Healthcare organization committees for the medical services

a)      Committee for the quality improvement of medical staff

b)      Committee for the quality improvement of nursing services

c)      Committee for the inspection surgical cases

d)     Infection control committee

e)      Tissue committee

f)       Committee for the medicine administration

g)      Committee for the evaluation of blood use

h)      Clinical meetings committee

Important steps for restructuring the healthcare services

1)      Abandoning the processes that do not add value

2)      New services that add value for the patients and physicians should be added

3)      Continuity of the care should be maintained

4)      Clinical care should be strengthened

The difference between positive and negative organizational cultures

In positive organizational cultures employees are proud of to be a part of the organization and they can devote themselves for continuous quality improvement. They will help each other to meet the targets and they will enjoy the process. In this kind of organizational culture employees will feel that they can add value to the organization and processes and their ideas and opinions are important for the whole organization. Positive thinking is considered as the main energy source of the organization. Employees can envision new opportunities and are open for change. They believe that they can solve their own problems and they can take risks for improvement and learning.

On the other hand, in negative organizational cultures employees will prefer to defend themselves and they will spend their energy to confront each other. They will refrain from taking risks in fear of punishment. They will resist change and will try to maintain status quo.

Main process for organizational culture in healthcare services

1)      Top management meeting

2)      Formulation and modification of organizational philosophy

3)      Establishing customer and human resources task units

4)      Spreading the organizational philosophy

5)      Reflecting the philosophy in the daily routine actions

6)      Determining the culture gap via data gathering

7)      Data feedback

8)      Establishing the customer and human resources action teams

9)      Developing primary action items and programs

10)  Implementation of the program

11)  Behaviour model of the key staff

12)  Evaluation and feedback for determining the culture gap

13)  Determination and modification of the human resources system

14)  Determination and modification of other essential systems

15)  Evaluation and feedback for determining the culture gap

Organizational Culture

One of the main pillars of total quality management is the proper integration of employees with the system. The major accomplishment in organizational transformation is to eliminate the unconsciousness and to include everybody in the change process. This will enable the organization to establish new efficient forms. The key parts of an organizational culture are the norms. Norms can be considered as the unwritten rules and regulations that explain how employees should behave in an organization. On the other hand, values are the assurances that explain which results should be achieved and preferred.

Leadership qualifications for organizational transformation

1)      A proper vision

2)      Social responsibility

3)      Managing ambiguous situations

4)      Handling change

5)      Getting along with people

6)      Sharing information

7)      Interaction with customer values

8)      Dedication for improvement and change

9)      Raising awareness

10)   Dedication for education and training

11)   Willingness to give responsibility to subordinates

12)   Good relationships with suppliers and vendors

13)   To know oneself

14)   Ability for creative thinking

15)   Willingness to take risks

Leaders of healthcare organizations should answer the following questions in order to develop a new vision

1)      How should our organization look like? 

2)      Will customers like the organization when the vision is implemented? 

3)      Which are the most important values for us?
  
4)      Will the vision meet all our important values and customers’ interests? 

5)      Where will everybody be located in the future vision?

Key elements for implementing a successful total quality management system

1)      Customer oriented vision 

2)      Capacity for change 

3)      Reaching the threshold for change

4)     Making plan for change

Customer oriented continuous quality improvement philosophy

Key elements of customer oriented continuous quality improvement philosophy are summarized in Edward Deming’s plan that includes 14 items:

1)      Being devoted to the main goal for improving the product and service.

2)      Developing new approaches.

3)      Abandon putting blame on someone in order to obtain quality.

4)      Accentuate fidelity and trust.

5)  Continue to develop product and service system in order to improve quality and   productivity.

6)      Adopt on the job training.

7)      Adopt leadership. Audit should only aim for helping the employees.

8)      Avoid anxiety and fear at the work place.

9)      Remove the barriers between departments.

10)   Instead of advising the employees, demand new levels of productivity from them.

