PDF CAHME Phase II: International Healthcare Management Education

[Pages:226]CAHME Phase II: International Healthcare Management Education

Daniel J. West, Jr., PhD, FACHE, FACMPE

Professor and Chairman Department of Health Administration & Human Resources

Panuska College of Professional Studies University of Scranton

Gary Filerman, PhD

Atlas Health Foundation

Bernardo Ramirez, MD, MBA

Assistant Professor College of Health and Public Affairs Department of Health Management and Informatics

University of Central Florida

Jill Steinkogler, MHSA

Senior Consultant

ACKNOWLEDGEMENTS

The PHASE II study was made possible through a grant from the ARAMARK Charitable Fund at the Vanguard Charitable Endowment Program. Additional contributions were received from the University of Scranton, Department of Health Administration and Human Resources and Atlas Health Foundation. Technical support was received from Mr. Neel Pathak and Ms. Lauren Majeski both serving as Graduate Assistants at The University of Scranton. A special acknowledgement to Dr. Robert Spinelli for conducting telephone interviews with CAHME Accredited Program Directors as part of this study.

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TABLE OF CONTENTS

ACKNOWLEDGEMENTS ............................................................................................................. 2 INTRODUCTION ........................................................................................................................ 4 OVERVIEW OF THE STUDY ........................................................................................................ 7

Domestic Methodology ............................................................................................................................... 8 International Methodology......................................................................................................................... 9 Accrediting Organizations Research ...................................................................................................... 10 SURVEY FINDINGS AND OBSERVATIONS .............................................................................. 18 Domestic Survey ......................................................................................................................................... 18 International ................................................................................................................................................ 27

The International Programs: An Overview .......................................................................................... 28 Accrediting Organization Profiles .......................................................................................................... 31 Limitations .................................................................................................................................................... 33 CONCLUSIONS ........................................................................................................................ 33 Domestic ....................................................................................................................................................... 33 International ................................................................................................................................................ 34 RECOMMENDATIONS ............................................................................................................. 37 APPENDIX A: DOMESTIC SURVEY .......................................................................................... 39 APPENDIX B: CAHME TELEPHONE SURVEY QUESTIONNAIRE ............................................... 41 APPENDIX C: INTERNATIONAL DATABASE........................................................................... 48 APPENDIX D: COUNTRY PROFILES AND PROGRAM TEMPLATES ......................................... 49 Colombia ..................................................................................................................................................... 49

Colombia Programs................................................................................................................................54 Czech Republic ........................................................................................................................................... 59

Czech Republic Programs ...................................................................................................................... 64 Germany...................................................................................................................................................... 68

Germany Programs.................................................................................................................................72 Ireland .......................................................................................................................................................... 86

Ireland Programs .................................................................................................................................... 90 Netherlands ................................................................................................................................................. 95

Dutch Programs .................................................................................................................................... 100 South Korea.............................................................................................................................................. 105

South Korea Programs ........................................................................................................................ 110 APPENDIX E: ACCREDITING AGENCY PROFILES .................................................................. 120 APPENDIX F: CAHME PROGRAMS AND FACULTY CONTACTS ............................................ 216 APPENDIX G: BIBLIOGRAPHY ............................................................................................... 225

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INTRODUCTION

The initial PHASE I study for CAHME was conducted during 2010-2011 and results were reported to the CAHME Board and approved in May 2011. The first phase examined 16 countries along with 66 CAHME accredited programs. PHASE I showed that the health administration education system is closely articulated with the recognized needs of the healthcare delivery system in several countries and appears to provide a sufficient number of graduates. Furthermore, the PHASE I study provided detailed information on CAHME accredited programs relative to international involvement, international courses and curriculum, alumni and ideas on global healthcare management.

Phase II study for CAHME was conducted September 1, 2011 ? May 31, 2012. The PHASE II study utilized findings from the PHASE I study to examine four main areas. First, six additional countries (Germany, Ireland, Czech Republic, South Korea, Netherlands and Colombia) were added to the existing 16 countries bringing the total to 22 countries that are analyzed. Comprehensive contact information for key institutions was added to country-specific profiles. Second, in-depth telephone discussions were held with CAHME accredited Program Directors (PDs) to gather additional information on global centers, courses, international research, partnerships, and faculty. Third, other accreditation programs in business, medicine, and public health were surveyed to identify domains that pertain to health services administration sponsorship, processes and memberships. Fourth, a strategy and plan of action to implement international demonstration site visits in different countries using the 2013 CAHME Accreditation Criteria was developed. This included identifying relevant CAHME criteria that can be used outside of the USA under some type of external review such as certification.

