LuẬN văn Chiến lược phát triển bệnh viện nhiệt đới trung ương tới năm 2020 THESIS TITLE DEVELOPMENT STRATEGY FOR THE NATIONAL INSTITUTE OF INFECTIOUS AND TROPICAL DISEASES TO 2020 STATEMENT OF AUTHORSHIP Except where reference is made in the text of the thesis (Capstone Project), this thesis contains no material published elsewhere or extracted in whole or in part from a thesis by which we have qualified for or been awarded another degree or diploma No other person’s work has been used without due acknowledgement in the main text of the thesis This thesis has not been submitted for the award of any degree or diploma in any other tertiary institution - - CONTENTS INTRODUCTION…………………………………………………………….…… Chapter 1: Theory …………………………………………………………….……11 1.1 Concepts…………………………………………………………….… 11 1.2 Stages in strategy establishment……………………………………… 12 1.3 Analysis of the operational environment of the business organization…15 1.3.1 Analysis of external environment………………………………… 16 1.3.2 Analysis of internal environment………………………………… 20 1.4 Proper strategies for the organization……………………………………21 1.4.1 SWOT Matrix………………………………………….…… 21 1.4.2 IE Matrix…………………………………………………… 23 Chapter 2: Analysis and evaluation of the operation of the National Institute of Infectious and Tropical Diseases………………………………………………… 29 2.1 General introduction to the institute …………….………………….… 29 2.1.1 History…………………………………………………………….…29 2.1.2 The organization of the hospital…………………………………… 30 2.1.3 Number of wards……………………………………….………… 32 2.2 Analysis of External Environment ………………………………….….32 2.2.1 General environment…………………………………………….… 32 2.2.2 Industry environment (Medical environment)………………………37 2.2.3 Competitors’ environment………………………………………… 38 2.3 Analysis of internal environment………………………………….…….42 2.3.1 Finance………………………………………………………………42 2.3.2 Organization and HR…………………………………………… .45 2.3.3 Infrastructure, facilities and technology………………………….….48 2.3.4 Image of the hospital and its brand………………………………….49 2.3.5 Training and research…………………………………………….….50 2.3.6 Leadership in the fight against infectious diseases………………….51 - - 2.3.7 International cooperation……………………………………………51 Chapter 3: Establishment of the development strategy of the hospital to 2020… 52 3.1 Vision………………………………………………………………… 52 3.2 Missions NIITD………………………………………………….…… 52 3.3 Bases on which NIITD sets up goals and objectives……………….… 52 3.3.1 Development estimates……………………………………….…… 52 3.3.2 SWOT Matrix …………………………………………………… 55 3.3.3 Internal-External Matrix ………………………………………… 56 3.4 Establishment of development strategy…………………………… … 58 3.4.1 Strategy on working skills……………………………………….….58 3.4.2 Strategy on scope………………………………………………… 62 3.4.3 Strategy on structure and organization…………………………… 62 3.4.4 Strategy on HR development……………………………………… 66 3.4.5 Strategy on infrastructure and other facilities……………………….66 3.4.6 Financial strategy………………………………………………… 67 3.4.7 Strategy on professionalzing the services provision of the hospital… 69 3.4.8 Implementation roadmap…………………………………………….69 3.5 Recommendations……………………………………………………….71 CONCLUSION…………………………………………………………………….73 REFERENCES…………………………………………………………………… 74 - - LIST OF ABBREV IATIO NS National Institute of Infectious and Tropical NIITD Diseases State Budget National Goals Projects Medical Insurance NSNN CTMTQG DA BHYT - - LIST OF TABLES Table 2-1: Description of wards……………………………………………………32 Table 2-2: Comparativeness and market share in 2008…………………………….38 Table 2-3: Number of patients when NIITD was a department of Bach Mai hospital……………………………………………………………….41 Table 2-4: Number of patients after separation…………………………………….41 Table 2-5 : Financial figures over the past three years…………………………… 43 Table 2- 6: Spendings over the years……………………………………………….44 Table 2-7 : Differences in revenue and spending………………………………… 44 Table 3-1: Estimates of patients to 2020………………………………………… 53 Table 3-2: Score table of internal factors………………………………………… 56 Table 3-3: Score table of external factors………………………………………… 57 Table 3-4: Human resources development plan……………………………………66 Table 3-5: Estimation of main financial sources up to 2020……………………….68 - - LIST OF FIGURES Figure – 1: Comprehensive model of strategy management…………………….11 Figure – 2: Model of the relations between business organization, external and internal factors………………………………………… ………………………….15 Figure – 3: Model of five competing forces according to M Porter…………….18 Figure – 4: SWOT Matrix…………………………………………………….….23 Figure – 5: IE Matrix …………………………………………………………….27 Figure 2-1: Structure of NIITD………………………………………………… 31 Figure - 1: Model SWOT Matrix…………………………………………….