SHORT VITAE

1. SHORT VITAE • Born in Cirebon – West Java • Medical Doctor, graduated fr Univ of Indonesia • Master of Public Health: HARVARD-USA • Doctor of Science: JOHNS HOPKINS-USA • Post Doc: UNIV of MICHIGAN-USA • Current Positions: • Indonesian Public Health Assoc, President • Dept of Health Policy & Administration, Univ of Indonesia,Head • Ctr for Health Administration & Policy Studies, Univ of Indonesia,Director

2. UMMAH EXPECTATION ON ISLAMIC HOSPITALS Adang Bachtiar MD MPH DSc adang@post.harvard.edu Ctr for Health Administration & Policy Studies UNIVERSITY OF INDONESIA 2009

3. Focus of This Presentation • Competitive hospitals are based on evidences • Patient’s Expectation begins the services • Provider’s roles for nurturing patient’s expectations • Our previous study on Islamic values for hospital • Lessons learned and application of the study • Future islamic hospitals? • The winning hospitals • The important of alliances among islamic hospitals • Stepping stones

4. EVIDENCE-BASED SERVICESas tool for competition

5. Pre-services Research • It’s a part of Strategic Plan cycle • Functions: • Identify • Who is the customers • What are their need & demand • Results can be used to: • Identify SWOT factors • Develop appropriate services • Visioning (part of strategic plan)

6. In-services Evaluation • Measuring service process indicators • Provider-client interactions • Procedures compliances • Patients safety measures • Client’s perceptions on services • Client’s expectations • Client’s satisfaction

7. Post-services Evaluation • Measuring overall services indicators, including: • Satifaction level and its trend • Compliance rates & trends • Cost-effectiveness level & trends • Cost-efficiency level & trens

8. Expectations BEGIN services SEGMENTING & TARGETING

9. Patient acceptance relationships among with units within hospital Patient Acceptance Marketing Research Sensory & Health Evaluation Legal Services Hospital Rel Office Hospital Services Service Research Hospital Promotion Services Design Expectation& Safety Measures Medical Committee Process devel. HR devt & Hospital facilities Safety Control

10. 3 Components of Provider Roles Musa, Nadhoriyah As Suluk At Tandzimi min Mandhuril Islam, 1995

11. AS Suluk al-mudir(Leadership)1 • Adil (Fairness) • Qudwah hasanah (leading “walk the talk”) • Al Fahm (visioner) • Shidq (Honesty) • Amanah (Responsible) • Fathonah (Intelligent/smart) • Tabligh (Orator/Communicator) • Mu’allim (Knowledgable/transfering know-how) Madhi, Al Qiyadah Al Muatsiroh, 2002

12. AS Suluk al-mudir(Leadership)2 • Munazzim (Skillful manager) • Mubaadarah (Decisive) • Ats Tsiqoh (Creating condusive working climate, i.e trust, warm, peaceful, outcome focus) • Al ‘Udhwiyah (caring interaction, i.e to subordinates, clients etc) • At Takayyuf (empowering and participation) • Tidak Mubadzir (effective-efficient)

13. As Suluk al fardiyah(Individual behavior) • Ihlas karena Allah • Muhaasabah (Self evaluation & correction) • Honesty • Optimistic • Taubat • Tadabbur (Managing Knowledge of Allah, qouliyah/Qur’an & Hadits and qouniyah/ sciences) • Tawadhu’ (humble for Allah/rendah hati)

14. As Suluk al jama’i(Inter-individual behavior) INCLUDING PROVIDER-PATIENT RELATIONSHIP

15. Ta’awun (team work for the benefit of patient) • Amar ma’ruf nahi munkar • Empathy and caring • Obey to the leader for the sake of Allah • Khusnudzon • Not doing Ghibah • Not doing Hasad Musa, 1995; Luth, 2001, Tasmara, 1996; 2001

16. Musyawarah • Al jiddu fil ‘amal (hard work for helping others) • Patience (for solving others’ problem) • Istiqomah (continuous positive improvement) • Al Himmah Al ‘Aaliyah (high/best achievement orientation) Musa, 1995; Luth, 2001, Tasmara, 1996; 2001

