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Title: Developing strategy in complex hospital settings
Keywords: Planning and programming
Country: Morocco
Institution: Morocco - École Nationale de Santé Publique
Course coordinator: Dr. Zakaria Belrhiti
Date start: 2021-04-20
Date end: 2021-05-08
About duration and dates: 3 weeks (Face to face 50 % and 50% eLearning using asynchronous sessions)
Classification: advanced optional
Mode of delivery: Blended-learning
Course location: Ecole Nationale de Santé Publique, Rabat, Morocco
ECTS credit points: 4 ECTS credits
SIT: 56 contact hours + 70 self-study hours = 126 hours SIT
Language: French
Description: At the end of the course the participants should be able to:
1. Develop a comprehensive understanding of strategic management in hospitals
2. Adopt a systemic approach in assessing organisational performance
3. Map hospital key contextual conditions and major stakeholders
4. Analyse hospital operational management functions
5. Assess the organisational culture
6. Adopt a systemic approach in problem and solution analysis
7. Formulate and operationalize valid and coherent strategic plans
Assessment Procedures: Assessing strategic capacities
Assessment will be based on an individual written assignment and an oral presentation of the strategic analysis. Each participant needs to develop a strategic note describing the context and organisational analysis as well as the strategic key scenarios.

The participant will also need to present his strategic analysis to a jury composed by the pedagogical committee of the course.

The assessment covers the following key competencies:

1. Contextual analysis

● Assessing current PESTEL (Political, Ecological, Sociological, Technological, Ecological and legal) contextual patterns.

● Identifying key stakeholders.

2. Hospital performance analysis

Assessing three hospital functions [ health service delivery, operational management )

3. Organisational culture assessment

4. Strategic synthesis

Using appropriate framework to synthesise key strengths, weaknesses, opportunities and threads

5. Strategy formulation

Listing key strategic problems and potential solutions and formulating sound and valid strategic scenarios

Scoring weight and evaluation criteria

Students will prepare a document entitled “strategic note” that will synthesise the above-mentioned strategic analysis steps. He will need also to present a 15 min oral presentation about the key components of his strategic analysis

The assessment of the short presentation has a weight of 40% and the document of 60%.

Students will get short feedback
● From the course leader on draft versions of the document and presentation during coaching sessions

● From a jury composed by the course leader and selected staff members on the short presentation and the document

An assessment grid will be used for marking assessment and providing feedback to participants.
Assessment criteria include :
- The quality and comprehensiveness of the analysis
- The coherence of strategic analysis
- The quality of the evidence and argumentation used to inform the analysis
- The overall quality of the report

Re-sit sessions

Participants who did not obtain the pass mark of 50% (10/20) for the overall assessment mark for the module in the first assessment session, get the possibility to present a revised version of the assignment(s) in a second (re-sit) session.
Content: The course content will be organised in 5 blocks:
1. Introduction to hospital strategic management (20 SIT)
2. Contextual analysis (20 SIT)
3. Health service provision analysis (22 SIT)
4. Internal organisational analysis (22 SIT)
5. Assessing hospital operational management functions (20 SIT)
6. Strategy formulation (22 SIT)

The content of the course is divided in 5 interconnected blocks that cover the hospital strategic management capacities using a multidimensional performance framework.

The course focuses on the use of systemic perspective in strategic and organisational performance analysis.

During the first block, an overall introduction to the strategic management in health systems, the difference between strategic planning and strategic management, emergent versus deliberative strategies. A special attention will be paid to the use of a multidimensional performance analysis framework adapted to the analysis of healthcare organisation performance in low- and middle-income countries (namely the (the Multipolar Framework : adapted version of the EGGIPS framework (Marchal,2014)

The second block aims to enable participants to analyse the contextual patterns that hinders the performance of hospitals using tools such as political economic sociological trends as well as the identifying the power and interest of specific hospital stakeholders.

The third block seeks to help participants understand the key determinants of health service delivery capacity including the volume, cost and quality of care. It aimed at showing the importance of analysing the organisation of health service delivery, planning, coordination and integration of care.

The fourth block will introduce students to the toolbox to perform analysis of the organisational culture and climate of the hospital and understand how different organisational cultures might influence individual, team, and organisational performance.

The fifth block will address the operational management capacities need to ensure adequate health service delivery. This includes ability such as assessing human resources management, financial and logistic hospital management. This block includes hand on tools that allow the participants to use comprehensive checklist to analyse key strategic hospital capacities.

The sixth block will help student synthesise key strategic problems and suggest potential coherent solutions in the form of strategic axis. This block will put emphasis on how to provide accurate and sound strategic solutions and translate them into operational terms (drafting a five year hospital operational)

In summary, this course aimed to fostering the critical analysis capacities of students and to help them identify the key organisational performance drivers and craft coherent strategies within hospital settings.
Methods: During this course, I use interactive teaching and lectures (A total of 50 contact hours in addition to the three coaching sessions (6hrs).

Concepts and toolbox will be introduced to students with short and focused lectures, videos, or classroom discussion. These learning methods will allow student to demonstrate good understanding of strategic management in hospitals.