11)   Do not impose the amount of work.

12)   Remove any obstacles that might hamper the pride of employees.

13)   Encourage training and self-improvement.

 

14)  Encourage everyone in the organization to work for transformation.

Definition and key elements of quality in healthcare

According to the definition of Joint Committee of Accreditation of Healthcare Organizations (JCAHO), quality in healthcare means “increasing the possibility of obtaining expected results and reducing the risk of unexpected results based on the most current knowledge”.  Quality in healthcare can be analyzed in two different ways:

1)      Technical Quality : Can be assessed by medical doctors

2)      Service Quality:  Patients and their companions can comment on the quality

According to studies conducted on healthcare quality, the most important issue that patients and their companions pay attention is the respect to personal feelings. For more information on related studies please contact me at mahmutcemsunar@gmail.com .

Hakkı Sunar

The initiative for quality improvement in healthcare facilities

A hospital can be considered as a temporary guest house for people that seek medical treatment. These people come from different social, economic and cultural backgrounds and therefore they all have quite different expectations and demands. The challenging task of offering a high quality healthcare service to those people depends not only on technology and knowledge but also on quality service.

Obviously quality requires a certain level of cost, however the implementation of quality management principles and scientific methods can help reduce quality related costs. The financial resources allocated for healthcare services remain uder pressure both in developed and emerging countries, therefore the only way to control costs remains to be “continuous quality improvement” initiative.

Giving quality healthcare service in a hospital to people that have different life styles, behaviours, habits and social backgrounds, remains to be a big challenge and brings out problems. Although rules and regulations may limit the flexibility of quality management teams, a structural transformation for quality improvement is still possible by good leadership and committed management.

Total Quality Management for healthcare facilities

The essence of “quality” concept in the healthcare sector arises from the fact that there is not only one type of patient and one type of treatment method. In fact, individual medical problems and patients vastly differ from each other and this makes the task of offering a standard healthcare service a challenging one. The term “standard” puts emphasis on quality and its indicators.

The input of the healthcare sector are patients (guests of healthcare facilities) that have unique characteristics and needs which require unique treatment methods. The healthcare services that are being offered with limited resources should be of excellent quality. Such a challenging task definitely requires a quality management plan that will look more complex than many other sectors. A well designed quality management plan will only start with a “commitment to quality” adopted by all parties involved in the healthcare services.

The Development of Economic Relations Between Turkey and The Netherlands

Although macroeconomic indicators of Turkey and The Netherlands differ from each other to some extent, both countries also have some similar characteristics. Turkey and The Netherlands can be considered as two countries which are strategically located along the boundary lines of Europe, one in the East and the other in the West. This gives them a unique position as being a distribution hub between Europe and other surrounding regions. However, the two countries have not yet been able to create a synergy from the advantages of their geopolitical locations and trading activities together.

Turkey has become a very attractive country for foreign investors in the last 5 years. Total FDI in Turkey between 2005 - 2007 has reached approximately $52 billion level. At the same period, The Netherlands provided the highest amount of FDI with $11.3 billion. As of March 2008, there were a total of 1,428 Dutch origin companies operating in Turkey. Dutch companies such as Philips, Unilever, Shell and ABN AMRO have decades of long presence in Turkey. In fact Philips started operations in Turkey back in 1930 under the name Türk Philips Ltd. As of June 2008, the total amount of Turkish investments in the Netherlands has reached $3.9 billion level.

