Master of Science (M.Sc.) in Health Services Management

Programme Content – Year 2

Year Two comprises of four key modules: Health Policy (5 credits), Strategic Management (10 credits), Comparative Healthcare (5 credits), and Research Methods and Healthcare Ethics (10 credits). Strategic Management constitutes a broad cluster of six sub-modules ranging from Organisation Theory to Risk Management, and also incorporates the Guest Lecture Series at the end of the academic year. Comparative Healthcare is another broad module which consists of four sub-modules.
Descriptions of each of the modules are provided below.

Health Policy

This module explores the nature of public policy and the environment in which it is practised.  It provides frameworks, processes and techniques for public policy formation. Interpretation and implementation of public policy in health and social services are examined.  Implementation of policy for the health services is explored at the macro and micro levels.

By the end of the module, students should:

• Understand the critical success factors as well as the barriers for the formulation and implementation of public policy in health and social care.
• Develop a policy framework that takes into account all the key relevant issues for topics that have been the subject of continuing policy debate.
• Design an approach as to how policy could be formulated, drawing on different policy development theories and models, and formulate a policy statement that helps ensure the actual policy developed will be comprehensive and well-founded.

Strategic Management

This broad module introduces students to key concepts, contemporary models and techniques for strategic management.  Lectures and case studies on organisation theory, strategic planning, change management, quality management, operations management and risk management are included. It aims to help students develop a clear understanding of the dynamics of the healthcare environment and the importance of a partnership approach amongst healthcare agencies. It provides managers with the tools to analyse change and develop effective strategies for managing in a rapidly changing healthcare environment. 

This broad module, through the presentation of models and case studies, aims to increase students ' ability to manage strategically. Students will be given a project on a subject relevant to the health service and will be expected to present their understanding of the various concepts and learning by way of oral/visual presentation. They will be expected to defend their conclusions and recommendations as part of the presentation of the project.

By the end of this broad module, students should:

• Understand the various management models that have been developed and the key issues featured in these models.
• Know the tools for analysis of organisational situations requiring strategic thinking and understand the benefits and drawbacks of each.
• Understand the main differences in managing strategically between the public and private sectors.
• Take a view of management that is beyond the day to day activities of their own work situation, and develop a wider perspective of  the overall framework of the service. 
• Apply the basic principles of strategic management to their own situation, drawing on the body of knowledge built up across the broad module.

The descriptions for each individual sub-module under Strategic Management are given below:

Organisation Theory

This sub-module offers an introduction to organisation theory using metaphors of organisation as vehicles for understanding theories and conducting organisational analysis.  The course places emphasis on applying organisation theory and conducting organisational analysis with reference to your own organisational experience.  Therefore, throughout the course students will be asked to relate course content to organisational contexts in which they are or have been a stakeholder. Students will also be asked to conduct a case analysis, the first case will be drawn from the third sector and the second will be from a health services setting.  At the end of the course, students will be asked to reflect on applications of organisation theory in their own organisation settings.

By the end of this sub-module, students should be able to:

• Identify and explain the contributions of the major ‘schools of thought’ in organisation theory.
• Use metaphors as tools to illustrate major schools of thought in organisation theory.
• Apply theories of organisation to analyse their own organisational experiences.

Strategic Planning

This sub-module introduces students to the concept of planning.  Through the use of real examples of health planning initiatives it familiarises the student with the context, content and process of planning.  The impact of the political environment, the necessity to involve actors and stakeholders beyond the health sector, and the importance of preparing in advance for public reaction to health plans are some of the issues covered in this module.

By the end of this sub-module, students should:

• Gain an understanding of the critical steps in any successful planning process.
• Become familiar with a number of planning tools and processes.
• Gain competence in the critical analysis of strategic plans.

Change Management

This sub-module will involve a study of the various models for the management of change and the identification of the key issues featured in these models. Students will be introduced to seminal case studies on change management in the health system and they will be asked to examine the strengths and weaknesses of the various models in managing change in practice.

By the end of this sub-module, students should:

• Understand the various approaches and strategies involved in the management of change.
• Develop the ability to differentiate between the various types of change and understand the particular difficulties involved in complex large scale change.
• Apply the basic principles of strategic change to their own situation and be competent enough to utilise the body of knowledge provided should they wish to lead or be part of a change initiative in their own area of activity

Quality Management

This sub-module is designed to enable students to obtain an insight into both the theory and practice of quality management for health and social services in Ireland. It covers models of quality management and the metrics by which service quality could be measured for healthcare users across the private, public, and voluntary sectors. Students will be given an overview of national and international frameworks of quality in healthcare and their implementation locally in Ireland, and will explore case studies of organisations which have undergone quality accreditation and improvement processes.

By the end of this sub-module, students should:

• Understand how the concept of quality has evolved over time and how it can be measured and evaluated in the context of healthcare. 
• Understand the legislative and socioeconomic frameworks within which quality accreditation operates in the Irish healthcare sector.
• Apply the insights of quality management to the organisation and delivery of their own services.

