SHORT VITAE

SHORT VITAEBorn in Cirebon – West JavaMedical Doctor, graduated fr Univ of IndonesiaMaster of Public Health: HARVARD-USADoctor of Science: JOHNS HOPKINS-USAPost Doc: UNIV of MICHIGAN-USACurrent Positions:

Indonesian Public Health Assoc, PresidentDept of Health Policy & Administration, Univ of

Indonesia, HeadCtr for Health Administration & Policy Studies,

Univ of Indonesia, Director

UMMAH EXPECTATION ON ISLAMIC HOSPITALS

Adang Bachtiar MD MPH [email protected]

Ctr for Health Administration & Policy StudiesUNIVERSITY OF INDONESIA

2009

Focus of This Presentation Competitive hospitals are based on evidences Patient’s Expectation begins the services Provider’s roles for nurturing patient’s expectations Our previous study on Islamic values for hospital Lessons learned and application of the study Future islamic hospitals? The winning hospitals The important of alliances among islamic hospitals Stepping stones

EVIDENCE-BASED SERVICESas tool for competition

Pre-services ResearchIt’s a part of Strategic Plan cycleFunctions:

Identify Who is the customersWhat are their need & demand

Results can be used to:Identify SWOT factorsDevelop appropriate servicesVisioning (part of strategic plan)

In-services EvaluationMeasuring service process indicators

Provider-client interactionsProcedures compliancesPatients safety measuresClient’s perceptions on servicesClient’s expectationsClient’s satisfaction

Post-services Evaluation

Measuring overall services indicators, including:Satifaction level and its trendCompliance rates & trendsCost-effectiveness level & trendsCost-efficiency level & trens

ProviderRoles

SEGMENTING &TARGETING

Expectations BEGIN services

Patient acceptance relationships among with units within hospital

Sensory &Health

Evaluation

MarketingResearch

HospitalRel

Office

HospitalServices

Expectation&Safety

Measures

ServiceResearch

ServicesDesign

Legal Services

HospitalPromotion

HR devt &Hospitalfacilities

Medical CommitteeProcess devel.

SafetyControl

PatientAcceptance

Akhlakul Islamiya

h(haqiqotul

nafsul insaaniya

h)

Leadership(As Suluk al mudir)

Inter-indiv behavior

(As Suluk Al jama’i)

Indiv Behavior in

Orgnz(As Suluk al

fardi)

3 Components of Provider Roles

Musa, Nadhoriyah As Suluk At Tandzimi min Mandhuril Islam, 1995

AS Suluk al-mudir(Leadership)1

Adil (Fairness) Qudwah hasanah (leading “walk the talk”) Al Fahm (visioner) Shidq (Honesty) Amanah (Responsible) Fathonah (Intelligent/smart) Tabligh (Orator/Communicator) Mu’allim (Knowledgable/transfering know-how)

Madhi, Al Qiyadah Al Muatsiroh, 2002

AS Suluk al-mudir(Leadership)2

Munazzim (Skillful manager) Mubaadarah (Decisive) Ats Tsiqoh (Creating condusive working climate, i.e

trust, warm, peaceful, outcome focus) Al ‘Udhwiyah (caring interaction, i.e to

subordinates, clients etc) At Takayyuf (empowering and participation) Tidak Mubadzir (effective-efficient)

As Suluk al fardiyah(Individual behavior)

Ihlas karena Allah Muhaasabah (Self evaluation & correction) Honesty Optimistic Taubat Tadabbur (Managing Knowledge of Allah,

qouliyah/Qur’an & Hadits and qouniyah/ sciences) Tawadhu’ (humble for Allah/rendah hati)

As Suluk al jama’i(Inter-individual behavior)

INCLUDING PROVIDER-PATIENT RELATIONSHIP

Ta’awun (team work for the benefit of patient) Amar ma’ruf nahi munkar Empathy and caring Obey to the leader for the sake of Allah Khusnudzon Not doing Ghibah Not doing Hasad