The breakdown of Dutch companies in Turkey points out that “real estate and construction” (22% of total) is the most prominent sector for Dutch investments in Turkey. Large Dutch developers such as Corio, Redevco and Multi Turkmall are either undertaking new commercial projects or acquiring local companies and real estate in Turkey. Furthermore, there are a lot of smaller sized Dutch origin companies which are specialized in the construction and marketing of residential projects in resort regions. Wholesale and retail trade (11%), tourism & catering (8%), transport & communications (7%), machinery & metal/plastic processing (8%), textile & ready-to-wear (7%) and IT-media publishing & education (6%) are other popular sectors for Dutch origin companies in Turkey. 53% of all Dutch origin companies in Turkey are located in Istanbul and 35% are located in Antalya, Mugla, İzmir and Ankara. On the other hand, the breakdown of Turkish companies in The Netherlands points out that “financial services and banking” is the largest sector for Turkish investments. Major Turkish banks in The Netherlands can be listed as Koçbank, Garanti Bankası, Yapı Kredi Bankası, Demir-Halk Bank, Dışbank, Ziraat Bankası, İş Bankası and Akbank.

As mentioned above, despite geographic size, The Netherlands is one of the most important economies in Europe due to its unique role in international trade activities. The Netherlands is considered as the main port for entering the Europe and a major logistics center for the EU countries. Many foreign investors perceive The Netherlands as a distribution center for entering the European market. One of the similarities between Turkish and Dutch economies, is the fact that exports make up a considerable amount of the total GNP in both countries. In The Netherlands exports constitute almost 60% of the GNP making the country vulnerable to global economic volatilities.

Economic and trade relations between Turkey and The Netherlands started some 400 years ago. In the Ottoman era the economic relations between the two countries were based solely on the trade activities. Following the foundation of the Turkish Republic, Turkish – Dutch Foundation was established in 1934 in order to promote trade and economic relations between the two countries. In the years ahead various trade and economic agreements were signed between the two countries.

As of 2007, The Netherlands has a very strong economy with GDP per capita at $ 38,754 and a growth rate of 3.5%. Total GDP in The Netherlands is EUR 789.1 billion and the inflation rate is only 1.3% as of 2007. As of the same period the country has a trade surplus of $ 66.5 billion. Although main export and import items in The Netherlands are pretty much the same, re export is the driving force behind the trade surplus. However, in Turkey’s case, most of the export items depend heavily on imported raw materials and intermediary goods. Therefore Turkish economy is facing a widening trade deficit hovering around $ 46 billion as of 2007. The development of economic relations between the two countries is encouraging as the trade volume is constantly rising since 2002 and Turkey has a trade surplus in economic relations since 2004. As of 2007, Turkey’s exports to The Netherlands were EUR 2.2 billion and imports from The Netherlands were EUR 1,9 billion.

As far as the tourism sector is concerned, Turkey continues to be one of the most popular travel destinations for Dutch tourists. The total number of tourists coming from The Netherlands to Turkey in 2007 was 1,053,669. Due the increase in trade and passenger traffic with Western Europe, the demand for transportation services has increased and Dutch enterprises such as Den Hartogh and Corendon have established local subsidiaries in Turkey. Telecommunication and IT sectors in Turkey are also attractive for Dutch investors since Turkey offers valuable opportunities with its large consumer base and qualified technical staff in these areas. As a result, firms operating in these branches including GreenCat, TopTel and BitBrains consider Turkey as a location for their investments abroad.

Turkey and The Netherlands do not have any major political conflicts and the political relations between the two countries have been very consistent for years supporting a favourable trade and investment environment between the countries. The mutual understanding between the two countries on global balance of forces helps to build a partnership on political fronts. In this context, The Netherlands continues to be well aware of the geopolitical location and influence of Turkey in the region.

Turkey and The Netherlands have much to share in common from regional security to global trade and investment activities. The presence of Turkish community (approximately 380,000 people) in The Netherlands and presence of a considerable amount of Dutch visitors in Turkey each year, put another emphasis on the importance of partnership between the two countries. The trade volume between the two countries that currently stands around of EUR 4.1 billion should be increased since The Netherlands remains to be one of the important markets for Turkish exporters and the share of exports to The Netherlands remains relatively low among Turkey’s export markets. Current breakdown of goods and services exported to The Netherlands also points out that Turkish exporters should work harder to diversify their export items to The Netherlands. On the other hand, Turkish and Dutch firms still have many new areas for investments in both countries as investment climate between the two countries remains supportive and investor sentiment is high.

