Whilst there is a need to understand management issues in health and to use existent resources both within and beyond the Faculty of Health Sciences there is a need for clinicians to assert themselves in how this is conceptualized, taught and researched.
See a summary of the book Health Systems Science developed by the American Medical Association.
The following are themes around which Health Systems Science is being developed at Wits for the African setting:
Health care delivery is becoming more complex and costly, with increasing changes that affect patient care. This area covers an understanding of health systems and social determinants of health with different analytical approaches, from World Health Organisation Building Blocks to Health Systems thinking. It also includes an understanding of the South African health system, both public and private, with a historical perspective.
Health Economics and Payment Systems
This area covers an economic and policy overview of South Africa as well as healthcare. It includes an understanding of economic concepts, policy issues and political economy relevant to healthcare. The prerogatives of universal health coverage and different financial considerations especially payment systems are included.
Clinical Governance, Law and Ethics in Health
This area covers relevant laws and regulations in South Africa, including regulatory bodies and contract law. It includes ethics and accountability in the health sector as well as patient safety and quality improvement philosophy. Practical skills like clinical audits and managing clinical governance processes like mortality and morbidity meetings are included. Patient safety is an important consideration.
Population Health and COPC
Population health is attracting increasing attention, especially with newer payment systems. This area covers an understanding of populations in health, including capitated populations and perspectives in prevention/health promotion. It includes community-oriented primary care (COPC) as a strategy to manage risk in capitation models of payment.
Leadership and Strategic Management in Health
Leadership and strategic management are essential skills that are required irrespective of where a health professional sits in the health system. This area covers understanding the environment and context of the organisation, being able to make strategic choices, implementing the strategic choice and them monitoring and evaluating the strategic choices. It includes theories of leadership and management, management ethics and accountability as well negotiation and conflict management.
Human Resources and Teamwork
This area covers an overview of human resources, human behavior, diversity, teamwork and human resource management (including change management, performance management and labour relations). Managing interprofessional collaboration and teamwork around patients is vital.
Quality and Service Improvement
It is important to measure quality comprehensively including its link to value. This area includes an overview of operations concepts, from competition, control and time to approaches to operational management in health service operations. It includes understanding quality and supply chain management issues in health care.
Value in Healthcare
There needs to be a clear understanding of value in health care from various stakeholders. Healthcare should be patient-centred, safe, effective and affordable. This area covers principles of accounting and its application in a healthcare environment. It includes measuring clinical performance against costs. Financial reporting and interpretation of financial statements are included.
Health Information Management
This area covers an understanding of information (types and flows), especially clinical, how information systems are managed (including contracting with providers) and how to approach various indicators and measures that emerge from information systems (both public and private). This includes approaches to electronic health records and various coding issues, from types to billing consequences.
Social Marketing and Health Promotion
This area covers basic concepts in marketing, its application in marketing practice (within ethical constraints) and its use in social marketing. The area includes understanding concepts in health promotion, including the Ottowa Charter, and its application to prevention strategies for populations
This area covers business administration and includes communication and integrated organizational skills.
Entrepreneurship and Personal Finance
This area covers skills in entrepreneurship, from thinking innovatively and developing a business plan to setting up practice. It includes being able to manage personal finances and investments.