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What Do You Mean by “Primary Care”?(การดแลปฐมภมหมายถงอะไร?)
1. Basic medical services
2. Self-care, and health for all
3. First-contact, continuous, coordinated, and comprehensive care
4. Health promotion practices, and actions on social determinants of health
1. Basic medical services
2. Self-care, and health for all
3. First-contact, continuous, coordinated, and comprehensive care
4. Health promotion practices, and actions on social determinants of health
(=What a layman usually thinks of primary care)
(The Declaration of Alma-Ata 1978)
(Starfield 1992, 1998)
(Ottawa Charter 1986, The 66th World Health Assembly 2013)
What Do You Mean by “Primary Care”?(การดแลปฐมภมหมายถงอะไร?)
Action on Social Determinants of Health
(การสรางเสรมสขภาพ)
Community-based Primary Healthcare
(การสาธารณสขมลฐาน)
Primary Care Medicine,Family Medicine
(เวชศาสตรปฐมภม, เวชศาสตรครอบครว)
Basic Medical Care(บรการการแพทยระดบพDนฐาน)
• Health promotion practice at the population health level
• “Health in All Policies”
• Self-care• Community health worker• Community health volunteer• “Health for All”• First-contact care• Continuous care• Coordinated care• Comprehensive Care
•Health center (สอ./รพ.สต.)•OPD, physician office•Mobile medical units
What Do You Mean by “Primary Care”?(การดแลปฐมภมหมายถงอะไร?)
Community-basedPrimary Healthcare
Clinical Practicesat Primary Care
Level
“The Doughnut Hole” of Primary Care
• Primary care services in developed countries
• Medical facilities in urban settings
• Medical facilities in private-sector (without public health functions)
• Primary care services in developing countries
• Medical facilities in rural settings
• Medical facilities in public-sector (with public health functions)
ØWhat exactly policies & systems are we talking about?
“Level” of Healthcare Delivery Systems: (Primary Care vs. Acute Care)
Primary Health Care (population-level, public health-type functions)
What’s probably missing?• How’s about Sub-acute Care?• How’s about Emergency Care?• How’s about Long-term Care?• How’s about Palliative Care?• How’s about Hospice Care?
Community(Self-care)
Primary Care Services(family doctor-type services)
Secondary Care Services
Tertiary Care ServicesSupra-tertiary/Quaternary Care Services
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What Do You Mean by “Community Health”?(สขภาพชมชนหมายถงอะไร?)
1. Health of people in the community
2. Community-based health programs/interventions
3. Population-based health programs/interventions
4. Health promotion practices, and actions on social determinants of health
Source: W. Simpson del.; E. Walker lith.; Day & Son, Lithrs. to the Queen.Pix source: http://en.wikipedia.org/wiki/History_of_hospitals#mediaviewer/File:Hospital_at_Scutari_2a.jpg
“Hospital at Scutari” - A ward of the hospital at Scutari where Florence Nightingale worked and helped to restructure the modern hospital
Primary Care vs. Chronic Care
FigureSource:www.improvingchroniccare.org
Primary Care vs. Palliative Care
“Palliative care is care provided based on patient & family needs & goals and independent of prognosis.”
Source: NEJM 2014;370(26):2457-60.
Primary Care vs.
End-of-Life Care(Hospice Care)
Primary Care vs. Long-term Care
Source: Tishihiko Hasegawa (2013)
“Care Cycle”
First Contact/Access
Continuity Coordination Comprehensiveness
• Cost sharing• Distance to PC
practice • Distribution of
PC physicians • List size • Home visits in
PC • Electronic access
• Computerization of the practice
• Patient habits with first contact visits/referrals
• “คณสมบตผดบงเกด” หรอ“คณสมบตอบตใหม” (emerging property) ทเกดขนใหมจากปฏสมพนธระหวางองคประกอบยอยภายในระบบ(“The whole is not equal to the sum of its parts.”)
• “การจดการตวเอง” (self-organizing) และการเรยนรผานกลไก “การตอบสนองยอนกลบ” (governance by feedback)
Adapted from: Wheelan and Hunger. (2006) Strategic Management and Business Policy.
To set a shared vision and mission of the project: “To build a medical institute that is publicly perceived as the incubator of change towards a better societal health"
To identify specific goals of the new campus from the perspectives of customer, learning and growth, process, and resource
To decide on how we can achieve such specific goals in BE 2560 and beyond
To set a broad guideline for team’s decision-making, (esp. when conflicting ideas arise)
To launch initiative or activities in each division/section/department
To figure out what the whole project really costs
To determine sequence of steps needed to do the jobs
To monitor performance of the management team and take corrective actions if needed
Adapted from: Wheelan and Hunger. (2006) Strategic Management and Business Policy.
To set a shared vision and mission of the project: “To build a medical institute that is publicly perceived as the incubator of change towards a better societal health"
To identify specific goals of the new campus from the perspectives of customer, learning and growth, process, and resource
To decide on how we can achieve such specific goals in BE 2560 and beyond
To set a broad guideline for team’s decision-making, (esp. when conflicting ideas arise)
To launch initiative or activities in each division/section/department
To figure out what the whole project really costs
To determine sequence of steps needed to do the jobs
To monitor performance of the management team and take corrective actions if needed
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#1 #2 #3 #4 #5
Strategic Management Process
Project/Program Management Tools
Planning Tracking
Reporting ManagingRisks
• Project charter• Gantt chart• Timeline chart
• Project status dashboard• Program status dashboard
• Team to-do list• Burndown chart
• Issues tracking
#1 Situation Analysis-Analyze internal factors of organization-Analyze external factors of organization-Define strategic advantages & challenges
Tools-Self-assessment-Market Survey & Public hearing-SWOT analysis
#2 Direction Setting-Define organizational visions-Define organizational missions-Set organization level strategies
Tools-Mandates from the government-Consultations with internal and external stakeholders
#3 Strategy Formation-Define strategic objectives of business units -Set business unit level strategies-Set functional level strategies-Define strategic objectives of functional units