17. Murroqobah (In Allah control, self control) • Honesty • Amanah (responsible) • Balance between hard work & achievement, with akhirat orientation • Ihsan (optimizing the works) Musa, 1995; Luth, 2001, Tasmara, 1996; 2001

18. Itqon (professional) • Efective and efficient • Creative • Managing new knowledge • Teamwork (amal jama’i) • Serving others with IHLAS for service excellence Musa, 1995; Luth, 2001, Tasmara, 1996; 2001

19. Study on Islamic values for hospital(3 hospitals in Jakarta, 2002) • Using 3 components provider roles, as explained before • Two stages of study: • Explorative study using qualitative approach: • Identifying construct-concept-variables-indicator of Islamic values & practices in hospital, including patient’s expectation • Confirmative study using quantitative cross sectional survey: • Diagnosing validity (construct-content-criterium) • Examining its reliability Alamsyah’s Master thesis in 2002 under direct supervision of the author

20. QUALITATIVE RESULTS

22. CONFIRMATIVE RESULTS

23. R PEARSON: 0,773 (P<0.0001) R PEARSON: 0,772 (P<0.0001) R PEARSON: 0,874 (P<0.0001)

24. Regression results • Akhlakul Islamiyah (AI): • = 11.352 + 5.767 (Indiv Behavior) + e • R2 = .927, meaning almost 93% variation of AI score is related to Indiv Behavior’s score • = 58.433 + 11.244 (Inter-Indiv behavior) + e • R2 = .843, meaning 84% variation of AI score is related to Inter-Individual Behavior/Client’s expectation • = 71.761 + 6.374 (Leadership) + e • R2 = .812, meaning 81% variation of AI score is related to leadership’s score

25. APPLICATIONS TO ISLAMIC HOSPITALS

26. THE CHALLENGES1 • Globalization with all its impacts • Negatives: • Disparity among poor and rich countries. Worsening accesibility for the poor and rich patient migration to “rich countries” • Increasing dependability to rich countries, which reducing local wisdom (deteriorating islamic values in health services) • Poor countries as dumping (health) products, including communicated diseases

27. THE CHALLENGES2 • Globalization with all its impacts • Negatives: • Brain drain of skillful professionals • Bioterorism/bio-security situations implicate new burden for hospital/laboratory services • Hedonistic-consumptive socialities implicate expanding hospital services to strengthen family values and resilience

28. THE OPPORTUNITIES1 • Positive impact to globalization: • Expansion of Healthcare business provide greater health technology with more technical efficiency consideration • Global healthcare standarization and quality brings new perpective to the local hospital • Greater accesibility (with more cost effective) to capital , technology and professional market

29. THE OPPORTUNITIES2 • Positive impact o globalization: • Greater competition pushes alliances & benchmarking • Global village for information, expertise and knowledeges need specific skills for hospital leaders to Kowledge Management paradigm • Choices for consumers bring greater competition. Franchising and internalization probably the answer

30. THE OPPORTUNITIES3 • Positive impact o globalization: • Democratization and customer voice need new orientation for hospital accountability in (also) the consumer and more transparancies • Counter response to globalization: strengthened local wisdom

31. Regionalization as ONE answer Standarization of guidelines; procedures in region ASEAN regulation harmonization ASEAN Single Market

32. 12 Priority Sectors for Integration Agro-based products Air-travel Automotive E-ASEAN Electronics Fisheries Healthcare Rubber-based products Textiles & apparels Tourism Wood-based products Logistics services JnJ,2008

33. Single Market & Production Base • Free flow of goods : • ASEAN Single Window by 2008/2012 • CSDT for Medical Device by 2010 • Post Marketing Alert System • Free flow of service : • 51% foreign equity participation for 4 priority service sectors & 49% for logistics (2008); 70% foreign equity participation for 4 priority service sectors. • MRAs for architectural, accountancy, …, medical & dental practitioners & other professional services (until 2012) JnJ,2008

34. Single Market & Production Base • Free flow of investment : • ASEAN Comprehensive Investment Agreement • Investment facilitation • Free flow of capital : • Tax structure to promote broader investor base in ASEAN debt issuance • Free flow of skilled labor: • Enhance cooperation among ASEAN University Network to increase mobility of students & staffs • MRAs in major professional services by 2008 JnJ,2008

