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Question: Discuss about the Leading Change in Healthcare System. Answer: Introduction Research indicates that a number of issues of concern in the healthcare system across communities are coming into limelight which is to be addressed at the earliest. Healthcare management in the contemporary era is marked by the application of a number of a strategic management framework that aims to address the diverse issues in the workplace (Duckett Willcox, 2011). Humanistic management model focuses on the humans as the most crucial resource of a health setting. When integrated as an element of strategic management framework it promises to bring about positive changes in the care settings within a short span of time (Mele, 2016). The present report is a review of four strategic health care issues within the current work place which is Queensland Ambulance Service. The strategic health issues considered for the report are are Ambulance Ramping, Enhancement of Workplace Health and Safety Occupational Violence, Developing Better Information Technology Capabilities and Proving High Quality Patient Care. The strategic issue identified are key concerns since they influence the QAS pertaining to the operational functioning at present and would continue to do so in the future. The report would put forward a critical analysis of the humanistic management model and demonstrate how it influences present practices. Lastly, the report would demonstrate the strategic management framework and how this would addresses the identified health concerns. Description of care setting The current workplace setting is the Queensland Ambulance Service (QAS) that is a part of the Queensland Health (QHealth). The organisation is a reputed statutory ambulance service functioning within Queensland (QLD). It is notable for providing non-emergency and emergency pre-hospital care in addition to disaster response and transport services to the community. The expectations from the setting are set high as the community considers this service as reliable and convenient. The current position held in the QAS is that of a Senior Operations Supervisor (SOS) within the Metro-North Local Ambulance Service Network. The position requires on to provide management and coordination of ambulance personal and resources and real time operational supervision. At this position, one is required to provide logistic solutions to challenges faced in operations through tactical management aids. An essential role is also played in establishing and sustaining a strong relationship with chief stakeholders within the QHealth Hospital and Health Services and QAS Operations Communication Centre. Explanation of managerial duties Holding a senior position in a healthcare service setting one is expected to demonstrate a set of competencies and core skills that are aligned with the objectives and mission of the organisation. At present the managerial responsibilities and duties held include supervising, leading and managing different domains of workforce performance and operations. The objective is to ensure adequate service delivery that is aligned with the set operational plans as well as the legislative requirements. It is also a part of the duty to engage in effective communication with the external stakeholders for maintaining a strong professional relationship. In addition, it is required to provide operational support that directs major incidents within the setting. Suitable leadership skills are to be showcased in this regard in the real-life scenarios. The position of SOS is one that demands te individual to look after diverse areas in the business for ensuring that the decision making process is guide d by best management models, legislative procedures and policies. Strategic issues pertinent to the health sector For identifying the present strategic health issues faced within the QAS, it is desirable to conduct a SWOT analysis. Through this assessment, a number of chief concerns became prominent, of which four would be considered for the present paper. These strategic issues related to ambulance ramping, improvement of occupational violence, development of better information technology capabilities and provision of high quality patient care. All of these highlighted issues are to considered as strategic since they require managerial interventions for coming up with resolutions to these concerns. Certain styles of management are elementary for addressing these situations, and the role of the manager is more prominent in here (Grant et al., 2011). Ambulance ramping- Ambulance ramping is the situation in which the patients transported to the Emergency Department (ED) through an ambulance suffers a delay in offload from the trolley of the ambulance to the treatment area of the ED. Usually, the delay in an ambulance offload into the ED of half an hour or more is considered as ambulance ramping. At the QAS it has been noticed that ambulance ramping is gradually becoming a strategic health concern and this is more evident in the last one decade. QAS is largely effected by this situation pertaining to providing a suitable and timely response to the community. As opined by Perry and Carter (2017) ambulance ramping is related to a significant measurement of adverse patient morbidity as well as mortality. The primary cause of ambulance ramping is overcrowding of the ED that is caused by multifaceted and complex reasons, including high demands for ED services, and processing insufficiency. Improvement of workplace health and safety (Occupational violence)- Occupational violence is the second prominent strategic issue at QAS. It has been found that the healthcare workers at this setting are continually being subjected to occupational violence since they come across individuals who are stressful and unpredictable. Since these individuals are in volatile situations, service providers at QAS are subjected to violence and aggression. The issue is strategic since the employees are confronted by certain ethical dilemmas regarding personal safety and patient care obligations. Moreover, combating this issue requires interventions that are broadly focused and based on shared responsibilities of the employees. Leadership is essential for addressing the issue in all functions. Enhancement of better information technology- In light of the advancement brought about in rapid implementation of information technology systems across healthcare service domains, it has been reported that QAS in lagging behind in this arena. There is an urgent need of implementing better and adequate information technology systems in the setting that would enable successful storage and analysis of