… 55 Figure – 2: Model of IFE Matrix…………………………………………………58 Figure 3-3 : Gantt model of activities and their time frame……………………… 69 - - LIST OF CHARTS Chart 2-1: Number of patients over the years…………………………………… 41 Chart 2-2: Comparison of revenue and spending over the years………………… 43 Chart 2- 3: Distribution of human resources……………………………………….47 Chart 2- 4: Distribution according to education and qualifications……………… 47 Chart 2- 5: Distribution according to ages………………………………………….48 Chart – 1: Estimates of patients to 2020………………………………………….53 - - INTRODUCTION The system of state-run hospitals in Vietnam is considered vital part of health care system in the country State-run hospitals receive a big part of total medical spendings of the state budget, accounting for 35.8% Increases in the financial resources and in the quality of services are those which should be paid attention to To this, the goverment of Vietnam issued two important decrees No 10/2002/ND-CP and 43/2006/ND-CP which gives state-run hospitals autonomy in their financial policies These two decrees are hoped to ease the operation of staterun hospitals by giving them a chance to increase their financial budget In addition, these are also hoped to give momentum for the whole medical system to increase their service quality and increase the public health In recent years, tropical and infectious diseases such as HIV/AIDS, SARS, different types of flu (H1N1) strike Vietnam heavily The National Institute of Infectious and Tropical Diseases (NIITD) is the leading medical organization in Vietnam which is fighting those diseases However, so far there is not a very comprehensive development strategy for the hospital In order for the hospital to operate more effectively, it is necessary to establish a comprehensive development strategy This study is conducted with the hope to provide a development strategy for NIITD to 2020 Aims of this project: - Provide a brief review of literature on the planning of development strategy - Provide some analysis, assessment and evaluation of the operations of NIITD over the past three years and different kinds of factors (internal and external) based on which the development strategy for NIITD will be built - Establish a developmental strategy for NIITD from 2010 to 2020 - Work out measures and make some recommendations and suggestions for NIITD to achieve its strategic goals - - Subjects and scope of the study: Analysing business environment of the hospital from 2007 to 2009 in order to orient the business strategy for the period of 2010-2020 Methodologies: Data collecting methods: Primary sources: personal meetings with those in charge and those who can provide information (Board of Directors and staff) Secondary sources: hospital’s reports, newspapers, medical magazines, Internet, etc Comparison, analysis and synthesis: Make comparisons between different variables, between specific objectives, goals and real business achievements, etc Then the authors will analyse the differences between variables, objectives and goals set up and those real achieved After that, they will synthesize and summarize the results Use of tables, figures and charts: The authors will use the tables and charts to find out the common things or differences or trends of those variables analyzed and reflection on them Connection with experts: The authors of the papers consult with experts in the subject matter for further understanding of the data and conclusions of the matters concerned SWOT method: Idenitifying and analyzing strengths, weaknesses of the hospital, opportunities it has and threats it encounters - - 10 Cooperate with other medical institutions to provide the protection of people and community from tropical and infectious diseases, particularly the outbreak of new diseases, and provide the containment and protection of those diseases Participate in the leadership and implementation of the fight against infectious diseases and epidemic nationwide Get ready to receive patients, quarantine and contain infectious diseases and make recommendations to authorities to prepare resources to cope with diseases and epidemic Leadership in the treatment of infectious diseases Help the Minister of Health to provide leadership in the treatment of tropical and infectious diseases and make recommendations and suggestions to develop and consolidate the network of hospitals nationwide which specialize in the containment and treatment of tropical and infectious diseases Transfer and provide support for lower-levels hospitals, inspect and assess the implementation of the process of diagnosis and treatment of tropical and infectious diseases at lower-level hospitals and medical institutions throughout the country Lead and provide support lowr-level hospitals to carry out projects in the area of containment and treatment of tropical and infectious diseases Participate in the fight against diseases after natural disasters such as hurricane storms or flooding International cooperation Actively establish cooperation and experience and staff exchange in the areas of diseases containment and treatment, research and staff training; Carry out joint-run projects with other countries and international organizations in medical areas according to the law Organize working visits to the hospital and to other domestic