Background
The necessity of health planning in defining, identifying and mitigating the health issues and concerns of a particular region or an area is extremely important in order to address the problems related to health and health care (Tucker et al., 2015). The report will attempt to formulate a health service plan with reference to the Queensland region of Australia. The health service plan will be formulated by identifying the key issues in Renal care and Chronic Kidney Diseases or CKD. This report will look into the concerned issues and the services that will be looked upon in the light of the goals and the objectives and will formulate the plan including the current trends in the issues, the existing infrastructure and policies and the needs and requirements of the issue.
The scenario with regards to renal diseases in Australia is increasing and there has been an increase in the number of cases of CKD and renal diseases. According a report of the Government of Australia, one out of every 10 people is diagnosed with CKDs and renal diseases. The increasing number of cases makes it important to formulate a health service plan to adequately manage the rise in the renal disorders and provide proper and adequate service and support to the concerned people in order to provide a safer health environment (Australian Institute of Health and Welfare, 2005).
A health service plan is devised in order to curb growing issues that needs to be addressed. In order to prepare a health service plan there are requirements and standards that should comply with the service plan of Queensland. According to the service plan of the Queensland, a health service planning is requires
- To serve the varied needs and requirements of the people
- The service planning should meet the safety standards and safety requirements.
- It should address the increasing demand and financial constraint in the said disorder.
The Renal health service planning in Queensland is identified on the basis of “Queensland Statewide Renal Health Services ACTION PLAN” for 2017-18 and the key objectives were identified according to the guideline laid out in the plan. The objectives can be summed up as follows:
- More deliberate investment plans for early detection of CKD and management.
- Provide multiple treatment options to patients who are in critical stages of renal diseases.
- Developing a multi disciplinary and sustainable human resource dedicated to renal care.
- Developing an integrated framework for the service and governance and monitoring to create effective output.
- Regulating and framing the guidelines within the minimum standards to make it available for all patients with renal disorders.
The plan aims to provide renal health care to indigenous Australian people along with non indigenous Australians at a cost effective rate to reach out to maximum patients (Kesselhut, 2009). The plan will also recommend the implementation procedures and monitoring of the services to keep a track of the programme.
The planning methodology of the renal service was framed with the guidance from private and public stakeholders. The methodology of the plan has been done in accordance with the government guidelines and after reviewing the Renal Action Plan of the government of Queensland. The methodology was framed based on the following activities:
- Analyzing and assessing the various literatures based on CKDs and renal disorders.
- Evaluating the information provided by the state with respect renal care and support provided by them.
- Analyzing the expected renal service demand in the future years by reviewing the past case studies and reports.
- Recognizing the target population and evaluating the required service model for the different categories of the target groups which include the inpatient care against domestic or community care.
- Evaluating the current service plan and identifying the gaps and requirements that are to be added to the current plan.
- Identifying the changes and amendments that are required for the new plan.
- Creating scope and opportunities for private public partnerships and the stakeholder engagements in the plan.
- Identifying the challenges and constraints that might create an impact in implementing the renal service plan.
- Determining the strategic requirements in the plan to create a smooth implementation process. The need to develop strategies accordingly is also important.
- Identifying the parallel support providers and formulating an integrated framework for area specific implementation and ease of operation.
Renal health service planning in Queensland
The health service planning is mainly focused towards the development of the instigating alteration in case of the delivery of the health care services. It is generally a procedure appraising the overall needs of health. The planning of the services therefore includes the amendment and the examination of the anticipated needs of the future. Some of the categories of the planning approaches as per Eager et al. (2001) includes the following:
The population-based approaches focus on the improvement of the health considering the targeted population together with a broad analysis and the identification of the requirement of the health and the determinants of the risk factors. The involved stakeholders in the population based planning approach are similar and wide ranging targeting a greater level of emphasis on the targeting community.
Institutional based approaches are the approaches that tends to focus on the existing services and the organization examining the situation with the effective use of the data on the basis of the goals and the objectives. The main target of the stakeholders in this procedure tends towards the service providers and the clinicians.
Health programs often tend to include both the educational and the social interventions with the aim towards the prevention or the promotion of the health. The program planning procedure attempts to illustrate the inter related and the cyclical nature of the program planning.
In respect to the above figure, the essentiality of the work force planning can be analyzed towards the majority of expenditure on the health care system. The key objective of the workforce planning is towards the ensuring the right of the community people. The planning procedure of the health workforce complicates the achievement and the planning targeting a balance aiming the demand and the supply of the health care professionals. It includes balancing the objectives of the cost control and the economic efficiency with improved access and equity together with the training of the health professionals and the necessity of the long term view of the workforce planning.
In accordance with the procedure of the health planning activities, the instance of the capital planning is also essential which includes services, workforces, financial and technological planning. The notion of the capital planning requires design flexibility together with the consideration of the recurrent expenses towards the advances in the technological changes or the improved policies.
The figure above illustrates a number of facility planning describing the fundamentals of the facility planning in the public sector with an outlined approaches and demand of the competitive advantage of the capital investment towards the health care services.
