The structural relationship between the physiotherapy profession and the clinical management team in the Hospital Authority of Hong Kong : the perspective of the physiotherapy department heads

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The structural relationship between the physiotherapy profession and the clinical management team in the Hospital Authority of Hong Kong : the perspective of the physiotherapy department heads

 

Author: Chung, Ming-kui
Title: The structural relationship between the physiotherapy profession and the clinical management team in the Hospital Authority of Hong Kong : the perspective of the physiotherapy department heads
Degree: M.Sc.
Year: 1997
Subject: Health services administration -- China -- Hong Kong
Hospital Authority (Hong Kong, China)
Physical therapists -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Pages: x, 104, [57] leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1403358
URI: http://theses.lib.polyu.edu.hk/handle/200/4980
Abstract: 'Cultivating organisational transformation and development' is one of the corporate strategies of the Hospital Authority in Hong Kong. Along this direction, New Management Initiatives implemented in the public hospitals have brought about fundamental reforms in hospital management. This includes the development of Clinical Management Teams (CMTs) at the basic operating level with devolution of management and budgetary responsibilities. CMTs aim at transforming the health care culture which has traditionally been divided into various disciplines into one which is more focused on the total needs of patients. Since its implementation in 1993/94, the greatest structural changes brought about by CMT have been concentrated on medical, nursing and supporting services. With the momentum of transformation, the needs and models of integrating allied health professions into the CMTs should deserve more attention. This research is an explorative study on the structural relationship between the physiotherapy profession and the CMT from the perspective of the Physiotherapy Department heads. Twelve Physiotherapy Department heads were invited for semi-structured interviews to collect information and opinions on their understanding of CMT, development of CMT, present organisational structure, preferred models of structural relationship with the CMT, as well as the advantages and disadvantages of the three most common structural options: Functional Model, Collective Model and Dispersed Model. From the advantages and disadvantages of the different models, their decision criteria on choosing between options were determined and analysed along four domains of factors, namely Clinical, Managerial, Professional and Financial Factors. The Functional Model was preferred by eight subjects and the Collective Model by three subjects. One subject preferred a variation of the Functional Model with resources allocated from the CMTs. The Dispersed Model with abolition of the Physiotherapy Department and dispersal of physiotherapists to the CMTs was opposed by the subjects. Professional Factors were found to be important but not dominant decision criteria in their model preference. They were also concerned about the impacts on patient services and the resource implications associated with the structural options. It is recommended that physiotherapists should take a balanced view towards the challenge to evolve a structural model which preserves attributes valued by professionals, enhances management transformation, delivers quality patient services and makes the most effective use of scarce resources. It is recommended that the existing and dominant Functional Model with profession-management and department-based structure should be retained. It is nested with the service delivery model (the CMT) into a matrix arrangement. Integration at the interface has to be improved in the areas of collaboration, accountability and contractual relationships, so that the resulting structure would be compatible with the development of CMT. An 'internal customer-provider' relationship is argued to be an appropriate basis for these improvements. In particular, contractual ways between the Physiotherapy Department and the CMTs are recommended to be increased through service agreements which do not involve exchanging funding with services.

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