2. Hospital Asset Strategic Plans NSW

Introduction

I was engaged by New South Wales Health and Public Works to develop methodologies and tools for Area Health Service Asset Strategic Planning in the context of the NSW Health’s development processes. In this context, an Asset Strategic Plan (ASP) is prepared to capitalise the accepted Strategic Clinical Services Delivery Plan. Following ASP approval, are various Project Plans, each of which has embedded other plans such as Procurement Plan, Work-force Plan, Surplus Asset Disposal Plan, Construction Plan, Maintenance Plan and so forth.

To ground my assignment in reality, I was to work with the respective management teams of the Lower North Coast and Wentworth Area Health Services.

Some short-comings of current hospital planning processes are:

• They are linear, partitioned, command driven, complex and inefficient whereas they should be heuristic, evaluative, iterative integrated, consensus partnerships and efficient;

• service delivery plans are neither resourced nor subjected to comparative cost effectiveness appraisal before promulgation;

• planning operates within the boundaries of the current dysfunctional service delivery structures when it should cross boundaries to ensure a functional infrastructure;

• critical decisions are made on the basis of inadequate information and frequently fail;

• there is insufficient monitoring and evaluation of the performance of existing infrastructures;

• cost shifting is common

• the process is more focused on the subset of costs to the particular health service than to the total costs and economics of providing health care to the community;

• the quality of service delivery receives scant treatment in cost-effectiveness appraisals;

• insufficient resources are devoted to planning despite large efficiency returns.

Project objectives were to

• present programs plans and budgets for the development of service-infrastructures resolving and satisfying the needs of both the communities and service providers;

• develop processes and tools which

• enable integrated service-infrastructure programming planning and budgeting;

• provide requisite information to decision makers

• enable monitoring and evaluation of existing service-facility performance;

• enable cost effectiveness evaluation to include qualitative factors;

• increases the efficiency of planning enabling a wider compass

Products of the engagement are described in the following pages. Reports included :

A simple effective model of the health infrastructure development process