, there are drawbacks, too. So, Two of the drawbacks are to:
Communication can be sluggish and time-consuming
Conflicts of a high degree may require management in addition to mediation
Collaborative leaders may need to grant the team some of their power as well as authority
While this sector is a difficult one to deal with leaders, it should welcome each other and work together to solve the related local problems. Therefore, saving on other unnecessary costs that may arise would prevail through the introduction of new ways and means of communicating a seamless flow of events. In the same way, Management and leadership should go hand in hand. In that, while leaders are individuals they are followed by others by their own choices and managers must be obeyed.
Patient counselling, in particular, is defined as providing medication information orally or in written form to the patients or their representatives on directions of use, advice on side effects, precautions, storage, diet and lifestyle modifications.
OBJECTIVES OF PATIENT COUNSELLING
In fact, the patient should recognize the importance of medication for his well-being. So, a working relationship and a foundation for continuous interaction and consultation should be established. To sum up, the Patient’s understanding of strategies to deal with medication side effects and drug interactions should be improved. Moreover, we should ensure better patient compliance. Correspondingly, the patient becomes an informed, efficient and active participant in disease treatment and self-care management. In fact, the pharmacist should be perceived as a professional who offers pharmaceutical care. So, Drug interactions and adverse drug reactions should be prevented.
STAGES OF PATIENT COUNSELLING
Review the patient’s record in particular
As well as introduce your self
Moreover, explain the purpose of counselling
Obtain drug-related information such as allergies, use of herbals etc.
Consequently, assess the patients understanding of the reasons for therapy
Assess any actual as well as potential concerns or problems of importance to the patient.
The medicine’s generic as well as brand name
In fact, in which way it helps the patient?
How it makes him/her feel?
How long it takes to begin working?
When to take the medicine?
How long it will be necessary to take the medicine?
When to take it: before, during, after meals? At bedtime? At any other special times?
How to take it? With water? With fruit juice? How much?
What to do if you forget to take it (miss a dose)?
Foods, drinks, or other medicines that you should not take while taking the medicines.
Restrictions on activities while taking the medicine
Possible side effects. What to do if they appear. How to minimize the side effects? How soon they will go away.?
When to seek help if they are problems?
How long to wait before reporting no change in symptoms?
How to store medicine?
The expiration date
The cost of the medicine
How to have your prescription refilled, if necessary?
The necessity to complete the course.
Drug-Drug, Drug-Food interactions
Supply medication reminder chart.
Issues regarding Manner:
Use language that the patient understands
Use appropriate counselling aids
Present facts and concepts in simple words and in a logical order
Use open-ended questions.
Verify the patient’s understanding using feedback
Summarize by emphasizing key points
Allow the patient to put forward any concerns.
Help the patient to plain follow-up
IMPORTANT ASPECTS OF COUNSELLING
The environment should be conducive to proper interaction between patient and pharmacist. So, there should be privacy and enough time for proper interaction.
In fact, Patients get a lot of benefit by way of information. So, Pharmacists get benefit by way of better business.
Barriers are three types:
In short, a patient may not like to listen. Furthermore, He/ She may have some disadvantage or may not know your language or may feel shy or inhibited. These barriers must be overcome with patience However, if the patient is reluctant about accepting advice, it is better to leave him and not insist on giving advice.
The owners of the establishment in particular, may not like patient counselling or there may not be enough space where counselling may be done.
Undoubtedly, the Pharmacist who is giving the counselling may have a problem with language or subject or some other problem may be there. So, all these barriers must be overcome to be able to give proper Patient Counselling.
Undoubtedly, Madagascar is a country located on an island off Africa’s south-eastern coast and is the fourth-largest island in the world. 1.8 million or 47% of the children below 5 years are stunt. This data obtained from Madagascar related to child stunting is the highest among all the countries in the world. As stated by the World Health Organisation (WHO), Globally around 155 million children below the age of 5 years suffered from Stunting in 2016. Poverty and weaker healthcare system have obstructed attempts for the implementations of interventions. So, some important determinants of malnutrition include Intergenerational transmission of growth failing as well as exposure to early life.
Undoubtedly, in the determination of health in the later stages of childhood, the most important aspect during the first 1000 days. The Linear growth or Height – for – Age among the children can change rapidly until 2 years of age. In Weight – for – Height, variability exhibits more. It shifts to 1 year of age, and since then it tends to recover. Malnutrition predicts low socio-economic position in the first year of life of adulthood. So, chronic malnutrition is the greatest barrier to the potential of a child’s development. One out of two children is a stunt in Madagascar. So, its annual Malnourishment costs are 7 – 12 % of the Gross Domestic Product (GDP).