and internation clinics and send staff to follow courses and research overseas; - - 62 Invite foreign experts to teach in staff training courses and accept foreign students to follow courses provided by the hospital Hold international workshops, seminars and courses within the capacity of the hospital and according the law of the country 3.4.2 Strategy on scope Stage (2010 – 2011): Continue the stability in the current location and increase by 200 wards Stage (2012 - 2015): Buiding new location with 1000 wards increase Stage (2016 - 2020): Increase the number of wards by another 1000 in the new location Move to new location with 1000 wards increase 3.4.3 Strategy on structure and organization As the requirement of the Ministry of Health, in 2010, functional Instituions of examining and treament will be switched to Hospitals To take advantage of this, starting on January 1, 2010 NIITD will be officially renamed “Nationnal Hospital for Tropical Diseases – NHTD” Based on the hospital’s regulation of operation, here is the structure of the Centrals Hospital for Tropical Diseases Leaders: - 01 Director - 01 Deputy Director (in charge of working skills) - 01 Deputy Director (in charge of administration and HR management) - 01 Deputy Director (in charge of logistic issues) Councils: - - 63 - Council for Science and Technology - Council for Medical Ethics - Other councils that can be set up according to the requirenment of circumstances Department: Leading specialism infirmary request Induced is perfect Pursuant to Regulation Hospitals are issued together with Decision No 1895/1997/BYT-QD on September 19, 1997 was amended in 2001 by the Minister of Health, pursuant to Decision No 1740/QD-BYT on May 16, 2006 the Minister of Health promulgating the Charter on organization and operation of National Institute of Infectious and Tropical Diseases, to meet the functions and tasks assigned, the Institute will establish a new science room and more to complete the structure of organizations working under the Regulations of the Ministry of Health has approved: Clinical Departments - Emergency Department - Respiration Department - Digestion Department - Pediatrics Department - Department for artificial kidney - Department providing treatment services according to patients’ requirements Paraclinical Departments - Department for Functions Detection and and Interfering Techniques - Nutrition Department - Surgery Department - - 64 Centers - Center for the Fight against Epidemics - Center for Research and the Application and Transfer of Advanced Technology - Center for Communication and Public Health Care Education - Testing Center - - 65 Organization of National Hospital for Tropical Diseases - Committee of Sicence and Technology - Ethical Committee - Department of Infectious Diseases, Hanoi Medical University Management Board - Other organizations such as Communist Party, Labor Union, The Communist Youth League Functional Department Centres - General Department - Department of Training and Sicentific Research - Department for Professtional Guidance - Deparment of Administration - Department of Finance - Department of Logistics - Department of Materials and Medical Equipments - Department of Nursing - Department of International Cooperation - Centre for Outbreak Control - Centre for High-tech Application Research Techology Implimentation Centre for Information, Propagation and Public Health Education Clinical Departments Paraclinical Departments - Department of Examination - Intensive Care Unit - Department of Hepatitis - Department of General Infection - Department of Viral and Parasitic Infections - Department of Emergency - Department of Respiratory Diseases - Department of Gastro-enterology - Department of Pediatrics - Department of Hemodialysis - Department of Requirement Care - Department of Imaging - Department of Pharmacy - Department of Clinical Laboratories - Department of Infection Control Figure 3-3: Organization of NHTD - - 66 3.4.4 Strategy on HR development Phase (2009 - 2012) : 320 staff Phase (2013 - 2015) : 1,200 staff Phase (2016 - 2020) : 1,200 -> 1,600 staff The hospital plans to achieve some objectives in the areas of human resources as follows: By 2015, the number of staff will be between 1,200 and 1,600 (about 1.2 -1.6 staff/per ward) Here are some more details: Table 3-4: Human resources development plan Phase I II III Staff with B.A degree or higher Medicine Drugs Others 50 250 300 63 63 Secondar Others Total y 130 680 680 73 107 157 300 1.200 1.400 40 100 200 3.4.5 Strategy on infrastructure and other facilities Phase 1: 2009 - 2012 Phase 2: 2012 - 2015 Phase 3: 2015 - 2020 Insfrastructure Phase 1: The hospital will be in the current location and will build one more sixstory building Plan the new project of moving the hospital to a new place Phase 2: Completion of the construction of the new site for the hospital to move to in Xuan Chung Commune-Dong Anh District-Hanoi - - 67 After that, all