Musa, 1995; Luth, 2001, Tasmara, 1996; 2001

Musyawarah Al jiddu fil ‘amal (hard work for helping others) Patience (for solving others’ problem) Istiqomah (continuous positive improvement) Al Himmah Al ‘Aaliyah (high/best achievement

orientation)


Murroqobah (In Allah control, self control) Honesty Amanah (responsible) Balance between hard work & achievement, with

akhirat orientation Ihsan (optimizing the works)


Itqon (professional) Efective and efficient Creative Managing new knowledge Teamwork (amal jama’i) Serving others with IHLAS for service excellence


Study on Islamic values for hospital(3 hospitals in Jakarta, 2002)

Using 3 components provider roles, as explained before Two stages of study:

Explorative study using qualitative approach: Identifying construct-concept-variables-indicator

of Islamic values & practices in hospital, including patient’s expectation

Confirmative study using quantitative cross sectional survey:Diagnosing validity (construct-content-criterium)Examining its reliability

Alamsyah’s Master thesis in 2002 under direct supervision of the author

QUALITATIVE RESULTS

CONSTRUCT-

CONCEPT

Leadership(As Suluk al

mudir):Adil, Qudwah

hasanah, Shidq,

Amanah, Fathonah, Tabligh, Al

Fahm, Mu’allim,

Munazzim, Mubbadarah, Ats Tsiqoh,

Al’Udhwiyah, At Takayyuf,

Not doing Mubadzir

Inter-indiv behavior

(As Suluk Al jama’i):

Amar Ma’ruf, Ta’awun,

Emphathetic communication, Serving

others, Musyawarah, Khusnudzon,

Not doing Ghibbah, Not doing Hasad

Indiv Behavior in Orgnz

(As Suluk al fardi):Ikhlas,

Murooqobah, Muhaasabah, Mujaahadah, AlHimmah Al’Aaliyah, Honesty,

Optimistic, Ihsan, itqon,

Creative, Patience, Taubah,

Knwoledgable, Istiqomah,

Tawadhu’,Valuing time, Obey

CONFIRMATIVE RESULTS

Akhlakul

Islamiyah

Leadership(As Suluk al

mudir):

Inter-indiv behavior/Clie

nt Expectation(As Suluk Al

jama’i):

Indiv Behavior in Orgnz

(As Suluk al fardi): R PEARSON: 0,874

(P<0.0001)

R PEARSON: 0,773

(P<0.0001)

R PEARSON: 0,772

(P<0.0001)

Regression results Akhlakul Islamiyah (AI):

= 11.352 + 5.767 (Indiv Behavior) + e R2 = .927, meaning almost 93% variation of AI score is

related to Indiv Behavior’s score = 58.433 + 11.244 (Inter-Indiv behavior) + e R2 = .843, meaning 84% variation of AI score is related

to Inter-Individual Behavior/Client’s expectation = 71.761 + 6.374 (Leadership) + e R2 = .812, meaning 81% variation of AI score is related

to leadership’s score

APPLICATIONS TO ISLAMIC HOSPITALS

THE CHALLENGES1

Globalization with all its impacts Negatives:

Disparity among poor and rich countries. Worsening accesibility for the poor and rich patient migration to “rich countries”

Increasing dependability to rich countries, which reducing local wisdom (deteriorating islamic values in health services)

Poor countries as dumping (health) products, including communicated diseases

THE CHALLENGES2

Globalization with all its impacts Negatives:

Brain drain of skillful professionalsBioterorism/bio-security situations implicate new

burden for hospital/laboratory servicesHedonistic-consumptive socialities implicate

expanding hospital services to strengthen family values and resilience

THE OPPORTUNITIES1

Positive impact to globalization: Expansion of Healthcare business provide

greater health technology with more technical efficiency consideration

Global healthcare standarization and quality brings new perpective to the local hospital

