The Improvement Process of Strategic Health Management In Nakhon Ratchasima Province

Abstract

The purposes of this research were to (1) study the situations of health strategy management, (2) develop the process for health policy and strategic plan, (3) develop the implementation of health strategies into action (4) develop the control, monitoring, and evaluation of health strategic plan, and (5) evaluate the development of health strategic management process using the CIPP model. The data were collected using an opinion evaluation questionnaire (Cronbach’s alpha coefficient = 0.95) and a satisfaction questionnaire (Cronbach’s alpha coefficient = 0.95). The samples were 235 administrators and personnel in knowledge worker positions working under Nakhon Ratchasima Public Health Provincial Office. The data were analyzed using percentages and standard deviations for quantitative data and inductive summary for qualitative data. The study was approved by Nakhon Ratchasima Public Health Provincial Office’s human research ethics committee (code: KHE 2018 – 050).

The results of the study showed that (1) The current situations of health strategic management were the results of the Ministry of Public Health’s formulation of the 20-year strategic plan for health and the adjustment of management system under health zones 1 – 12. The implementation of public health plans resulted in the overall performances of the provincial public health office’s 81.58 percent passing of all indicators at the provincial level. This was because process of managed the strategic plan in many steps was not complete. It was necessary to develop a strategic management process. (2) the Development of policy making, health strategic plan had integrated strategies at all levels, development of policy making, strategic plan by SWOT analysis and the systematic Six Building Blocks. (3) The development of strategic health plan into action was done using various measures including creating handbooks and health strategic plan posters, signing of memorandum of understanding (MOU) between administrators, conducing workshops to develop action plans, measures, and key activities through PDCA process, developing coaching teams to help mobilizing the health strategies at the local levels, and developing the strategic management system (SMS) to control and monitor the action plans. (4) The system to control, supervise, and evaluate the health strategic plan with the development of integrated public health supervision, health performance evaluation, program for strategic management system (SMS) that showed the real-time evaluation and budget data, and a monitoring cockpit reporting system. (5) The overall opinions on the strategic health management process were at a high level (84.5%). The satisfaction with the use of the strategic management system program was at the high to highest level (84.5%; Mean = 4.4, SD = 1.2). It was suggested that executives at all levels should pay attention to the strategic management process especially when transferring the policy into practices. The strategic management program (SMS) should be taken into consideration for further development and implementation to every public health provincial offices.