a large pool of health information. The concern is strategic since it requires the employment of competent personnel and additional resources (Kellermann Jones, 2013). Provision for high quality patient care- For a healthcare service provider it is essential to provide optimal quality patient care. QAS has been recently showing deviation from this motto as the patient satisfaction scores are not high. The patient's outcomes are not aligned with the guidelines of clinical practice in this setting. Quality health care perceived to be an overarching umbrella beneath which the aspect of patient safety resides. The issues need strategic interventions in the form of interaction between the human and non-human resources. Processes that are variable are to be eliminated, and enhancement of provider competencies and education is crucial through training and supervision. Monitoring and evaluation processes when integrated into the functioning of the setting leads to improvements (Mohammed et al., 2016). Critical analysis of humanistic management model As highlighted by Pirson (2017) the humanistic management model is a noteworthy management and administration theory that has is now being considered for application across different healthcare settings for achieving best outcomes. The model, in the present era, has become a preferred and dominant management paradigm for healthcare services. The management model gives prime importance to ethical foundations of the organisation and thus the management as a whole. As per this model, an organisation must perceive the humans that is the employees as the most crucial resource. The approach has the emphasis on the need for managers to stimulate the activity, motivation and creativity of the employees to work in collaboration and achieve the set goals of the organisation. The models stress to a large extent the requirement for human aspects to be considered as fundamental for suitable management processes. Through showing concerns and care for the wellbeign of the individuals managers can s uitabley addresses all challenges coming up in due course of time. The elements of human welfare that are encomapassed in this model are human dignity, comprehensive knowledge, wholeness, common good, development, stewardship-sustainability and transcendence. Pirson (2014) highlighted that integrated into the humanistic model is the set of humanistic principles that respect individuals concerns and provoke their enthusiasm. Such an approach enables collaboration between employees and managers which is very much required for bringing in key developments nin the setting. Humanism is perceived from an individuals standpoint of the indispensable concerns related to the organisations motto, its demands, and its purpose. Mele (2016) argues that the humanistic model has some key disadvantages that make it not appropriate for application in healthcare settings. The argument put forward is that the model is too positive pertaining to human behaviour. The model has the underlying principle that humans would choose the positive path under all circumstances and that motivation can be augmented for all individuals in a group through one stimulus, which is not true for all cases. Carr et al., (2017) further opposed that the approach is not scientific a nd lacks a strong foundation of evidence. Nevertheless, the importance of humanistic model cannot be ignored since it is a people-oriented management model and looks for benefits for human ends. Application of humanistic management practices as part of the practice and a strategic management framework The humanistic management model, as established by Brousseau et al., (2017) is a pioneer of modern-day management practices that aim to bring developments in the planning, staffing, organisation and control process of a healthcare system. Thoughtful observation and research identify that potential that this management approach holds to carry out a change in the system. If QAS is to reformulate management practices based on the humanistic management model, a set of managerial practices are to be embedded in the operations and functioning. The manner in which humanstic management practices can be integrated as a part of the strategic framework can be elaborated under the following aspects- Establishment of institutional statements- Institutional statements for QAS must be rooted in the ideas of the setting being committed to what holds more value for the employees. What the employees do, meaning the mission, what they want to be in future, meaning the vision, and what they value more, meaning the corporate values, must be relevant to the permanent element of human wellbeing. Along with technical elements humanistic values such as ethics and dignity are also to be included (Ozcelik et al., 2014). Leadership- There exist different definitions for leadership with the common aim of influencing employees in a positive direction through a collaborative approach. For a proper functioning of a healthcare system, it is essential to set common goals and determine what is to be done under different situations. A humanistic approach would imply that QAS organisational structure has power evenly distributed over all levels of employees to the extent feasible. In contrast to paternalistic management modules, leadership model would ensure that all stakeholders are given equal importance and are treated as collaboraters. It is needed that the human condition of being free and independent is acknowledged and human dignity is given prominence. An interactive dialogue and relationship between the healthcare leaders and the followers would ensure that the need for personal and professional growth of the employees at QAS are taken care of (Cameron Green, 2015). Communication- The managers at QAS are required to engage in informal communication along with formal communication so that two-way transmission of feelings, values and thoughts are promoted. Dissemination of decisions of the managers at all levels is pivotal so that relevant messages are shared to all employees. The first humanistic and ethical requirement is to avoid manipulative information and lies since this would foster respect for human values. Managers and leaders are to sustain truthfulness in all forms of communication that have transparency as its prime feature (Grant et al., 2011). Organisational structure- An organisational structure refers to the set of responsibilities and roles for individuals in an organisation that considers processes, policies, resource allocation, supervision, technology and finances at the core. Though there is no perfect humanistic organisational structure, the humanistic model demands respect for all people