Greater accesibility (with more cost effective) to capital , technology and professional market

THE OPPORTUNITIES2

Positive impact o globalization: Greater competition pushes alliances &

benchmarking Global village for information, expertise and

knowledeges need specific skills for hospital leaders to Kowledge Management paradigm

Choices for consumers bring greater competition. Franchising and internalization probably the answer

THE OPPORTUNITIES3

Positive impact o globalization: Democratization and customer voice need new

orientation for hospital accountability in (also) the consumer and more transparancies

Counter response to globalization: strengthened local wisdom

ASEAN regulation

harmonization

Standarization of guidelines; procedures in

region

ASEAN Single Market

Regionalization as ONE answer

12 Priority Sectors for IntegrationAgro-based products

Air-travelAutomotive

E-ASEANElectronicsFisheries

HealthcareRubber-based products

Textiles & apparelsTourism

Wood-based productsLogistics services

JnJ,2008

Single Market & Production Base Free flow of goods :

ASEAN Single Window by 2008/2012CSDT for Medical Device by 2010Post Marketing Alert System

Free flow of service :51% foreign equity participation for 4 priority

service sectors & 49% for logistics (2008); 70% foreign equity participation for 4 priority service sectors.

MRAs for architectural, accountancy, …, medical & dental practitioners & other professional services (until 2012)

JnJ,2008

Single Market & Production Base Free flow of investment :

ASEAN Comprehensive Investment Agreement Investment facilitation

Free flow of capital :Tax structure to promote broader investor base

in ASEAN debt issuance Free flow of skilled labor:

Enhance cooperation among ASEAN University Network to increase mobility of students & staffs

MRAs in major professional services by 2008

JnJ,2008

Integration into Global Economyto strengthen regionalization

ADB,2008

AFTA (excl CLMV) more or less completedAFTA (incl. CLMV) 2010AEC 2015

INDIAFA 2003FTA (excl CLMV) 2011FTA (incl CLMV) 2016

PRCFA 2002FTA (excl CLMV) 2009FTA (incl CLMV) 2014

KoreaFA 2004FTA (excl CLMV) 2009FTA (incl CLMV) 2014

JapanFA 2003FTA (excl CLMV) 2012FTA (incl CLMV) 2015

Australia, NZFA 2004FTA 2015

FUTURE ISLAMIC HOSPITALS?AS THE CONSEQUNCES

HOSPITALCAPACITATION

FAMILY & PATIENT EMPOWERMENT

HEALTH PROTECTION

TRANSPARANCIES ACCOUNTABILITY

EFFECTIVE-EFICIENTHI QUALITY-SUSTAINABLE

SERVICES

VISIONINGTHE HOSPITALS

HOSPITAL CONTEXTUALS

Strategy Tactic Value

GLOBAL

REGIONAL

LOCAL

Strategy Tactic ValueGlobal

Hospitalsvalues

Dynamic Contextualities need..Glorecalization Approach

Strategi esWithin

regional

OperationsFill local needs

ISLAMICHOSPITALS

THE WINNINGHOSPITALS?

PARADOX

PERSPECTIVEPARADIGM

PERSUASION PASSION

PEOPLE CENTRED

Dimension-1

PARADOX “First of something”

Creative solution for old problems (excellence among the crowd)

Managing problem(s) for effective chain effect not only for hospital/health interest

Solution for political and social image

In Marketing JargonBrand Loyalty

Name Awareness

Perceived Quality BrandEquity

CompetitiveAdvantage

Cognitive Associations

Brand Assets

Dimension-2

PERSPECTIVE Each solution clearly define for the benefit of

patient, family dan the community

Transfering effectively tacit knowledge to embedded procedures and hospital product

KnowledgeBase

Ideas

Insights

Learn

KnowledgeCreation

KNOWLEDGEMGMT

KnowledgeAbsorption

CodificationEmbeddedKnowledge• Products• Processes

Rapid ConversionTacitKnowledge

ExplicitKnowledge

Dimension-3

PASSION Hospitals need to grow:

