Interview with Bernadette Murray, the MBA director, The Academy of Health Care Education is the Education Division of the Academy of Medical Laboratory Science

You are the director of Director of MBA in Healthcare Programme at AMLS. What does a nurse require to join this programme? 

This MBA in Health Care Management is opened to those who hold a level 8 qualification on the Irish National Qualifications Framework and who have 5 years post qualification experience.  Nurses may also enter through recognition of Prior Experiential learning where their substantial experience is recognised as an entry requirement.

The MBA in Health Care Management is a Level 9 programme on the National Framework of Qualifications and accredited by the Higher Education and Training Awards Council. 

You have a background in continuous professional health care management education and have successfully worked with numerous professionals seeking to get into healthcare management. What are the main challenges that they face in this move? 

The MBA in Health Care Management synchronises two streams of learning - business and health care.  Many health care professionals have considerable expertise and knowledge of the health care stream, especially in their own sector. The language of business is often a challenge for nurses, midwives and other health care professionals.  The first challenge for nurses and midwives is to move from localised health care thinking that is applicable to their sector into strategic thinking that is applicable to the wider health care environment. The second challenge is to harmonize business and health care models of practice.  

Healthcare management has become more common in the last few years. What does it involve/entail? 

Traditionally, when one had an expertise in their profession of origin, there was a view that that skill was transferable into a management role. However, health care management is a profession with a competence level unique to that position.

Where traditionally, functional competence (i.e. the ability to carry out a task) was considered to be the most important competence, healthcare management requires a broader competence range.

Health Care managers need high levels of Personal Competence (the ability to manage themselves), Interpersonal Competence (the ability to manage others), Informational Competence (the ability to communicate in different ways) Actional Competence (the ability to carry out and complete tasks), Functional Competence (the ability to apply business thinking to health care management).

The MBA in Health Care Management offered by the AMLS provides an interactive learning experience where health care professionals enhance their competences in each of these areas.  In the key assessment tool of this MBA, the participant produces a journal of competence based on their experience of integrating business and health care principles into their day-to-day practice.

From your own experience, why should a nurse/midwife want a course in healthcare management?

Nurses/midwives who wish to advance into leadership or management roles will take an MBA in Health Care Management to widen and deepen their knowledge, skill and competence on managing people and sectors. To quote from one of our learners (this quote is used in our brochure and given by a person who since was promoted to a very senior management position within his profession):

“This MBA has empowered me to think beyond the obvious and to look at every situation from a number of angles.  I have emerged from the course with the skills to deconstruct and analyse complex issues and to arrive at practical, reasoned solutions to Health Care challenges”   Moving into a management position is not about turning up for work the day of appointment. It is about growing into the role. The Academy’s MBA is structured in such a way that allows for learners to have the best opportunity of gaining skills.    I have watched MBA groups perform under pressure to meet targets and deadlines. I have seen them carry out really valuable work with findings that many senior Academics felt should be incorporated into publishable academic papers. I have witnessed groups working with the different lecturers and Health Care professionals, debating cutting edge management theories and their applicability to current needs of the Health Service.  Most of all, I have seen groups who develop very close links with their colleagues that supports them in their new management roles.    

What positions are available in health care management? 

The hierarchical model of management that has been the traditional structure within health care is changing. Local managed sites and units often see specialised personnel from within the area of specialism moving into management positions.  

• 90% of those who were conferred with the MBA in Health Care Management last October were at a grade of senior or higher at the beginning of the programme.
• 50% of the group was promoted to higher management positions during the term of the programme or in the three months after completion of the programme.  

In your opinion, what characteristics should an applicant have to succeed in management position?

The ability to think on strategic and operational levels is important for those in management positions.  Strategically, the manager must have a long-term view, while managing operations in the short term. 

Managers do not work in isolation; they are part of a team and report to a larger team. This requires the ability to work well with people in a constructive way where positional power of the manager translates into empowerment of the team and its members, while at the same time having a confidence and competence to work with managers from other units and sectors.

Critical analysis and self-reflection enables the manager to deconstruct personal, interpersonal and operational issues in a proactive and professional manner.  This enables the manager to reflect on action and in action in a structured format that supports the manager in working through managerial events.

Would you say that a nurse or midwife considering a position in health care management is considering a career change or is it a career development?  

In my opinion, it is a career development.  The key word in this is development.  The nurse/midwife who moves into management is not closing a door to the wealth of experience of their area of specialism, but using that skill in understanding structures, people and patients.  Grafted onto this area of expertise are managerial skills thus giving a rounded competent manager who manages effectively. 

What would you recommend to a nurse or midwife who is thinking of getting into management career?  

A nurse/midwife should think deeply about moving into a management role.  There are many benefits to taking on this role and also challenges.   The benefit is that the nurse/midwife as manager has the opportunity to make a difference but may also be challenged in the endeavour to make that difference.   The nurse/midwife should reflect on the management role that will require them to:

• Observe how things are working in an objective way;
• To be patient and considerate of others and to lead by example;
• To be available and serve the team so that in turn the team will be available and serve the manager.  

The greatest challenge for the nurse/midwife moving into the management role is the change in identity. Moving from a group who are at one level on the scale to managing that same group, can leave the new manager with feelings of isolation and confusion.

• Isolation because the manager now has to deal with issues that previously were sent “up the line”. 
• Confusion because it can be daunting when previous colleagues wish to discuss issues and the new manager is expected to abstain from this discussion.  

Another challenge is where the nurse/midwife moves from a “hands on work” in dealing with patients to management work etc.  There is a challenge where team members and others look to the managers to find solutions.   Managers are expected to be organised, structured and meet targets; to deal fairly with staff and patients  

How could one overcome these challenges?

My recommendation is to take a programme on management that does more than just present theoretical structures of management, but rather gives the nurse or midwife the opportunity to engage in in-depth and effective dialogue with other health care professionals. The MBA in Health Care Management offered by the AMLS is one such programme.  This will enhance the skills of the N/M and also give them an understanding of other health care units.  

How can one become a successful manager? 

“Competent Managers are those who are able to manage because they know what to do, they have the required skills or behaviour to manage, and they believe it is right to do so”The Office of Health Management. In the Academy’s MBA in Health Care Management, five domains of competence developed within the programme: See diagram:

Personal Competence

• Managing Self internally
• Managing self externally
• Conceptual Thinking
• Strategic thinking
• Ethics and social Responsibility 

Interpersonal Competence

• Leading and empowering individuals
• Leading and empowering groups
• Understanding cultural difference
• Leading a health care sector
• Linking the health care service 

Informational Competence

• Communicating with individual groups
• Managing communication processes of individuals and groups
• Information literacy and research competence
• Written literacy
• Technology literacy

Actional Competence

• Administering
• Planning
• Prioritising
• Organising
• Implementing 

Functional Competence

• Economic trends in health care
• Financial management in health care
• Health care needs and analysis
• Organisational knowledge
• Patient and service knowledge. 

What other courses does at Academy of Health Care Education offer?

The Academy of Health Care Education is the education section of the Academy of Medical Laboratory Science (www.amls.ie ). We offer the following programmes: 

• MBA in Health Care Management
• Higher Diploma in Training and Quality Management
• Other specialised programmes for Medical Scientists  

What advice would you give a nurse or midwife who is contemplating joining one of the programmes offered by Academy of Health Care Education?  

Any person who is interested in taking the MBA in Health Care Management or Higher Diploma in Training and Quality Management should contact Ber Murray, M.Ed., BCL, BA, HDEA at bbm@eircom.net or directly to the Academy Office at 31 Old Kilmainham Dublin 8.