Planning methodologies of the renal service
Given the nature of the disease concerned the requirement for renal care includes a proper integration of the workforce from multiple disciplines. The workforce included should be proactive and include resources from medical, nursing, dieticians and other supplementary sources (Queensland Health, 2007). The professional involved in delivering renal health services should be amalgamated from sources listed as follows:
- General physicians and practitioners, para-medics and nurses for emergency situations, remote healthcare professional and nurses to cover the whole of the data. These are the primary resources required.
- The medical staffs will include resources as junior health staffs, associate medical officers, visiting medical officers and specialized staffs, doctors and nephrologists.
- Clinical staffs will include managers, consultants, doctors, educators and trainers, psychologists, and support system analysts.
- Specialized staffs will include dialysis specialists, social workers, cultural liaison officers and educators.
- Support staffs will include dieticians, therapists, pharmacists, physiotherapists, radiologists and imaging staffs, machine operators and other services.
- Technical support staffs will be required and will include biomedical engineers, pharmacologists, telehealths staffs and maintenance staffs.
- Allied staffs will include welfare workers, field workers and podiatrists and rehabilitation therapists.
- Finally administrative staffs are required to maintain and administer the work load and ensure smooth functioning of the processes.
The integrated workforce will ensure that the patient and the system coordination are in sync and that the services are properly implemented and there is there is no gap in the process of the functioning of the same. The work force will also ensure that there is proper communication among the multiple disciplines is adequate and there is no lag in between.
An efficient and competent workforce would be fruitless without a proper infrastructural support. The service plan also indentifies the requirements of the basic infrastructure and the necessary infrastructures required to implement best practices and state of the art facilities. The requirements can be summed up as follows:
The infrastructure should be developed in a hierarchical framework to meet the gradual demand of the people of the in the various sections of the society and remote locations. These should include
- Primary, secondary and tertiary level health care facilities
- Critical care and intensive care facilities with a adequate instrumentations and dialysis channels to handle greater capacities than the lower facilities.
- Inpatient intake must be increased and adequate extended renal departments should be formulated.
- Proper collaborative institutions should be developed within the region to cater to the domestic and community based renal services. The intake should be adequately distributed among services.
- The hub and spoke frame work should be initiated in the infrastructural framework to ensure the hierarchical functioning in order.
The most basic necessity is to provide adequate service in all proximities so that the indigenous, the most affected, the remotely placed patients have accessibility to these institutions and thereby create impactful outcomes and thereby help achieving the objectives of the renal health service plan. The hub and spoke facility that is operational in the Queensland region needs to be integrated in a more connective way to promote greater accessibility. The spokes are providing the basic facilities in the remote level and are the first to interact with the patients in the initial level.
Prioritization at the operation and the strategic level in the case of the health care system are the essential part of the core cultures aligning with the vision and the goals of the organization. Effective responses towards the health care system towards the derivation of the major challenges tend to require some of the strategies and the effective planning techniques. The assignment aims to illustrate the effective application of the integrated planning of the health for the improvement of the quality of the services of health in the scenario of chronic kidney disease.
The prevalence of the chronic kidney disease is an important aspect. The renal health is being defined as per the care of the continuum including the following aspects. The strategies in context to the prevention and the management plan for the kidney diseases includes the early detection and the management of the chronic kidney diseases, the management related to haemodialysis that is both community based (McDonald, 2015). Some of the major strategies in relation to the investment in the chronic kidney diseases detection and the management will be:
- Expansion of the practitioner nurses or the care givers together with the allied health practitioner towards the concentration of the detection of the initiatives towards the population with high risk of the fat diseases in case of the advanced kidney disease.
- Ensuring that the chronic kidney diseases is appropriately addressed in the initiatives such as the partnership working with the heath care in the local connection in the partnership of the communities for the raise in the profile of the kidney disease
- Development of proper share care model among the general practitioners and the nephrologists in the areas where the domain is remote or rural
- Establishment of the clinics for the one stop chronic diseases where the patients and the rural victims can access services towards the multidisciplinary care terms and the treatments.
Workforce and infrastructure for renal care services
According to the Queensland population, there lies 4.6 million where the age of the people varies from 65 years of age. According the data, the people of the region posses the most or the highest risk towards the chronic kidney diseases and the figure is increasing by time (Tucker, Scanlan & Dalbo, 2015). As per the reports of the 2005, more than 487 people per million among the age bracket above 65 years of age are the regular sufferer of the end stage kidney disease. The reports furthermore highlight some of the top causes or the reasons that leads towards the chronic disease among the people which eventually causes death. Among the detected cause leading towards death, the kidney disease tops the list.
Strategies for the prevention towards the end of the life causing due to chronic kidney disease includes the instances of dialysis and transplantations. The transplantation of the kidney is a procedure including life saving techniques. The major challenges to the transplantation services are the shortage of the donor and the increasing and unaffordable financial costs. According to the repot report by the health care units, more than 1355 people in the country are still living with the kidney transplant scheme (Australia, 2006). The financial measures and the planning related to the costing of the kidney transplantation varies widely all over the country of Australia. The cost of the financial chart related to the end stage of the kidney transplantation and the renal disease as per the renal replacement therapy.
