JORDAN UNIVERSITY OF SCIENCE AND TECHNOLOGY

Faculty of Medicine - DEPT. of Public Health.

Directed readings

(PH 735) - 2 Credit Hours

Instructor:Dr. Yousef Saleh Al-Gaud

Office: Department of public Health

List of topics to be covered by this module

1. Health information system, statistics and informatics

Rationale

A health information system (HIS) provides information for the management of health programs and services, based upon population characteristics, disease and injury prevalence and its resulting morbidity and mortality, in addition to different health resources and facilities availability and utilization. It is essential for monitoring and evaluation of the health situation, the performance of promotive, preventive, curative and rehabilitative health services and activities, and the availability and utilization of health resources. It constitutes mechanisms and procedures for acquiring and analyzing data, and for providing information to:

-all levels of planners and managers to enable planning, programming, budgeting, monitoring, assessment and coordination of health programs and services

- health care providers and research workers and educators to support and guide their respective activities

-Socio-economic planners and concerned authorities of other health related sectors for intersectoral linkages of activities and its coordination

-national policy and decisions makers for evidence-based health policy formulation

Aim:

To understand the application of basic statistics for making sense from the available data and give statistical significance to the research studies conducted.

Learning Objectives

By the end of this unit the students will be able to:

  1. Explain the significance and use of different aspects of statistic in the investigation of community health and biomedical problems in medical research.
  2. Explain importance of statistics in research;
  3. Collect and record statistical information on medical related fields from surveys, population registers, hospital record, etc.
  4. Collect, enter and process data including the determination of frequency distribution, etc;
  5. Prepare graphs like: frequency polygon, histogram, bar chart, and pie chart, etc. and give an elementary interpretation of the data including simple analyses of tables charts and graphs.
  6. Compute different measures of central tendency and spread.
  7. Explain and use normal curve, measures of dispersion, standard deviation, standard error, parametric tests of significance, Z Test, T. Test, Chi-square and Correlation
  8. Investigate community health and biomedical problems in medical research.
  9. Explain the steps to conduct a community survey;
  10. Explain the steps to collect, compile, interpret and make inferences from the data gathered in the community.
  11. Identify the types and utilization of health services and resources in the community;
  12. Identify sources of demographic data like, periodic census, vital registration, etc.
  13. Demonstrate ability to compute: service coverage of population, achievement of program and services objectives and targets, volume of services provided (workload), quality of care provided, client satisfaction, community participation and contribution in the facility activities, resource availability and use and health situation and trends;
  14. Interpret the information collected through various methods to use them for health system performance indicators and its analysis and health information system assessment
  15. Know how to use Informatics applications in health management

Competencies / Levels
Aware of / Knowledgeable / Proficient
  1. Health information categories and sub systems :

epidemiological surveillance of diseases and injuries and outbreaks notification / *
services records and reporting from all health care delivery facilities / *
specific program monitoring and evaluation e.g. TB, AIDS, EPI, malaria, MCH/FP
administration and resource management information (budget, personal, supplies .etc)
vital registration (births, deaths.. etc) / *
*
*
  1. Facility and district level information to enable measurement of:
/ *
service coverage of population / *
achievement of program and services objectives and targets
volume of services provided (workload)
quality of care provided
client satisfaction
community participation and contribution in the facility activities
resource availability and use
health situation and trends / *
* / *
*
*
*
*
  1. Patients care information : diseases diagnosis and its classification, management, follow up and monitoring through efficient medical records, and archives
/ *
  1. Varieties of Data collection, collation, processing, analysis, application, storage, archiving and retrieving for scientific analytical utilization
/ *
  1. Health system performance indicators and its analysis
/ *
  1. Health information system assessment
/ *
  1. Informatics application in health management
/ *

2. Health and population

Rationale

Health is among the most fundamental issues that affect human development, welfare and productivity. Human population have certain general socio-economic and behavioral characteristics governed by their demographic profile components including life cycle (infants, children, adolescent, adults and elderly), gender, profession (office work, agricultural, industrial … etc), living site and society (urban, per urban, rural, nomads, slums, homeless … etc), family configuration and ties, prevailing social practices and life style, safety and security assurance and coping with stress ability. Most, if not all these components, have substantial effects on population health in general. However, certain other factors related to behaviors and social practices (life style) adopted by individuals will certainly affect their personal health and reflect the values and identities of the group and community in which they live. Such practices include personal hygiene, food habits, physical activity, tobacco and drugs, stress and tendency to violence, sexual behavior involving risks to health in general and particularly to reproductive health.

Moreover, certain situations like natural or manmade disasters may lead to massive internal displacement or across boarder immigration resulting in large masses of homeless or stateless population with grave living environmental conditions and serious health problems.

Aim

Students should be aware of the above demographic issues affecting the public and the individual health of the population and should be knowledgeable in means and ways of its mitigation and management. Areas of concern in this domain may include different levels competencies.