WHAT IS MALNUTRITION?
Malnutrition is a term used for referring deficiencies and imbalances in the intake of nutrients by a person. Moreover, malnutrition is mainly classified into two groups based on their characteristics which are as follows:
It includes stunting, wasting, underweight and micronutrient deficiencies. Undernutrition makes children vulnerable to illness and death. Wasting is the term used for the low weight for height. Moreover, there is a severe drop in a person’s weight.
Stunting is the term used for low height for age. It occurs due to chronic undernutrition caused due to poor socio-economic conditions, faulty maternal and nutritional health. Additionally, recurrent illness as well as early-life improper feeding and the care of infants as well as younger children. Achieving physical and cognitive capacity is prevented in children due to stunting. Low weight for age is referred to as underweight which makes children vulnerable to disease, illness or death.
Overnutrition is used to refer to deficiencies and imbalances in the intake of nutrients by a person. It includes overweight, obesity and Non-communicable diseases (NCD) related to diet. Micronutrients deficiency is the inadequacies during the intake of vitamins and minerals. Vitamin A, Iodine and iron are important micronutrients for global public health. An insufficiency in these micronutrients is a major threat to the world’s health and development.
Overweight as well as obesity is when a person’s weight is too high. To differentiate between Overweight and Obesity it uses The Body mass index (BMI). It represents in meters by the square of the height divide by the weight of a person in kilograms. Overweight as well as obesity results due to a disparity in the consumed energy (input) and expended energy (output). Non – Communicable Diseases (NCD) are linked to a diet. It includes Cardiovascular disorders like Hypertension, Angina Pectoris, Congestive Cardiac Failure, Cardiac Arrhythmias. Moreover, Type – II Diabetes Mellitus. Globally, unhealthy diets which include a large number of junk foods and insufficient nutrition are the main risk factors.
Malnutrition is further classified into the following subtypes:
Martin Vogl described Acute Malnutrition as a condition where a child suffers when there is a severe lack of food. Sometimes, children suffering from acute malnutrition are very thin, and they can have a swollen abdomen and limbs at times.
Martin Vogl described Chronic Malnutrition as a condition where there is a lack of essential nutrients in a person. The external symptoms of chronic malnutrition are not as easy to find. Children with chronic malnutrition are smaller and thinner than other children of the same age, otherwise they may look fairly healthy. The tragic thing about chronic malnutrition is that it’s having long-term effects on the brain development of children.
STEPS TAKEN TO PREVENT OR REDUCE CHILD STUNTING IN MADAGASCAR
In Madagascar, poverty and a weaker healthcare system have slowed down the attempts for the implementation of various interventions related to malnutrition for saving their lives during the critical phases of faltering growth. Some important determinants of malnutrition include Intergenerational transmission of growth failing as well as exposure to early life. So, Malnutrition is the greatest hindrance to the ability of a child and the long – term production of human resources and economic growth of Madagascar. One child in two is a stunt in Madagascar. Furthermore, the annual cost of the national measures at 7 to 12% of the Gross Domestic Product (GDP).
Stunting is a red flag indicator. It associates with a variety of issues such as low dietary awareness, poor approach to healthcare facilities, water, sanitation as well as dietary behaviours. Madagascar’s government is planning and implementing various methods to reduce stunting by the year 2021 from 47 % of the total affected child population to 38 %. As of 2013, the national overweight prevalence of children below five years of age is 1.1 %, which fell from 6.2 % in 2004.
The national stunting prevalence of children below five years of age is 48.9 %, which is significantly higher than the 25 % average of the world’s developed countries. Conversely, the age group of under 5 years, the waste prevalence of 7.9 % in Madagascar is lower than the 8.9 % average in the developed countries of this world. In Madagascar, 41.9 % of infants under the age of 6 months are exclusively breastfed, the 59.7 % average is observed in Eastern Africa. The low birth weight prevalence of 17.1 % in Madagascar in the year 2015 has been slightly decreased from 19.8 % in the year 2000.
Stunting causes devastating effects because it would be difficult for the children to manage with the underdevelopment of the brain. Stunt children learn slowly and are less likely in reaching full potential till adulthood as a result of a possible irreversible cognitive damage. The prevalence of stunting in children below the age of 5 years has declined from 32 per cent in 2000 to 22 per cent by 2017 globally. Senegal triumphed in decreasing the prevalence of stunting from 30 per cent in the year 2000 to 19 per cent as of today, meanwhile, Peru has seen a decline in more than half of its rates of stunting in a time period less than a decade, from 28 per cent in the year 2008 to 13 per cent in the year 2016.
HOW COULD STUNTING CRISIS BE RESOLVED?