Enthusiasm to achieve result (ihsan) Shared vision Effective communication with caring Obsession to improve anything (quality

obession) Hospital ownership among the staff Invovle hospital community, especially

patient& his/her family to (self) help (empowering)

Dimension-4

PERSUASION Creative approaches among critical stakeholders

for: Establishing shared values Stimulating creativity of the beautiul minds Differentiating issues for unique solution Conducive environment for teaming the works Motivating staff for learning from day-to-day

experiences (value added) Commitment to achieve best health interest

Learn fr the best(no Hasad)1)

Flourishing innovation

Quick Problem-Solving 6)

Effective teamwork

for solutions 7)

Share with others(Ihlas) 3)

Understanding & supporting colleagues4)

Fast moving creativity5)

Long life Learn & Amal2)

Performance orientation

Eff-Eff not doing mubadzir

(7)

Hati yg bersih AktualisasiKelompok

AktualisasiOrganisasi

Customer orientation

culture

Comprehensive understanding

SUSTAINABLEISLAMIC

HOSPITAL

Bachtiar, 2008

1) QS 2:10; 18:662) QS 18:75; 9:122 3) QS 2:146; 4:374) QS 58:11; 7:199

5) QS 7:1816) QS 17:36 ; 22:87) QS 37:1658) QS 2:267

SOFT SKILLS HOSPITAL PEOPLE

Dimension-5

PARADIGM Developing specific paradigm:

Packaging the services appropriate to the needs and demand of

Strategic hospital positioning Community and patientsShareholdersLocal leadersRegional leaders (Global standarization and

harmonization, i.e. Asean Charter for Health Services)

ALLIANCES as requirement

INVESTMENTNETWORKS

HOSPITAL USERS PRO ORGNZ

THE LEADERS & MANAGERS

ISLAMIC HOSP

INVESTMENT FOR HIGH QUALITY

ISLAMIC HOSPITALS

CAPACITATION OFTHE SYSTEM

COMPETENCIES DEVT&STANDARIZATION

EMPOWERMENT &PARTICIPATION

High Performance

Islamic Hospital

EFFECTIVE COLLABORATION

Best Practices Among Islamic Hosp

Benchmarking to high achiever at localities

Harmonization in regional

World class quality

“Collaboration gives the ability to link diverse assets into unique capabilities and leverage in pursuit of new

opportunities” (Ghoshal and Bartlett)

TOWARDS EXCELLENCE Periodic meetings and coordination for best services.

Among providers, providers-users, providers-regulators etc (creating interfaces)

Commitment for visioning, planning, programming, implementing services to Ummah as a specific nihe (beneficial programming)

Hospital is multidiscipline and human resources investment, so Managing People is critical Identifying and atracting new talents Motivating them to achieve best achievement

Establishing dan developing the hospital institution as a trusted healthcare service (Premiere institution)

STEPPING STONES

Knowledge Management

Proessional standarizatin & appraisal

Quality Assurance & standarization

Malcolm Baldrige World Excellence

Professional development

TQM-Safety for hospitals

CONCLUSIONS

STRUCTURING&

GOVERNINGHOSPITALS

Strategy,Structure and

Mgmt

Contextualfactors

Demand dynamics

RelatedSupporting

services

CHANGES

Turbulence changes push everybody to corner

The presentation conclusion Evidence-based management in hospital is critical for

sustainability Pre-service, during, and post-services research Indonesia with est. around 90% of muslim or 220mi

target for health industry, is too big to be neglected (as it was shown)

Alliances is the answer for globalization big stream. Otherwise we are the Bubbles

Sustainability in facing “global tsunami” is related to managing local wisdom including people centred mgmt

CLOSING REMARKS

AKTUALISASIHATI BERSIH

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kebahagiaan saat membimbing orang lain.

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