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Changes in Health Services Management in Canada
Healthcare Management FORUM Gestion des soins de sant6
137)
Communications Changes in Health Services Management in Canada by Ed Chow
ealth services management in Canada has become increasinglyprofessionalized. Amid the many changes occurring today, health service executives face the double challenge of not only responding to change, but also defining and influencing its direction for the organization they lead. The health system, and indeed the entire social system, are rapidly evolving, presenting an ambiguous and uncertain context for the practice of health administration. At a fundamental level, professionalism must focus on the individual practitioner. Each is judged according to the quality and appropriateness of daily actions. Many judge the professionalism of health service executives: trustees, employees, other health professionals, other agencies, governments,media, peers, clientele and increasingly the general public. It is highly likely this judgment is not based on the traditional characteristics of a profession (e.g., control over entry, specialized body of knowledge, an ethical code, disciplinary procedures). How then are health service executives evaluated? For the individual practitioner, Sister Shone Roach’ has identified five attributes of professional caring which are a good synopsis of the intuitive criteria used by others to judge individual professionalism: 0 compassion (a genuine sensitivity for others) 0 competence (skills and knowledge) 0 confidence (ability to foster trusting relationships) 0 conscience (moral awareness) 0 commitment (strong desire to M i responsibilities). These five C‘s are not all inclusive but certainly are principal attributes. As individual practitioners, health service executives face the task of improving performance on the five C’s. The catch, of course, is that the expectations are evolving over time. Norms of 1970 are no longer current; future years will see new standards. For example, competence is clearly a moving target. “Shoot from the hip” responses by health administration practitioners risk missing the mark in this more complex world. Health service executives are now expected to have some competence in areas as diverse as information systems, strategic management, marketing and policy development. At the same time, they are accountable formally and informally
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to more and more groups and bodies. Health service executives must strive to develop their capabilitiesin relation to these emerging requirements. CCHSE addresses the collective dimension to professionalism in health administration.The College periodically defines and refines standards for health services management and provides programs which foster their achievement. Educational activities, self assessment, certification and fellowship are all steps in the process. Participation in the College standards programs allows measurement against national norms determined by peers. The voluntary nature of each stage demonstrates a commitment to professionalism far better than any mandatory program. Health service executives choose to participate in Certification and Fellowship which demonstrates commitment to professionalgrowth. Fellowship provides the opportunity to continue one’s professional learning in a rigorous manner and should not be viewed as proof of competence in practice. Rather, it is a demonstration of striving to advance capabilities. The Fellowship projects become an important ingredient in personal learning and also part of the collective knowledge about the changing field of health services management. In the final analysis, professionalismis a social contract. Recognition is conferred upon those who incorporate compassion, competence, confidence, conscience and commitment in their actions. Professional status is determined by the public, not the profession.However, individually and collectively, health service executives must demonstrate that public trust in health service executives is merited. This confidence is gained through educational preparation, professionalcredentialling and, most importantly, professionalism in carrying out responsibilities.
References and Notes 1. Roach, Sister M.Shone. 1987. The HumanAct of Caring.
Ottawa: Canadian Hospital Association.
137)
Communications Changes in Health Services Management in Canada by Ed Chow
ealth services management in Canada has become increasinglyprofessionalized. Amid the many changes occurring today, health service executives face the double challenge of not only responding to change, but also defining and influencing its direction for the organization they lead. The health system, and indeed the entire social system, are rapidly evolving, presenting an ambiguous and uncertain context for the practice of health administration. At a fundamental level, professionalism must focus on the individual practitioner. Each is judged according to the quality and appropriateness of daily actions. Many judge the professionalism of health service executives: trustees, employees, other health professionals, other agencies, governments,media, peers, clientele and increasingly the general public. It is highly likely this judgment is not based on the traditional characteristics of a profession (e.g., control over entry, specialized body of knowledge, an ethical code, disciplinary procedures). How then are health service executives evaluated? For the individual practitioner, Sister Shone Roach’ has identified five attributes of professional caring which are a good synopsis of the intuitive criteria used by others to judge individual professionalism: 0 compassion (a genuine sensitivity for others) 0 competence (skills and knowledge) 0 confidence (ability to foster trusting relationships) 0 conscience (moral awareness) 0 commitment (strong desire to M i responsibilities). These five C‘s are not all inclusive but certainly are principal attributes. As individual practitioners, health service executives face the task of improving performance on the five C’s. The catch, of course, is that the expectations are evolving over time. Norms of 1970 are no longer current; future years will see new standards. For example, competence is clearly a moving target. “Shoot from the hip” responses by health administration practitioners risk missing the mark in this more complex world. Health service executives are now expected to have some competence in areas as diverse as information systems, strategic management, marketing and policy development. At the same time, they are accountable formally and informally
H
to more and more groups and bodies. Health service executives must strive to develop their capabilitiesin relation to these emerging requirements. CCHSE addresses the collective dimension to professionalism in health administration.The College periodically defines and refines standards for health services management and provides programs which foster their achievement. Educational activities, self assessment, certification and fellowship are all steps in the process. Participation in the College standards programs allows measurement against national norms determined by peers. The voluntary nature of each stage demonstrates a commitment to professionalism far better than any mandatory program. Health service executives choose to participate in Certification and Fellowship which demonstrates commitment to professionalgrowth. Fellowship provides the opportunity to continue one’s professional learning in a rigorous manner and should not be viewed as proof of competence in practice. Rather, it is a demonstration of striving to advance capabilities. The Fellowship projects become an important ingredient in personal learning and also part of the collective knowledge about the changing field of health services management. In the final analysis, professionalismis a social contract. Recognition is conferred upon those who incorporate compassion, competence, confidence, conscience and commitment in their actions. Professional status is determined by the public, not the profession.However, individually and collectively, health service executives must demonstrate that public trust in health service executives is merited. This confidence is gained through educational preparation, professionalcredentialling and, most importantly, professionalism in carrying out responsibilities.
References and Notes 1. Roach, Sister M.Shone. 1987. The HumanAct of Caring.
Ottawa: Canadian Hospital Association.