the facilities and staff of the hospital will be moved to the new place with 1,000 wards in the area of 10 hectars of land The hospital in the new place will have three sections: - Section 1: Diagnose and treat patients - Section 2: Training and research - Section 3: Offices and other services The cost of the construction is estimated at about VND 1.5 b per ward Phase 3: Operation and development of the new hospital Facilities and equipment Phase 1: Use the facilities already available and equip more so that the hospital can operate effectively with the scope of about 200 wards Besides, the hospital will try to maximize the capacity of the testing center Phase 2: Equip more facilities for each department with the scope of 1,000 wards The hospital will try to build a testing center which meets the international and national standard in order to strenghthen the ability of the hospital to diagnose, treat patients nationwide and for the purpose of research and training The hospital will also try to computerize its processes of treatment and paperwork Phase 3: Sustain develop the hospital and improve its services by equipping more advanced facilities according to the development of the society and meet better the needs of patients throughout the country 3.4.6 Financial strategy Investment and Construction Phase 1: Build one more 6-story building at the current location with the capital of VND 54 b which comes from the hospital’s construction budget Phase 2: Build the new hospital in the new place with the amount of about VND 1,800 b which come from the government’ budget - - 68 Financial sources Measure to mobilize money: - Funded annually by the Ministry of Health for the operation activities, construction - Money from the treatment fee and medical insurance and from other services - Sources from the provision of services of science, training, cooperation and other activities - From domestic and internation sponsors and governmental and nongovernmental organizations - Joint-run projects in the areas of treatment according to the law Table 3-5: Estimation of main financial sources up to 2020 (VND million) Sources State budget % increase over the years Fees and from medical insurance % increase over the years 2007 2008 2009 2010 10.680 10.395 11.180 15.000 15.000 50.000 100.000 8% 30% 0% 56.682 62.500 69.000 30% 76.000 50% 550.000 10% 70% - 3% 29.965 33.343 11% 70% 10% 2012 10% 2015 2020 Measures to increase the financial sources: Partial financial autonomy: The hospital actively makes the best use of the money from the state budget every year The hospital also tries to cut down on its expenses by means of better management and increasing the duration and effectiveness of the facilities and equipment The hospital also tries to increase its financial sources by providing more and better services Further strengthen international cooperations and coordination with domestic bodies to increase the numbers of sponsors and thus increase the funds from those organizations - - 69 3.4.7 Strategy on professionalzing the services provision of the hospital Gradually improve the management system of the hospital by simplifying the procedure of check-ups and treatment of diseases and computerizing many links in the process, easing the storage of information and retrieving information of patients This is to reduce costs of both patients and the hospital, facilitate and improve the provision of the hospital’s services, which in turn helps improve the image and prestige of the hospital 3.4.8 Implementation roadmap The roadmap to implement the strategy is summarized in the following Gantt model of activities and the timeframe to carry out those activities Figure 3-3 : Gantt model of activities and their time frame Activities Time 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Complete the construction of the 6-storey building in the current location Complete the legal documents for the building of the new hospital - - 70 2020 10 11 12 13 14 15 16 17 18 in the new place Train and increase the work skills for the current staff Build a model of proffestional management Build a test lab which meets national standard Equip the new 6-storey building Build a project to recruit, train and use of staff in the area of infectious diseases treatment Complete the model of professional management and carry it out in small scale Consolidate the network of hospitals in the infectious areas nationwide Continue the current international cooperation and establish new cooperation with other organizations/ Build the hospital in the new location Train staff to work in the new hospital Select young staff to send overseas for further training Complete the building of the new hospital Supplement equipment for the new hospital (basically funded by JICA project) Move all facilities and equipment to the new hospital and give back the current hospital to Bach Mai Hospital Complete the organization and HR system for the new hospital Stabilize