Risk Management

This sub-module covers the Risk Management Programme in healthcare, including the sources for the identification of risk, risk analysis, management, monitoring and control of risk, and relates this to other industries/organisations. It introduces students to the developments nationally and internationally around the management of risk in healthcare, and covers the meaning of the term “Integrated Risk Management”, the benefits of case reviews and the different levels of review including the principles of completing a RCA or system analysis.

By the end of this sub-module, students should:

• Understand “Integrated Risk Management” and how it can be managed corporately within an organisation.
• Gain an understanding of a reporting and learning culture supported through Incident Reporting, Incident Review, Clinical Audit, Peer Review, etc., and develop a recognition for the need to measure risk and the use of risk registers.
• Grasp the challenges to introducing a Risk Management Programme in an organisation and understand the role of a Risk Manager in Healthcare.

Comparative Healthcare

This broad module compares the health systems of four countries – Canada, Germany, Finland and Ireland – which provide an interesting range and mix of approaches to healthcare. At the same time, they have sufficient in common for participants to be able to understand the systems without too great a difficulty. In designing this course, we have attempted to structure it around four sub-modules, each with a particular emphasis or theme:

Module 1

Introduces the concept of Comparative Analysis and participants will learn about the basic structure and health status in the other three countries.

Module 2

Deals with Financing Health Care with an emphasis on cost containment and quality management.

Module 3

Considers Delivery of Care issues: Two topics are explored, integrated services and care for older persons.

Module 4

Addresses Health Care Reform: with the focus on trends in healthcare reform in each of the countries in the past few years.

Although this broad module does not cover all possible topics concerning national healthcare systems, we believe that, by addressing these particular themes and topics, participants will, at the end of the four-month period, have achieved a substantial grasp of comparative health care issues.

We believe that the best way in which students can learn is to share their views with their colleagues from other countries. The Internet provides a useful tool to help students to learn from each other. This e-learning course will enable students to work on joint papers, debate issues, argue their case and critically analyse the arguments made by their counterparts in other countries.

By the end of this broad module, students should:

• Develop an understanding of the healthcare systems of the participating countries, and a deeper understanding of their own health system.
• Gain new insights into the management of healthcare and innovations in other countries that could be applied in Ireland.
• Network with their peers from other countries, helping to develop an in-depth understanding of the major challenges and dilemmas facing the health systems in each of the four countries.

Research Methods - Part 2

Part 2 of the Research Methods module focuses on the refinement and execution of the research proposal that the students have developed at the end of Part 1 of the course. This second module is tailored to the students’ chosen research designs for their M.Sc. dissertations. Students are asked to submit a literature review assignment which they work on during the summer period, on the basis of which they will be supported to develop a refined research plan. The class is divided into specific research design groups for hands-on workshop sessions, in order to equip students with practical research skills to fulfil the research component of the programme. The practice of research methods, both quantitative and qualitative, will be covered, along with the use of specific software packages.

Special sessions on research ethics, delivered jointly with the Ethics lecturer for the programme, will assist students in applying for ethical approval from both university and local research ethics committees. Students are expected to participate in group and class discussions throughout the course. They are also required to report on their research progress by means of class presentations towards the end of the course, and guidance is also given on the writing of dissertations.

By the end of the module, students should:

• Appreciate the strengths and weaknesses of various health systems research methodologies in answering different research questions.
• Be able to design research projects and manage them from conception through to completion.
• Develop competencies in specific data collection and analysis methods.
• Understand the value of research in the context of organising and managing health systems.

Healthcare Ethics

This module explores the ethical issues which health service managers need to consider when developing health care policy.  While consideration is given to core medical ethical principles such as "respect for autonomy", "beneficence" and "justice"; the different moral philosophies of teleology, egoism, utilitarianism, deontology and relativism are also explored so as to ascertain their influence on ethical decision-making.  Some of the key ethical questions such as "informed consent", "resource allocation", "confidentiality", "non-resuscitation orders" etc. are also explored.  In the section on resource allocation, reference is made to the report on "Quality Adjusted Life Years" (QALY) - an investigation of the ethical implications of measuring the quality of life applicable to a range of diseases and health states for use in the allocation of resources in prevention, diagnosis and treatment.  This module also examines the present state of Research and Clinical Ethics Committees in Ireland and their future development.  It explains how a Clinical Ethics Committee is set-up in a healthcare system and how it operates at the level of planning and policy development.

By the end of the module, students should:

• Understand core medical ethical principles and appreciate how they inform the key ethical questions relevant to healthcare
• Understand the system of research and clinical ethical review and governance in Ireland.

M.Sc. Health Services Management at TCD: Guest Lecture Series

A highlight of the M.Sc. programme is the Guest Lecture Series, which takes place at the end of the academic year. Here we bring together leading policy-makers, various subject matter experts and practitioners in the field to give talks on a topical health system issue, to generate discussions and reflections about the topic from multiple perspectives. The guest lecture series is designed by the Course Director in collaboration with students in the Second Year of the programme. All students from both years of the programme are invited to attend these lectures.