The World Bank’s team in Madagascar acknowledged that the stunting crisis in Madagascar could be benefitted by the Multiphase Programmatic Approach (MPA) which is a systematic but versatile and adaptive process. The Bank and Government’s support resulted in the approval of the MPA operation which provides 200 million USD over a period of 10 years. Its programmatic structure ensures that work on chronic malnutrition across the country.
A close to 75 % of children under 5 targets with the help of this programme. In the first phase, the highest stunt rates include after which the programme expands to 15 regions by its end. There are few priorities that promote proper nutrition for the initial 1,000 days from a child’s birth until the age of 2 years. This seeks to decrease the number of children stunted in the selected regions by 30 per cent by the year 2028 and also to offer a brighter future to about Six hundred thousand children in Madagascar.
HOW CAN MALNUTRITION BE PREVENTED?
Malnutrition is one of the most common conditions which occurs when there is a deficiency during the intake of micronutrients. In addition to this, it is one of the main causes of death in children belonging to the age group below five years. It is also a common cause of a decline in the health & the lives of children, resulting in reduced learning ability, skill-acquisition and inefficiency. In the continents of Asia and Africa, nearly half of the children below the age of five years died due to malnutrition. Insufficient nutrition raises the possibilities of death. Additionally, the only way malnutrition could be avoided is by eating a safe and nutritious diet. To conclude, here are some recommended foods:
A variety of fruits and vegetables
A variety of starch-based foods such as bread, rice, potatoes and pasta
Milk and milk products, or non-milk alternatives
Moreover, protein sources like beef, fish, eggs and beans
Dengue fever is a disease borne by the dengue virus. Symptoms usually begin 3 to 14 days after infection. This may include a high fever, headache, vomiting, muscle and joint pains and a characteristic muscle rash. Recovery generally takes two to seventeen days. In a small proportion of cases, the disease develops into a life-threatening dengue haemorrhagic fever. This results in bleeding, low levels of platelets in the blood and blood plasma leakage, or into dengue shock syndrome. Dengue is transmitted by many Aedes-type mosquito species, mainly A. Aegypti.
Treatment of acute dengue is supportive and includes giving fluid either by mouth or intravenously for the mild or moderate disease. Paracetamol is recommended instead of Non-steroidal anti-inflammatory drug (NSAID’s) for fever reduction and pain relief in dengue due to an increased risk of bleeding. Once a mosquito carrying dengue virus bites a human, the virus reaches the skin along with the saliva from the mosquito. This binds and joins white blood cells and reproduces in the cells as they pass across the body. The white blood cells respond by producing a no. of signalling proteins, such a s cytokines and interferons, which are responsible for many of the symptoms, such as fever, the flu-like symptoms, and the severe pains.
In extreme infection, the development of the virus inside the body is significantly increased, and it can affect many more organs. Fluid from the bloodstream leaks through the wall of small blood vessels, and the blood pressure becomes so low that it cannot supply sufficient blood to vital organs. Furthermore, dysfunction of the bone marrow due to infection of the stromal leads to reduce no of platelets. So, This increases the risk of other major complications of dengue fever: bleeding.
SIGNS & SYMPTOMS
People infected with dengue virus are typically asymptomatic (80%) or only have mild symptoms such as uncomplicated fever. Others have a more serious illness, and it is life-threatening in a small proportion. The incubation period ranges from 3 to 14 days, but most often it is 4 to 7 days. Therefore it is unlikely that travellers returning from endemic areas will have dengue if fever or other symptoms start more than 14 days after they arrive home. Children often experience symptoms similar to those of the common cold and gastroenteritis and have a greater risk of severe complications, though initial symptoms are generally mild but include high fever.
Dengue fever is a disease borne by the dengue virus. Symptoms usually begin 3 to 14 days after infection. This may include a high fever, headache, vomiting, muscle and joint pains and a characteristic muscle rash. Recovery generally takes two to seventeen days. In a small proportion of cases, the disease develops into a life-threatening dengue haemorrhagic fever. This results in bleeding, low levels of platelets in the blood and blood plasma leakage, Or into dengue shock syndrome. Many Aedes-type mosquito species, mainly A. Aegypti, transmits Dengue. Furthermore, dysfunction of the bone marrow due to infection of the stromal leads to reduce no of platelets. So, This increases the risk of other major complications of dengue fever: bleeding.
Last week I was surfing on the internet regarding the health industry and I came across a popular search term that was “Who are the most influential people in the healthcare industry?”
I was really very curious to know about who are those influential persons belonging to the industry of healthcare. To know more I started to gather details from many websites and made my own blog based on the information obtained.
