International Hospital Federation and HDI Team Up in China

After teaching the Effective Hospital Management workshop to 25 Chinese TB hospital managers, I am overwhelmed with a sense of fulfillment and gratitude for the role HDI is playing to improve health around the globe. The International Hospital Federation sponsored this one week conference November 17-22 with a grant from Eli Lilly and Co. to develop the management skills for TB hospital leaders across the country.

China leads the world in the prevalence of multiple drug resistant TB (MDR-TB) with government hospitals in every province filled to capacity and community-based detection programs stressed by limited resources. The highly contagious airborne pulmonary disease has the potential to become a global epidemic unless it is contained in the volatile environments of developing countries. The purpose of this workshop was to equip hospital and program leaders with management skills and insights to leverage their potential in the battle against the disease.

Their responsiveness proved that HDI is offering a uniquely valuable service. The managers represented almost 6,000 inpatient beds, plus outpatient clinics, and over 8,000 employees serving hundreds of thousands of patients in more than 20 provinces. The conference hosted representatives from South Africa and India as well where MDR-TB is also on the rise. Wise management of resources has the potential to prevent the spread of the disease to millions. Infection rates are already as high as 45% in places like China. Keeping those infections from becoming active, contagious cases will require management excellence at every level. HDI is beginning to play a small but critical role in the fight against the threat of a global epidemic.

The experience of this workshop affirmed some positive directions for HDI:

• Participants appreciated the interactive teaching method, case studies and group projects. The HDI approach is a welcome change from didactic traditions, leaving them both informed and inspired to share with others.
• The course improvements won high praise, but constructive feedback also showed the need for continuing development of the curriculum.
• Developing relationships with the International Hospital Federation, Eli Lilly and Co., and TB program leaders in both South Africa and India have the potential to expand HDI’s global role significantly in the next few years.
• We are leveraging the impact of HDI’s voluntary efforts by sharing the workshop materials freely. We are training each participant to be a trainer in his/her own facilities, sparking an “epidemic” of wise management.

By the end of the week, I received invitations to South Africa and India, and positive affirmations for the potential of more workshops and mentoring relationships in China. It’s an exciting time for HDI.

Training of Trainers Conference

The first HDI Training-of-Trainers conference has just concluded with resounding success. Two dozen volunteer health care managers, consultants, physicians, nurses and other supporters met for three days at the Haworth Inn and Conference Center in Holland, Michigan to learn about the opportunities for making a difference with HDI. Medical missionaries from Latin America, Asia, Africa and Eastern Europe shared their stories to illustrate the needs for health care management training. As the President of HDI, it was my honor to introduce the Effective Health Care Management workshop materials and coordinate practice training exercises to give each participant some familiarity with the role of an HDI trainer. I also presented perspectives on how to develop sustainable health care services in poor countries, emphasizing the critical role HDI can play to bring health care programs where they can have the greatest impact.

Participants came from nine states and three other countries, with Kenyan physician, Dr. Thomas Odeny, winning the award for coming the greatest distance. Each person was challenged to discern the roles they can best fill with HDI as trainers, mentors, and those who can make introductions to ministries and supporters. We also shared ideas for refining and expanding the training materials to increase their value for hospitals and clinic in the two-thirds world.

I came away with a deep sense of gratitude for this calling, for the commitment of talented volunteers and for the historical foundations of HDI under Dr. Rufi Macagba. But my most poignant observation was the overwhelming magnitude of the need for health care management training in developing countries and the impact HDI can achieve by training and mentoring targeted organizations to become models of business and clinical excellence. I was also struck that HDI appears to be the ONLY organization equipped to meet the long-recognized need for health care management training in developing countries. We have been given stewardship of a sacred - and huge - calling.

This training-of-trainers conference was the first for HDI, but it will not be the last. There are already about a dozen people who have expressed interest in being trained that could not attend this time. We'll use feedback from this experience to plan the next one, and it will need to be scheduled soon, based on the growing list of invitations.

We are planning the next workshop to be presented in Soddo, Ethiopia, October 20-23, and have just received an invitation to Uganda the following week. November will find me in Beijing, China, leading 25 TB hospital managers through the workshop as well as training five trainers from South Africa and India. We're waiting for a response to our proposal to conduct the workshop in Guatemala in December, and tentatively making plans for trips to India and Kazakhstan in 2009. We are receiving about 2-3 inquiries per month for HDI training assistance.

I want to thank all who participated in the HDI conference, including those who worked behind the scenes. The three HDI interns and my Executive Assistant, Beth Vander Goot, did an excellent job managing hundreds of details. Scott and Deb Witteveen helped with the picnic and my wife, Marybeth, and HDI Board members pitched in with transportation services. I am grateful to God for this ministry. It is fulfilling at the highest level, and the best is yet to come.