The above table illustrates the expenditure of the kidney transplantation and the strategies for the prevention of the renal disease in the country. Thus improvement in the health and the wellbeing of the people in the country is an important factor for the consideration syncing with the standards and the guidelines of the renal services and the standards of the development of the strategies of the action plan. The strategies for the action and the workforce agenda for the improvement of the wellbeing in relation to the kidney failures and the diseases related to chronic kidney failures includes the effective improvement of the health of the population, improvement of the health care delivery, strengthening of the partnerships, improvement of the access towards the safe heath services and emphasizing on the effectiveness of the business by the enhancement of the system of the organization.
The action plan for the implementation of the strategies involves the development of the plan for the submission of the final draft of the Service Plan. This needs to be submitted to the governance team along with the process of supplying to the stakeholders who contribute to the organization as well as to the senior members of the management who are part of the facilities and the health care services who involved in providing comment and the approval to the prior of the implementation of the Service Plan (Venuthurupalli et al.,2012). The process of implementation also involves translation of the service plan into the process of operational and the development. Most of the time this function is performed by the service operations along with the service managers in association of the implementation team. The initial stages of the implementation are performed through the process of handover of the facilities of the plan. While the attempt of planning is taken into consideration, care of certain facts should be taken into account which involves a myriad of factors that surrounds the factors like the economic, social, cultural and political factors that surrounds the future. Through this process it is most of the time possible to compromise with the unforseen effects that requires effective implementation. Therefore it can be perceived that this process is almost unpredictable and this might also lead to protracted or contested processes (Garcia-Garcia et al., 2014). Another significant aspect of this implementation process is that there must be communication in open forms along with strategies related to negotiations that needs to be accrued out between the planners and the implementers that provides a solid foundation to proceed to successful implementation. It requires to be ensured that the factors as will be mentioned in the following are implemented and incorporated between the teams of planning and the implementation that will lead to the success of the effective implementation. The factors are as following:
- There should be prevalence of effective coordination between the implementation and the planning teams
- Implementation and incorporation of the mechanisms that are appropriate to resolve the difficulties of implementation difficulties which includes the issues such as the issues regarding registries and the risk management plans
- For the implementation actions, clearly assigned and monitored responsibilities
- Management controls and incentives in place that are appropriate in nature
- Resistance prevention along with the implementation at an operational level through the involvement as well as communication with the community and service providers at a time that is appropriate
- preparation of workforce that is appropriate in numbers long with the mix, training, skills and expertise
- allocation of adequate resources for the implementation in the form of personnel and time
- Training for new systems that is appropriate and the procedures in addition ot the technology for all those affected by the plan (Queensland Health Strategic Plan (2007-2012).
Strategies for prevention and management of chronic kidney diseases
In terms of monitoring of the planning during the implementation, this process of monitoring allows the opportunity so that there can be adjustment review of the strategies of the service plan. It should also be taken care that the process of monitoring is adeptly performed through the use of the progress reports which are involved in observation of the measures that is against the indicators of performance which were established earlier. The process of the evaluation of the service plan is should be perceived as the concluding assessment in regards to the value along with the worth of the process of planning process (Webster et al., 2017). There is also subsequent output including the document of service planning along with its process of implementation. There is evaluation of a service plan along with the implementation that seeks to inform and also there is provision of assistance in the efforts of future planning. This in turn plays a role to involve a series of the initial stakeholders who include the service providers, health professionals and the patients, consumers. The evaluation design is effective in reflecting the initial goals and also the objectives that are formulated at the beginning of the process of planning (Venuthurupalli et al., 2012)
The process of planning along with implementation and evaluation are iterative processes which all together forms an integral part to the delivering of health care services in Queensland. The objectives and the goals help to establish the direction towards the future development of renal services within Queensland. The clinicians involved in leadership and support along with the clinical networks which has guided this process of state-wide planning. This has helped in the continuation of the leadership which is essential to the successful of the implementation and evaluation of this Plan at a state-wide, Area and local level (Government, Q, 2017).
The action plan also includes and suggests and also recommended that reporting at an Area level for renal services be reviewed yearly. As the state-wide plans are reviewed, it should be ensured that the Area Health Service plans should also be reviewed along with making sure that the stated initiatives are updated and ensures along with the actions that are current and are involved in reflecting the changing of health service that needs of the community. At a minimum, evaluation comprises of a review of all strategies. This includes the assessment of data of service utilisation. As this plan states, the reliability of some projections in the plan is uncertain given limitations with the currently available data (QueenslandStatewide Health Services Plan, 2012).
Financial costs and transplantation services
Conclusion
The necessity to have a proper service plan with effect requires proper planning and implementation of the renal service plan. The increasing cases of renal disorders and chronic kidney diseases in Queensland can only be addressed with the proper planning of the renal health service and adequate execution of the same. The strategic devising of the plan will require the proper synchronization of the various disciplines with proper coordination of the inner disciplines. The monitoring of the plan will also ensure the progress from time to time and will ensure the modification of the plan accordingly.
References
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