Do you want to know who are the Top 10 most influential people in the Healthcare Industry? This blog is made by collecting information on individuals based on the level of leadership and impact created by them. These influential persons are ranked as per the data obtained from Modern Healthcare.
HEALTHCARE INDUSTRY: INFLUENTIAL PEOPLES
1. Seema Verma
Seema Verma is an American health policy consultant and the administrator of the Centers for Medicare & Medicaid Services (CMS) since March 2017, serving in the administration of Donald Trump, The President of the United States of America. She is the founder and previous CEO of SVC Inc., a health policy consulting firm, which was acquired by Health Management Associates (HMA) before her nomination to head CMS. Click to know more about her.
2. Bernard Tyson
Bernard Tyson was an American health executive. He was the CEO of integrated managed care consortium Kaiser Permanente, the largest organization of such kind in the United States of America, which provides health care to more than 12 million people. Bernard Tyson died in Oakland, California on the 10th of November 2019 at the age of 60. Click to know more about him.
3. Jeff Bezos
Jeff Bezos is an American internet entrepreneur, industrialist, media proprietor, and investor. He is the founder, CEO, and the president of Amazon. Bezos has been the richest person in the world since 2017 and has been named the “richest man in modern history” after his net worth increased in July 2018 to $150 billion. Consequently, Amazon is the second company in history to reach a market cap of $1 trillion. Click to know more about him.
4. Dr Rod Honchman
Dr Rod Hochman is the president and CEO of Providence St. Joseph Health, a Catholic not-for-profit health system. It has served the Western part of the United States of America. for more than 165 years. Under Rod’s leadership, Providence St Joseph Health is transforming health care for the future through digital innovation as well as population health, mental health, genomics, whole-person care and outreach to the poor and vulnerable. Firstly, he is the chair-elect designate for the American Hospital Association (AHA). Above all, he is the 2019 recipient of the National Health Centre’s Gail L. Warden Leadership Excellence Award. Click to know more about him.
5. Larry Merlo
Larry Merlo is President and Chief Executive Officer of CVS Health which helps people on their path to better health. The company touches more than 100 million people each year through its unique combination of assets. CVS Health also serves an estimated 34 million people through traditional, voluntary and consumer-directed health insurance products and related services, including expanding Medicare Advantage offerings and a leading stand-alone Medicare Part D prescription drug plan. Click to know more about him.
6. Karen Lynch
Karen Lynch is Executive Vice President, CVS Health and President of the Aetna Business Unit. Not only she is responsible for driving the CVS Health strategy to deliver consumer-focused but also provides high-value healthcare to the nearly 45 million people that Aetna serves. As a result, Ms Lynch has almost 3 decades of experience in the healthcare sector. So, she started her career as a Certified Public Accountant ( CPA), with Ernst & Young. To read more about her click here.
7. Sean Slovenski
Sean Slovenski is the Chief Executive Officer of Intel-GE Care Developments. In summary, it is a collaboration between Intel and GE that transforms the delivery of healthcare connects people to their care teams and gives them the trust to live independently. Click to know more about him.
8. Elizabeth Warren
She is a fearless consumer advocate who has made her life’s work the fight for middle-class families. Therefore, she was re-elected to the United States Senate for a second term on November 6, 2018, by the people of Massachusetts. Without a doubt, Elizabeth is one of the leading progressive voices of the United States of America who is fighting for big structural change that would transform our economy and rebuild the middle class. Click to know more about her.
9. Donald Trump
Donald Trump is the present-day US president at this time. Before entering politics, he was a businessman and television personality. Born and raised in Queens, a New York City borough, Trump received a Bachelor of Economics degree from Wharton School. In 1971, he took over the real-estate business from his family, renamed it The Trump Organization, and moreover expanded its operations from Queens and Brooklyn to Manhattan. So, His firm built and renovated Skyscrapers, hotels, casinos, and golf courses. Trump later commenced several side ventures, mostly by licensing his name. In addition to this, he purchased beauty pageants brand Miss Universe in 1996 and sold it in 2015. Furthermore, he produced and hosted The Apprentice, a reality television series, from 2003 to 2015. As of 2020, Forbes estimated his net worth around $2.1 billion. Click to know more about him.
10. Steve Ubl
Steve Ubl is president and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents America’s leading biopharmaceutical research companies. As he leads PhRMA’s work preserving and strengthening a healthcare and economic environment that encourages medical innovation, new drug discovery, and access to life-saving medicines. As a result of which he is recognized worldwide as a leading healthcare advocate and policy expert who successfully collaborates with various stakeholder groups – including patient and physician groups, regulators, public and private payers, and global trade organizations – to help ensure timely patient access to innovative treatments and cures. Click to know more about him.