On May 16, 2012 CAHME conducted a 2012 corporate member meeting at the Feinstein Institute for Medical Research, North Shore-LIJ Health System, Manhasset, New York. The program "Healthcare Reform: Positioning Graduate Healthcare Management Education for the Future" had several objectives:

1) Develop a shared understanding of the leadership challenge to our profession in transforming the future.

2) Reconfirm the compact between practitioners and the academic community about "what comes next" in graduate healthcare management education.

3) Collectively determine what skills and attributes will be required of future leaders. Develop a shared understanding of what steps need to be taken in the next decade to better prepare future leaders.

4) There has been a transformative change in graduate education in the past decade leading to competency-based education and more sophisticated assessment. Do practitioners feel academic programs are meeting their needs?

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A final report is forthcoming; however, lectures, presentations and group discussions suggested that future leaders need to understand the impact of globalization and associated competencies when considering future innovations. In looking at CAHME and the future, the "2012 CAHME Survey of Program Directors and Faculty" presents information that could help to frame further thinking around international accreditation/certification with respect to value, quality, potential difficulties, advantages of accreditation, and disadvantages/drawbacks of accreditation. Although USA responses cannot be generalized to other countries and faculties, the survey responses raised areas worthy of discussion within an international context.

Globalization has impacted graduate education in the USA. The number of international students enrolled in graduate education in the USA is significant. Career opportunities for graduates with multi-national corporations, NGOs and international organizations appear to be increasing. The global competencies needed by future students are constantly changing placing pressure on graduate programs in health management education to re-examine the importance of accreditation, competency models and specific competencies, demonstrated knowledge and skills and placement following graduation. Dr. Stephen F. Lobes, Professor Emeritus, the Ohio State University was commissioned by The National Center for Healthcare Leadership to examine the "status of university based graduate education in health management." As presented at the AUPHA Leaders Conference (March 20, 2012), the "Report on Graduate Health Management Education in the United States 2001-2011" provides a critical examination of prior accomplishments; but more importantly, challenges and recommendations for improvement. The future direction of CAHME accreditation and AUPHA membership offers opportunities for national dialogue regarding global health management, and how to engage global health systems.

The U.S. Agency for International Development (USAID) has issued a report "USAID Policy Framework 2011-2015" that provides an agenda for change and development. This plan also suggests a strategic framework for international development and promoting U.S. national interests (USAID, 2011). It also addresses principles consistent with the Presidential Policy Directive on Global Development (PPD-6), the Quadrennial Diplomacy and Development Review (QDDR), and the U.S. Government Strategy for Meeting the Millennium Development Goals (MDGs). The opportunities for graduate education programs to prepare future leaders to meet the new challenges and opportunities is immense. In a global economy, graduate programs in health management education can have an impact on research, partnership development, service opportunities for students and faculty, outcomes assessment, leadership preparation, improving quality, access to care and promoting public-private sector development.

In a very interesting article "Lost in Translation: Degree Definition and Quality in a Globalized World", Madeleine Green (2011) examines quality, the need for diversity and innovation in universities and organizations across borders. Green thoughtfully offers the following:

"As if it weren't difficult enough to compare quality and to define degrees within

a country, the problem is exponentially greater globally. Intensified globalization

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has resulted in increased academic and employee mobility, a growth in the number of academic programs offered across borders, and the multiplication of institutional partnerships. The need to understand institutional quality, however it is defined, and to compare learning outcomes across borders is even greater in this new environment, with practical and serious implications for mobile students and faculty, globally engaged institutions, and employers and organizations with global reach." (p. 19)

This article challenges current thinking about accreditation and suggests other approaches may be needed to address teaching methods, quality and outcome measurement of specific competencies that have global application.

OVERVIEW OF THE STUDY

This survey research is an initiative of the Commission on Accreditation of Healthcare Management Education (CAHME), implemented by the University of Scranton and The Atlas Health Foundation. It is supported primarily by the ARAMARK Charitable Fund with contributions from the University of Scranton and Atlas Research, LLC. The project team included:

Daniel J. West, Jr., PhD, FACHE

Principal Investigator The University of Scranton

Gary L. Filerman, PhD, MHA

President Atlas Health Foundation

Bernardo Ramirez, MD, MBA

Assistant Professor & Consultant University of Central Florida

Jill Steinkogler, MHSA

Senior Consultant

Neel Pathak

Graduate Assistant, MHA Program The University of Scranton

The Phase II study was designed to expand and elaborate findings from the Phase I study as well as to provide future direction.