Learning Objectives

By the end of this phase the students should be able to:

  1. Analyze the composition of population in terms of:
  • Sex, age, marital status etc.
  1. describe the basics of dynamics of population;
  2. compute different rates ratios and proportions in terms of:
  • fertility (gross fertility rate, total fertility rate)
  • population replacement rate
  • mortality (crude death rate, infant mortality rate)
  • morbidity (incidence and prevalence)
  1. describe demographic characteristic and dynamics of demographic changes in relation to
  • demographic stages
  • demographic transition
  1. identify and explain the population pyramid Interpret the major health problems of the community;
  2. prioritize the problems with full involvement of the community and select the one they think is most feasible to manage;
  3. Understand about the effect of health lifestyles on the humans at personal and community levels.
  4. Prevent and control non-communicable diseases through research and teamwork.

Competencies / Levels
Aware of / Knowledgeable / Proficient
1. Overall socio-economic
determinants of health
demographic profile : demographic pyramid and life cycle, gender, profession, living site and conditions, family type and ties, prevailing social practice and life style, security and safety … etc / *
individual social life styles and practices :
personal hygiene, food habits, physical activities, disability, coping with stress ability, tobacco and drugs, tendency to violence, sexual behaviors and risks to general health and reproductive health / *
2. General disastrous situations
affecting health status of large
masses of population, and its
management : / *
massive displacement and immigration of population due to natural or manmade disaster
3. Population enabling community
environment : / *
caring for others : children, older people, vulnerable people and restitutes
extended versus nucleus family benefits
community and society : friendly relations, human and civil rights and privileges
4. Reproductive health WHO goals : / *
experience healthy sexual development and maturation
achieve desired number of children safely and healthily, when and if needed
avoid illness, disease and disability related to sexuality and reproduction and receive adequate care when needed
sexuality and reproduction free of violence and harmful practices
5. Healthy life-style : / *
physical activity and recommended weekly exercise
hazards of active and passive smoking and drug abuse
balanced diet and recommended daily intake of fats, proteins and carbohydrates / *
healthy sexual behavior : religious injunctions, puberty and physical development with age
stress : common stressors, natural response to stress and how to cope with stress

3. Human Resources Development and Management

Rationale

Human Resources are considered as the most important resource of any health care system. It consumes the largest share of the financial resources and budget of a health care system. Human resources are expected to make the maximum use of all the other resources of the system to produce acceptable, effective, and efficient health care services.

Development of human resources for health incorporating policy and strategy formulation, planning and assessment of needs to resolve mismatches between requirements and supply of human resources, training for the production of the required numbers and high quality health personnel and the proper and efficient management of human resources for health are the most important functions of human resources development

Management of human resources implies that the available resources be utilized economically to produce the best mix of human resources and utilize them efficiently for the delivery of comprehensive and integrated high quality health care services to the community.

Countries encounter many problems in their management of human resources for health in varying proportions. The major problems include mal-distribution between rural and urban communities; shortages in certain categories and surpluses in others as well as consideration of gender related problems; poor utilization and productivity; poor motivation; unclear and unsatisfactory career structures and remuneration; lack of proper supervision and continuing education; and poor working environments and living conditions.

Aim

It is expected that students of this program will study in detail all the major issues related to the Management of Human Resources for Health, as part of human resources development

Learning objectives

At the end of this course, the students should be able to:

  1. Understand and explain the Components of Human Resources for Health Development;
  2. Describe and analyze the processes of developing a human resources for health policy and strategies: Needs assessment, Formulation of policies and Human resources planning cycle;
  3. Describe and analyze the processes of training and production of human resources;
  4. Elaborate on the principles underlying Management of human resources concerning: Managing organizations, Leadership development and motivation, Staff employments and recruitment, Management of staff relations, Staff development techniques and Evaluation of staff performance

List of topics to be covered by this module

Competencies / Levels
Aware of / Knowledgeable / Proficient
  1. Components of Human Resources for Health Development
/ *
  1. Needs assessment
/ *
  1. Formulation of policies
/ *
  1. Human resources planning cycle
/ *
  1. Training and production of human resources

Basic education training / *
*
* / *
In-service training
Continuing education
Postgraduate education
  1. Management of human resources

Managing organizations / *
Leadership development / *
Staff motivation / *
Problem solving techniques / *
Working environment / *
Staff employments and recruitment
  • Job description
/ *
  • Advertisement
/ *
  • Short-listing
/ *
  • Recruitment examination
/ *
  • Interviewing
/ *
  • Selection (committee)
/ *
  • Workload / Skill mix
/ *
Management of staff relations
  • Work organization
/ *
  • Resolving of conflicts
/ *
  • Team work
/ *
  • Delegation and devolution of authority
/ *
Staff development
  • Training (continuous)
/ *
  • Skills development
/ *
  • Job rotation
/ *
Evaluation of staff performance
  • Objective planning of work
/ *
  • Tools for appraisal
/ *
  • Feed back techniques
/ *

4. Hospital Management and Accreditation

Rationale

Hospitals are resourceful, politically apparent, important and costly component of the health system. Their management entails a set of managerial processes that actively co-ordinate and promote team work and its complex and sustainable functions complementing those provided by other PHC facilities and cannot therefore be decentralized further.