Practical exercises based on case studies, virtual forum discussion, and experiential learning through group resolution of case studies and personal work related to the analysis of the participant own hospital performance will allow them to practical hand on knowledge about how to apply the different taught toolbox to formulate a sound hospital strategy.

Students will benefit also from asynchronous lectures and videos as well as illustrations from real world hospital strategic plans as well collaborative group work oriented toward the resolution of specific cases studies inspired from real hospital settings to foster the students’ critical analysis capacities.

At the end of block 3, 4 and 6 we will organise three coaching sessions (2 hours each) that will allow students to get feedback from lecturers on their progression and critical analysis.

Self-study (70 hours) are needed to complete the required learning outputs (strategic note, resolving case studies, preparing for the strategic analysis communication, additional reading) .
Prerequisites: Academic degree
Applicants must hold a university degree of minimum 4 years equivalent to 240 ECTS (referred to as a Master’s degree in the European Union) in medicine or health sciences.

Applicants need at least some (1 year) cumulative experience as health manager, professional, clinician or researcher in hospital related settings.

Language proficiency

French version : Native speakers are exempt from proof of language proficiency.
For non-native French speakers, at least upper intermediate B2 level (CEFRL) is required.

English version: proof of English proficiency will be required for non-native English speakers, if relevant we might need proof of English proficiency (Toefl 88 internet version or IELTS 6.5 or equivalent)
Native English speakers and students who hold an English education diploma are exempt from these tests.
No additional language requirement is needed.

Additional admission requirement:
1 year cumulative experience in hospital related settings
Attendance: Min 15-max.25 students
Selection: Selection criteria
● 1 year cumulative professional experience in hospital related settings
● Motivation
● References
● A degree of master’s in public health or equivalent is an asset
Fees: For 2021 course: 5500 Moroccan Dirhams
Scholarships: None available
tropEd accreditation: First submission Online GA October 2020 cat 2; EC Telco 12 November 2020: cat 2; EC Telco 08.12.2020: cat 1.
Remarks: Key Didactic References:

Belrhiti Z, Damme Wv, Belalia A, Marchal B. Does Public Service Motivation Matter In Moroccan Public Hospitals? A Multiple Embedded Case Study . International Journal For Equity In Health. 2019;18.

Belrhiti Z, Nebot Geralt A, Marchal B. Complex Leadership In Healthcare: A Scoping Review. International Journal Of Health Policy And Management. 2018;7:1073-84.

Belrhiti Z, Van Damme W, Belalia A, Marchal B. The Effect Of Leadership On Public Service Motivation: A Multiple Embedded Case Study In Morocco. Bmj Open 2020;10.

Belrhiti Z, Van Damme W, Belalia A, Marchal B. Unravelling The Role Of Leadership In Motivation And Performance Of Health Workers In A Moroccan Public Hospital: A Realist Evaluation Bmj Open. 2020;10.

Champagne, F., Contandriopoulos, A. P., Picot-Touché, J., Béland, F. & Nguyen, H. (2005) Un Cadre D'évaluation De La Performance Des Systèmes De Services De Santé: Le Modèle Egipps. Résumé Du Rapport Technique. Montréal, Groupe De Recherche Interdisciplinaire En Santé. Secteur Santé Publique. Faculté De Médecine. Université De Montréal.

Henry Mintzberg, Bruce Ahlstrand & Lampel, J. 1998. Strategy Safari : A Guided Tourthrough The Wilds Of Strategic Management, The Free Press.

Marchal, B., Hoerée, T., Silveira, V. C. D., Belle, S. V., Prashanth, N. S. & Kegels, G. 2014b. Building On The Egipps Performance Assessment :The Multipolar Framework As Heuristic To Tackle The Complexity Of Performance Of Public Service Oriented Health Care Organisation. Bmc Public Health, 14, 1-11.

Mintzberg, H. 1989. The Structuring Of Organizations. Readings In Strategic Management. Springer.

Stacey, R. D. 2007. Strategic Management And Organisational Dynamics: The Challenge Of Complexity To Ways Of Thinking About Organisations, Pearson Education.

Sicotte, C., Champagne, F., Contandriopoulos, A. P., Barnsley, J., Beland, F., Leggat, S. G., Denis, J. L., Bilodeau, H., Langley, A., Bremond, M. & Baker, G. R. (1998) A Conceptual Framework For The Analysis Of Health Care Organizations' Performance. Health Serv Manag Res, 11, 24-41; Discussion 41-8.
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Date Of Record Creation: 2020-12-10 07:28:05 (W3C-DTF)
Date Of Record Release: 2020-12-10 13:38:35 (W3C-DTF)
Date Record Checked: 2020-12-10 (W3C-DTF)
Date Last Modified: 2021-11-21 19:42:15 (W3C-DTF)

Fifteen years of the tropEd Masters in International Health programme: what has it delivered? Results of an alumni survey of masters students in international health

L. Gerstel1, P. A. C. Zwanikken1, A. Hoffman2, C. Diederichs3, M. Borchert3 and B. Peterhans2

1 Royal Tropical Institute, Amsterdam, The Netherlands
2 Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
3 Institute of Tropical Medicine and International Health, Charite – Universit€atsmedizin Berlin, Berlin, Germany