  

Hakkı Sunar

Biotechnology and Pharmaceuticals

Today healthcare sector is considered as one of the most important investment sectors, because health is the most valuable asset that we own in our lives. Since the early years of the evolution of biology and modern medicine, tremendous research efforts are dedicated to health sciences to pave the way for innovation in healthcare sector. Financial and business community is clearly aware of the potential future benefits of biotechnology and pharmaceutical industries in our lives. For this reason tremendous amount of investments are allocated for these two sectors. Although biotechnology and pharmaceutical sectors seem to be similar in nature, it is quite important for investors to make a distinction between them.

In its simplest form, biotechnology is the technology that deals with living organisms whereas pharmaceutical industry is primarily limited to chemical substances and formulas. Clearly, both sectors serve human life, but their core production methods are different. From production point of view, biotechnology is the technology that utilizes biological production methods. And pharmaceutical technology is primarily chemical production.

All kinds of animals (both living on land and in water), plants growing in nature can be considered as raw materials of biotechnology. Also smaller living organisms such as cell, cell culture, stem cell, bacteria can also be considered as part of the living universe. Genetic engineering also deals with living organisms. Another big difference of biotechnology is that, the aim of biotech research is not limited to only modern medicine. Certain food products, industrial components and unfortunately certain mass destruction weapons are also produced by biotechnology.

For biotechnology and pharmaceutical sectors, it might take quite some time before investors start to see the first signs of profits and their new value added products and procedures. In fact, new investments may not seem to be profitable in the early stages of development at all. Especially, in biotechnology sector an average research period that is spent to develop a new product takes quite a long time from Phase I trials to Phase III trials. And unfortunately this is the part of the investment that possibly very limited or almost no revenue is expected. So, eventually it is quite hard and unpredictable for biotechnology investors to make a “go-ahead” decision. In addition, during this long journey towards the final products, there may be a number other negative factors such as the usual slow down of the economy where many investment and research efforts are not given priority. During this research period, certain biotechnology companies may be financially supported by other subsidiaries or organizations.

Some of the major biotechnology activities can be listed as follows:

• Developing and researching DNA chips which can be used to improve the diagnosis and treatment of diseases,
• Developing antibody therapeutic products for the treatment of a variety of diseases and conditions,
• Analyzing genetic information in order to improve the diagnosis, monitoring, and treatment of diseases,
• Discovering and designing novel small-molecule pharmaceuticals using structure-based drug design,
• Genomics  (Gene nomenclature),
• Molecular biology and genetic engineering techniques,
• DNA sequencing systems,

The pharmaceutical companies producing a variety of drugs may continue to survive on their own using the revenue of their existing products. And they can continue to finance their research activities until their new products come out of the pipeline. However, this is not the case for certain biotechnology firms which concentrate only on one single technique or product. Investors may not always be patient enough to support those companies until their miracle products are ready to use. As many investors notice, biotechnology and pharmaceutical research studies are getting more integrated into each other. Biochemistry is also another common term that we encounter in both sectors. Clearly after defining certain functions of both sciences it may still be challenging to make a clear distinction between the two sectors.

The main criteria to differentiate a  pharmaceutical company from a biotech company is the fact that, pharmaceutical companies concentrate primarily on chemistry and biochemistry as their conventional scientific production methods and they develop new chemical compounds and pharmaceutical substances. Obviously they will continue to contribute to healthcare sector by deriving new chemical formulas and pharmaceutical substances. Biotechnology on the other hand, will continue to support the pharmaceutical research activities and more importantly it will continue to be the driving force behind the new treatment methods for human life. The current revenues of biotech and pharmaceutical companies may not clearly reflect the real profitability of future years. Investment community will be able to allocate its resources better if the final products are understood better by the investors. 

Hakkı Sunar