The outcome of these functions should aim at the well-being of patients through provision of the best possible quality of medical care, their safety and satisfaction, in a pleasant friendly environment, with a rational and human ethical consideration of their sufferings.

In addition, hospitals should undertake a well defined professional out-reach role to investigate and contribute to solving health problems of the community they serve through health promotive and preventive activities in addition to its mainly curative ones.

Aim

The aim of this module is to provide with a sound foundation students with the basic principles and methods of: Human resources development and management as one of the most vital elements of hospital management. Their professionally dominated technical or administrative competencies and responsibilities might lead to some confrontation.However,their teamwork spirit, attitudes and behaviors based upon unified vision and shared beliefs, culture, will promote integrated areas of understanding, schemes of work and subsequent joint solutions of major difficulties and constraints facing various levels of hospital facilities.

Continuous quality improvement and eventual accreditation of the hospital as a whole or some of its departments and its reflections on the outcome of patients care services it provides will continue to be an important landmark of efficient hospital management. Moreover, hospitals remain to be among the important sources of health information system. Hence, due and serious consideration should be directed to patients medical records and its analysis for specific data and its subsequent reporting to health authorities.

Learning objectives

At the end of this course, the students should be able to:

  1. Understand and explain the historical evolution of Hospitals, its planning processes and components;
  2. Enumerate the essential public health functions of the Hospitals in a health system;
  3. Explain the emergence of the modern Hospital organization;
  4. Describe and Analyze hospital Financial management system;
  5. State how Patients health care management operates;
  6. Analyze the interaction between patients with health problems and hospitals through the referral system;
  7. Describe and Analyze hospital personnel management policy;
  8. Explain the significance, role and use of continuous quality improvement of hospital services;
  9. Describe and AnalyzehealthHospital waste management;
  10. Describe and AnalyzeHospitals health information management;
  11. Understand the different stages of Hospital preparedness, mitigation and response to disasters;
  12. . Describe and AnalyzeHospital housekeeping and catering services
  13. Describe and AnalyzeHospital pharmacy management

The concern and importance of these managerial processes should be directed to develop various levels of competencies in the following domains:-

Competencies / Levels
Aware / Knowledge / Proficient
1. Hospitals planning :
  • Hospital location; its catchment area and accessibility; health and demographic characteristics of its community;
  • Environmental dimensions and design according to hospital construction standards; types and functional levels; departmental components and its inter-relation;
  • Circulation of patients, staff support service, and visitors; expansion liabilities
/ *
2. Hospital organization : -
  • Hospital policy and mission statement

  • Organizational structure :

  • hospital boards with community and health related intersectoral representation
/ *
  • Executive management :
/ *
  1. Chief of medical staff

  • clinical services
  • allied health services
  • community oriented services
ii. Chief of nursing services
iii. Chief of administrative staff
  • budgeting, financing and accounting
/ *
  • human resources development and management
/ *
  • logistic support services
/ *
  • public relation and information
/ *
  • hospital regulation :

hospital departments and its services units / *
administrative regulations and operational manuals defining duties and responsibilities of each department and its units and their inter-relations and co-coordinating channel of communication / *
standards and protocols of clinical performance / *
  • hospital autonomy :
/ *
Pre-requisites, regulations and control
3. Financial management : -
  • Cost estimation and subsequent regular and contingency budgeting
/ *
  • hospital financing, management and control
/ *
  • Cost analysis of activities and its variances as compared to its outputs
/ *
  • Recording and reporting financial transactions of every department expenses and revenues, if any
/ *
  • Material utilization management
  • policies and procedures for acquisition of new technologies, and procurement, storage, distribution and usage of materials and drugs
/ *
  • Facilities, equipments and fixed assets management
/ *
  • strengthening hospital financing channels

  • Increasing government resources
/ *
  • Encouraging bilateral, multilateral, NGOs and community donations
/ *
  • Institution of feasible and affordable users fees with exemption to vulnerable people and emergencies
/ *
  • Cost containment and reduction by prohibiting unwarranted use of material and equipment and increasing functional output and utilization of existing resources
/ *
  • Encouraging affordable health insurance schemes
/ *
  • Raising taxes on goods contributing to poor health and allocating their revenues to health system
/ *
4. Patients health care management : -
  • Outpatients facilities for reception and management:
/ *
i. walk in patients / *
ii. referred patients / *
iii. emergencies / *
  • Inpatients care and hospital beds utilization

  • bed capacity and distribution
/ *
  • measurement of hospital beds utilization
/ *