and develop the hospital 3.5 Recommendations To the government: - - 71 The government should work out a systematic set of policies which give financial autonomy to the hospital More specifically, the government should make the policies which give a free hand to the hospital to decide on how to operate and earn money For example, now the hospital wants to open some new services which aim at rich patients to increase its earning but still not allowed Now what the hospital is doing is most of the time to with the devotion rather than service Clearly, this is not suitable in the market-oriented economy The government should allow the hospital to socialize some of its services For example, staff of the hospital should be allowed to open up some new joint-stock services The government should issue new prices for medical services according to the real circumstances To control the working skills, human resources for the hospital, the State should have a policy priority for health workers at public health facilities to help them with attention may professional tasks (Currently, the health sector are advocated socialization, diversification of types of medical treatment, but if the state human health from the public sector "running race" are running into the private sector will lead to negative consequences such as more student after graduation Left submission to the private hospital, many doctors eat food in public hospital, but the main source of income from the private hospital ) To the hospital Change the staff attitude toward patients in the sense that patients are customers or those who receive services and pay for what they receive The hospital should be considered the supplier of the services Increase the responsibility of the staff and their awareness of the missions, earnings and other issues within the hospital Increase the capacity and the quality of services provided by the hospital in order to increase the patients’ trust with the hospital - - 72 CONCLUSION Patients needs are changing quickly Now they not only pay attention to the results of treatment but also the overall quality of services such as time of treatment, - - 73 quality of medical facilities and services, attitude from staff, etc The hospital now has to face the fact that many private medical clinics have been set up and start competing with it in attracting patients In order for the hospital to develop sustainably, it is necessary for it to establish a comprehensive development strategy that take account of all internal and external factors REFERENCES Strategic Management – Griggs University HRM Management – Griggs University - - 74 Concepts of Strategic Management – Fred R.David – Statistical Printing House Kenneth L.Andrew (1965) Chandler, A (1962), Strategy and Structure Cambrire, Massacchsettes MIT Press Johnson, G, Scholes, K (1999), Exploring Corporate Strategy, 5th Ed Prentice Hall Europe Quinn, J., B (1980) Bateman and Zeithaml,( 1990) Dess and Miller, (1993) 10 Michael , Porter (1985 ) 11 J.E Barriers to New Competition (Combridge, Mass: Harvard University Press, 1956) For a review of the modern literature on barriers to entry, see R,J Gilbert, “Mobility barriers and value on Incumbency” in R Schmalensee and R.D Willig, Handbook of Industrial Organization, (Amsterdam,, Holland 1989),I 12 Decision No 30/2008/QD-TTG of the Prime Minister on February 22, 2008 approving the development plan examination and treatment network in 2010 and Vision 2020 13 Decree 43/2006/ND-CP on 25 April 04 2006 of Prime Minister's on self regulation, self-responsibility for implementation of tasks, organizational structure, staffing and financing 14 1740/2006/QD-BYT decision on May 16, 2006, the Minister of Health promulgating rules and organizational activities of NIITD 15 Overview of the health sector in Vietnam - Medical Publishing House 2008 16 Financial report of NIITD 2007 17 Financial report of NIITD2008 18 Financial report of NIITD 2009 19 The report of NIITD’s operation 2007 - - 75 20 The report of NIITD’s operation 2008 21 The report of NIITD’s operation 2009 22 http://www.hspi.org.vn 23 http://www.moh.gov.vn - - 76 [...]... and Tropical Diseases starts to operate independently, out of the control of Bach Mai Hospital and takes full responsibility of its operation and professional knowledge Business name: Viện Các bệnh Truyền nhiễm và Nhiệt đới Quốc gia International name: National Institute of Infectious and Tropical Diseases Name in Abbreviation: NIITD Address: 78 – Giai Phong road – Dong Da district – HN Tel: +84.4.35763023... theory to evaluate the operation of NIITD Organization: Three chapters Chapter 1: Theory Chapter 2: Analysis and evaluation of NIITD operations Chapter 3: Establish the developmental strategy for NIITD to 2020 - - 11 CHAPTER 1: THEORY 1.1 Concept There are many different definitions of business strategy Many of them claim that business strategy is to do with art of implementation and monitor of business