China: a moving experience

I am recovering from two weeks of intensive teaching in China. The jet lag will subside in due time, but the memories, stories, reflections and insights will stay with me. Dr. Rufi Macagba and I presented the Effective Hospital Management Workshop to about 145 hospital managers in two settings. The first week, we had five engaging days with rural hospital managers from as far away as Xinjiang Province, 3,000 miles west. We also had a few Beijing-based leaders who are likely to become mentors to rural hospitals. They responded warmly to the interactive teaching methods we introduced as well as to the content about management tasks and skills that are essential for improving hospital services. Our host was the Loving Heart Hospital Management Committee of the China Rural Health Association, so we had opportunities to integrate principles of integrity and compassion along with our management philosophy.

The second week turned out a little differently than we had planned. We thought we were going to go to Dengfeng Hospital in Henan Province to teach the management teams from ten rural hospitals in the region. Instead, our venue was changed to Zhengzhou, the capital of Henan Province. The government officials got word of our plans and decided to expand the audience to include several top managers from urban hospitals as well. We entered the room to find 100 people applauding us, ready to learn. The entire four-day workshop was videoed for future distribution, so HDI will have a continuously growing influence with support by the Chinese Ministry of Health.

We clearly felt the earthquake during a break on the first afternoon of the Zhengzhou conference. We were 600 miles from the epicenter, but the earth moved noticeably for 10 minutes as we evacuated the building. Some of the participants were called away to join the rescue teams as the magnitude of the tragedy unfolded, but we still had about 70 participants on the last day.

Rufi's engaging style, his Asian charm, and his personal stories of Lorma Hospital in the Philippines won the day. He has lived the content of this workshop and has developed simple methods for sharing his life's lessons in ways that stick with audiences. I added my own stories from around the globe and offered a contemporary view of basic management principles. I also came to appreciate how future faculty members can enrich the workshop material with their own stories and build on the interactive exercises that allow participants to personalize their learning experience.

This was an experience of several firsts. It was the first time in twelve years of sharing this material that Rufi has shared the podium with another trainer. It was the first time to work with audiences larger than 25. We had to improvise to keep people engaged in the exercises, but we figured it out with as many as 100 people in the room. It was the first time to be videoed. It was also the first time to present in China. But it won't be the last.

HDI has accepted an invitation by the International Hospital Federation and Eli Lilly to return to Beijing in November, 2008 to present this workshop for TB Hospital Managers. We'll also be training trainers from 4-5 other continents so they can take this workshop back to their own countries and expand the impact it can have. The relationships that are forming may produce some other surprises for us as well. For now, we'll just go with the flow.

I'm grateful to the many supporters of HDI and to those who stayed in touch with me through this trip. The earthquake was a vivid reminder of the brevity of life and the connectedness we each have to each other around the globe. I'm glad we have an opportunity to serve in ways that can impact millions.

Preparing for China, and more

I leave for Beijing, China on Friday, May 2 for two weeks of teaching management skills to about 140 hospital managers along with HDI founder, Dr. Rufi Macagba. Our 150-page training manual is translated and ready, and so are we. This will be an opportunity to bring organizational and management skills to those working in rural hospitals where the conditions are extremely challenging and the opportunities for making a difference are palpable. We'll be doing a five-day course in Beijing first, and then traveling to a city where the leaders of an 800-bed government hospital have asked for more intensive training.

In the past two weeks, another invitation to China has emerged from an altogether different source. The International Hospital Federation (Ferney, France) has invited HDI to return to Beijing in November for a four-day management course designed for managers of TB programs throughout China. This effort is supported, in part, by a grant from Eli Lilly and Company, the global pharmaceutical manufacturer. I'll be training trainers from four other continents in addition to the Chinese managers, and the workbook will be printed in Chinese, Spanish and French.

Report from Romania

We're in Pitesti, Romania for our annual meeting of the policy-making group for the Dr. Luca Medical Center. This time we're looking at plans for building a second building to more than double our capacity for services. Last year we had 73,000 ambulatory visits and this year we're on pace for over 90,000 visits - nearing the capacity of our current 13,000 square foot building. It has been an incredible journey to see this business grow in nine years from nothing, and now the next building will be about 16,000 square feet and financed locally with collateral from internal equity. Wow!

We also spent a few days in Galati near the Danube Delta to explore ways to stimulate the development of a husband/wife primary care practice linked with a local church. We were joined by four members of a partner church from Fond du Lac, Wisconsin who commented at the conclusion of the trip that, "we would have wasted our time if [Ken/HDI] hadn't been there." There is an opportunity for a management consultant to continue in mentoring the team in Galati, so if you are interested, please reply to this blog or email me directly.

One more highlight of this trip is that a plan started to take shape for a health care management training conference in Romania. The details of time and place have yet to be determined, but there are three people from three different cities in the country who have expressed a desire to work together to make it happen. The five-day conference will help us identify and train potential mentors for future projects in Eastern Europe. HDI is on the move...

Ken