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The Role of Management

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  • Good clinical practices are being followed because (trained) health providers have been hired
  • A lack of expertise in medicine or health means factory managers cannot play an effective role in supervising health operations

Health services need to be actively managed just like any other part of the operation. Medicine and health knowledge is not needed. You are capable of managing health functions more effectively by:

•Establishing processes and oversight practices;

•Managing and supporting the health staff;

•Working towards continuous improvement.

Processes and oversight practices

1. Setting goals, priorities and operating procedures

2. Assigning roles and responsibilities

3. Budgeting for health functions

Setting goals, priorities and operating procedures

•Use the senior and middle management meetings to report on the health activities and performance – beyond the required reporting on safety and injuries. Such communication ensures that worker health and infirmary practices receives a level of attention by senior management and is communicated throughout all levels of management.   

•Creating a regular staff meeting schedule for tracking performance, planning and solving problems - Two types of staff meetings need to be established: 

Internal meetings among the nursing (and other health) staff alone once a week.  This is a basic good practice for nurses and health staff to review planned or post activities, discuss issues or problems, and prepare for week. 

Management-health staff meetings.  These meeting should take place initially once a week (to develop effective meeting skills, build relationships, and establish the process) but not less than once a month. 

•Adopting clear policies for clinical practices - The senior manager for health with senior leadership should formally adopt policies for required good practices and ensure these are communicated widely and followed by the health staff (Guidance available here).

Assigning roles and responsibilities

•Develop job descriptions for nurses and other health providers. 

•Develop an organization chart or organigram that defines reporting and oversight relationships. It will be simple if you have only one or two nurses but more complex if you have more. 

Nurses can do much more in your factory – if you give them the responsibility and management support they need.  They can provide preventive care to workers, educate them and promote good health behaviors. Nurses, who are usually women, are often in a unique position particularly if you have a significant number of women in the workforce.  They can talk to women workers about personal health issues that men health providers cannot.  Nurses can also walk around the factory, when they are not busy with patients, and talk with workers and supervisors about simple health behaviors.

Budgeting for health functions

Health services and education activities need a formal line item in the overall factory budget and a more detailed one developed by the senior manager to ensure resources for key areas: 

•medicines,

•educational materials,

•nurse training, compensation and bonuses

•other items for continuous improvement that may incur costs. 

The value of a budget is that it enables management to compare business potential benefits (lower absenteeism, productivity etc.) with the overall costs.  

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Accountability and rewarding performance

•Annual performance reviews. Individual nurses and health providers should have an annual review with the senior manager (and others members of the management team as appropriate) as part of end-of-year assessment and annual planning, both to assess performance but also to build capacity and skills as this is a time to identify concerns, challenges and needs.  

•Compensation. Nurses and health providers should receive compensation in same way other employees are compensated (and according to national laws). For instance, if you provide bonuses to some or all of your workers based on performance and production goals, you should consider similar kinds of bonuses for nurses based on performance in achieving annual goals.  

•Hiring and firing.  Health providers should be hired (and fired) through a standards-based process. The hiring process is an essential way to improve the quality of your health staff and services. A more formal process enables you to select new nurses based on a fair review of qualifications rather than on personal connections and determine the best candidate based on job expectations and responsibilities.

Promoting professional development

All health providers need ongoing capacity building and training to maintain and expand their skills. For most workplaces, the providers need to build skills. These may include training in:

•a specific health area (preferably a condition affecting workers),

•counseling skills on sensitive issues,

•participatory education techniques,

•client-centered services, or

•expanded clinical skills.

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•Tracking progress against plans and targets (Module 2):

Self-assess, prioritize, develop action plan and monitor progress with the help of the  Workplace Health Facility Scorecard on:

 

1. Management processes

2. Supervision of health services

3. Integration of health into workplace operations

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  • 1.Identify the senior manager responsible;
  • 2.Assess if a deputy to support the senior manager is necessary and appoint one;
  • 3.Schedule the weekly management health staff meetings with the clinic staff.