You Can’t Say Enough About Leadership
During a recent visit to a district hospital in the Vientiane municipality of Lao People’s Democratic Republic, I was once again reminded of the critical influence effective leadership has in strengthening health workforce productivity.
Since the region’s development of its strategic action plan, Vision 2009, the hospital director has taken implementation of his hospital’s plan to provide quality health care very seriously. This was especially evident in the productivity gains that he recounted to our visiting team: from 2006 to 2012, outpatient visits increased from 6,000 to 16,000 per year while institutional deliveries rose from 85 to 250.
The director credits this success to improvements to the facility (e.g., renovations, upkeep, cleaning) and equipment, an increase in the number and capacity of staff, and an increase in revenue from the revolving drug fund. In addition to facilitating these efforts, the director instituted the provision of a small financial incentive to health workers who arrive by 8 a.m.
The financial incentive has helped reduce health worker absenteeism as well as patient waiting time, and the patients are noticing the difference in the quality of service delivery. As part of Vision 2009, the director and his team installed a patient feedback mechanism and they have observed that the number of complaints has been greatly reduced as they have made policy changes to address patient concerns. These included providing laboratory test results in the same day to reduce patients’ opportunity costs and having staff personally guide patients to where they need to go next after registering. Likewise, for the four health centers in the district hospital’s network, the director strives to ensure that the staff has clear performance expectations and supports them to implement a detailed action plan of prioritized service delivery areas and village outreach.
The director was very modest in accepting our congratulations for his hospital’s achievement of being among the top two performing district hospitals in the region—though he did share his tips for success:
- The leader has to be a model for others to look up to.
- Teamwork and solidarity are essential.
- Training and other capacity-building opportunities should be attended in teams of four to five people in order to transfer the learning to the facility.
- Selection of participants should not necessarily include the best people in the facility, as the poorer performers need help to improve.
While all health workers have an important role to play in ensuring high levels of productivity and quality, as the case of this district hospital illustrates, a strong leader has an even greater opportunity to bring health workers together and motivate them toward a common goal: saving more lives.
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Photo courtesy of Wanda Jaskiewicz.
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