within the organisational structure. The minimum requirement is to avoid poor treatment of individuals as receptors of orders, to show eagerness to guide and to give feedback and suggestions at all levels (Kaplan, 2014). Coordination and control- Controlling the complexity of a care service owing to diverse scope and functionality are difficult under certain environment. A humanistic approach entails harmonisation, synchronisation and unification of different elements of management practices to generate a congruent outcome. Motivation is perhaps at the heart of such an approach that requires the managers to constantly provide motivation and encouragement to come up with their best initiatives. At QAS there is a requirement for managers to enagage in conflict resolution and eliminate dysfunctional aspects that impair the overall functioning of the centre. Decision making- The previous approach to decision making by managers in healthcare systems focused on the sole role of managers in this process. It is to be relaised that decision making needs to firstly consider the need of defining the nature of the problems before a plan is made for solving them. The human dimension that prevails in this regard is how the problems and needs influence individuals. Humanistic management style focuses on long-term benefits of the employees rather than short-term benefits of the organisation. Against this background, it is to be stated that the managers at QAS must involve the employees at all major decision making processes and have an insight of the possible social reactions that would possibly come up as a result of the decisions taken (Buchbinder Shanks, 2016). Application of strategic management framework for addressing the issues As opined by Buchbinder and Shanks (2016) health service providers must manage to effectively bring about change in their systems, strategies, products and services for surviving the challenges coming up for external as well ass internal forces. Only an application of a robust and evidence-based strategic framework is capable of addressing the four issues highlighted within the context of QAS. Developing human resources would be the key aspect of strategic management model to be applied at QAS. The idea would be to enhance the capability and skills of the healthcare professionals. This step would be two-dimensional, encompassing increase in skills of individuals and change in the skill mix of these professionals. QAS must consider conducting training sessions that have a positive impact on the professionals. Counselling sessions when conducted with the professionals ensure that they lead to better client satisfaction. Training also augments better information transmission and decreased complaints from service users. At QAS, this approach can combat the concern of ambulance ramping to a moderate extent. Division of roles and responsibilities among the different workers reflct the proper distribution of tasks. Changing the skill mix permits resolution to conflicts and misunderstandings among professionals. Reviews point out that tasks done by one group of professionals can y ield better and comparable results when done by a different group. QAS can consider changing roles in forms of delegation, substitution and innovation. Changing interface between key services would also be beneficial (Ginter et al., 2013). Walston (2014) highlighted a set principle strategic approaches that would be beneficial when applied to the QAS context. The activities that QAS must carry out in the near future must include the introduction of regular evaluation and monitoring cycles, workshops for identification of employee concerns and training activities. The results would ensure more rational utilisation of funds due to better planning; enhanced coordination and integration of programs; better working methods; enhanced morale of staff and increased worker participation. For improving the current status of health IT system at QAS, infrastructure is to be made better that can support modern and advanced IT systems. QAS can consider pooling in resources from different healthcare systems that can be beneficial for both quality patient care and high technology. Recruitment of professionals who are a pro in the field of IT would be the key strategic step. Experts of the health IT domain are to be made a part of the system who can successfully collect and manage health information and maintain it on a regular basis. Increasing the human resource would surely bring in improvement within a short span of time. Occupational violence at QAS can be combated through suitable leadership skills demonstrated by all managers. Governance and leadership enable individuals to report against occupational violence so that appropriate measures are taken. When support is received from the higher authorities, employees will come forward to report all incidents of harm and injury suffered by the employees at QAS (Ginter et al., 2013). Patient care quality can be improved through establishment of relationships. Employees are to be guided to work in collaboration with each other for delivering comprehensive care. The requirement for teamwork is to be felt at all levels. The managers must come forward to instil an essence of teamwork and solidarity fostering healthcare (McCalman Potter, 2015). Along with this comes the need of a robust monitoring process that accurately identifies the gaps in care delivery. Without such a monitoring system QAS would not be able to move forward regarding quality. The monitoring system can encompass a number of tools available that are effective in collecting subjective as well as objective data regarding service provision. Based on the data collected QAS can outline a plan that corresponds to the breaches identified in adhering to service guidelines (Walston, 2014). Conclusion The requirement for safety and quality improvement initivates pervades health care services at QAS. The extent to which the services provided to the individuals enhance the chances of suitable health outcomes, and are aliged with the professional guidelines, is to be changed for the better. Interventions for improving quality must lead to changes in the completeset of primary end points and must contribute to results in different sections of the system. Through a humanistic management model, the wholeness of the individuals can be taken into account with a comprehensive knowledge of each of the members. Through an emphasis on human flourishing QAS can achieve its key goals and objectives. QAS must give focus on the creation of institutional statements based on humanistic approach as deemed fit for the organisation. 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