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The grant award had a domestic initiative/methodology and an international initiative/methodology. Specifically the study was structured to:

1) Examine the supply of professionally trained health care administrators in six countries. A country profile template was created. Within each country program profiles were created that provide available information on universities, degrees awarded, and other information.

2) Provide a summary of the health systems of the six countries.

3) Use an expert panel to provide opinions, advice, and access to information.

4) Assess the extent of international health care management education activities of CAHME accredited programs and their faculties and describe involvement in international health administration education.

5) Survey accreditation programs in business, medicine and/or public health to identify their domains, sponsorship, processes and memberships.

As part of the study progress reports were prepared and submitted to CAHME. Continuous input and contact was maintained with Mr. John Lloyd providing clarification and utilizing appropriate feedback. The expert panel was used throughout the study by Dr. Gary Filerman and his staff. The University of Scranton provided marketing and publicity associated with the study. Suggestions have continuously been sought from a variety of sources on presenting results of the study in journals and at professional meetings/conferences, both in the USA and to international audiences.

DOMESTIC METHODOLOGY

The study required a survey of CAHME accredited programs and their faculties focusing on global centers, research grants, partnerships, courses and study abroad opportunities. Based on the results from PHASE I, 40 graduate programs were identified for inclusion in the PHASE II study.

In the design of the survey instrument, specific information and points of interest to CAHME were considered (Appendix A). Authorization to conduct the study was secured and articulated in a letter of engagement dated August 12, 2011. The study was initiated on September 1, 2011. The project team analyzed results from the PHASE I study and decided to conduct in-depth telephone interviews with CAHME graduate PDs. A survey instrument was designed to capture detailed information (Appendix B). Research Assistants were trained to conduct telephone interviews using the survey instrument. The telephone survey consisted of 40 questions. In advance of making telephone contacts, an e-mail was sent to all PDs with a copy of the survey instrument asking for their cooperation in the survey.

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The project team submitted an IRB/DRB Application Form B on March 8, 2012 at the University of Scranton. IRB approval for a period of one year was received on April 13, 2012. The approved survey had 40 questions in five sections that focused on global centers, international research, study abroad, global health courses, and partnerships.

The CAHME website and office was contacted to secure a current listing of all CAHME accredited programs in the United States and Canada. Updated PD names and telephone numbers were secured for 40 programs that participated in the PHASE I study.

The telephone survey was titled "CAHME PHASE II Study: International Health Education Survey" and was composed of 40 questions with specific instructions. The entire survey was designed to take 15-20 minutes to administer and complete using a telephone interview. Participation in the study was voluntary, could be discontinued at any time, all responses were treated with confidentiality, and results reported in aggregate.

Telephone surveys were initiated on April 16, 2012 by two trained Research Assistants. Forty (40) PDs were contacted. Several PDs responded immediately, others were contacted multiple times. One program declined to participate. There were no withdrawals from the study. Efforts were made to reach all 40 identified graduate programs. Twenty-six out of 40 PDs (65%) responded to the telephone survey. Interviews were conducted from April 16, 2012 to May 11, 2012 (4 weeks). Data analysis was done using Microsoft Excel.

INTERNATIONAL METHODOLOGY

The study team had the benefit of counsel from an advisory committee that reviewed the design and suggested sources of information about programs. The members of the committee were:

Gilles Dussault, PhD Professor, National Institute of Hygiene and Medicine, Portugal

Alex Preker, MD, PhD, Lead Health Economist, The World Bank

Bernardo Ramirez, MD, MBA, Assistant Professor and Director, Global Health Initiatives, University of Central Florida

Anne Rooney, RN, MS, MPH, Vice President, Consulting and Education Services, Joint Commission International

Jorge Talavera, PhD Rector, Universidad Esan and Executive Director, CLADEA, Peru

The intent of the study was to identify university and other providers of programs that lead to a credential that is recognized by the health services delivery system/community as attesting to the successful completion of a course of study that is appropriate preparation for management practice.

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