35. Integration into Global Economyto strengthen regionalization PRC FA 2002 FTA (excl CLMV) 2009 FTA (incl CLMV) 2014 Korea FA 2004 FTA (excl CLMV) 2009 FTA (incl CLMV) 2014 Japan FA 2003 FTA (excl CLMV) 2012 FTA (incl CLMV) 2015 INDIA FA 2003 FTA (excl CLMV) 2011 FTA (incl CLMV) 2016 AFTA (excl CLMV) more or less completed AFTA (incl. CLMV) 2010 AEC 2015 Australia, NZ FA 2004 FTA 2015 ADB,2008

36. FUTURE ISLAMIC HOSPITALS?AS THE CONSEQUNCES

37. VISIONINGTHE HOSPITALS EFFECTIVE-EFICIENT HI QUALITY-SUSTAINABLE SERVICES TRANSPARANCIES ACCOUNTABILITY HEALTH PROTECTION HOSPITAL CAPACITATION FAMILY & PATIENT EMPOWERMENT HOSPITAL CONTEXTUALS

38. Dynamic Contextualities need.. Glorecalization Approach Strategy Tactic Value Strategy Tactic Value Global Hospitals values GLOBAL Strategi es Within regional REGIONAL LOCAL Operations Fill local needs

39. Glorecalization with Islamic values NOT DOING MUBADZIR Optimizing Professional Staffing Customer & Safety Orientation ISLAMIC HOSPITALS

40. THE WINNINGHOSPITALS?

41. PEOPLE CENTRED PARADOX PERSPECTIVE PARADIGM PASSION PERSUASION

42. Dimension-1PARADOX • “First of something” • Creative solution for old problems (excellence among the crowd) • Managing problem(s) for effective chain effect not only for hospital/health interest • Solution for political and social image

43. Competitive Advantage In Marketing Jargon Brand Loyalty Name Awareness Brand Equity Perceived Quality Brand Assets Cognitive Associations

44. Dimension-2PERSPECTIVE • Each solution clearly define for the benefit of patient, family dan the community • Transfering effectively tacit knowledge to embedded procedures and hospital product

45. KNOWLEDGE MGMT Knowledge Base • Embedded • Knowledge • Products • Processes Codification Knowledge Absorption Learn Ideas Rapid Conversion Tacit Knowledge Insights Explicit Knowledge Knowledge Creation

46. Dimension-3 PASSION • Hospitals need to grow: • Enthusiasm to achieve result (ihsan) • Shared vision • Effective communication with caring • Obsession to improve anything (quality obession) • Hospital ownership among the staff • Invovle hospital community, especially patient& his/her family to (self) help (empowering)

47. Dimension-4 PERSUASION • Creative approaches among critical stakeholders for: • Establishing shared values • Stimulating creativity of the beautiul minds • Differentiating issues for unique solution • Conducive environment for teaming the works • Motivating staff for learning from day-to-day experiences (value added) • Commitment to achieve best health interest

48. SOFT SKILLS HOSPITAL PEOPLE Learn fr the best (no Hasad)1) Fast moving creativity5) Flourishing innovation Quick Problem-Solving 6) Customer orientation culture Long life Learn & Amal2) SUSTAINABLE ISLAMIC HOSPITAL Comprehensive understanding Share with others (Ihlas) 3) Effective teamwork for solutions 7) Understanding & supporting colleagues4) Eff-Eff not doing mubadzir (7) Performance orientation Hati yg bersih Aktualisasi Kelompok Aktualisasi Organisasi 1) QS 2:10; 18:66 2) QS 18:75; 9:122 3) QS 2:146; 4:37 4) QS 58:11; 7:199 5) QS 7:181 6) QS 17:36 ; 22:8 7) QS 37:165 8) QS 2:267 Bachtiar, 2008

49. Dimension-5 PARADIGM • Developing specific paradigm: • Packaging the services appropriate to the needs and demand of • Strategic hospital positioning • Community and patients • Shareholders • Local leaders • Regional leaders (Global standarization and harmonization, i.e. Asean Charter for Health Services)

50. ALLIANCES as requirement