gms | German Medical Science

Health care systems around the world are under pressure to adapt to rapid change and development of scientific and technical innovations, legal regulations, global competition, and cost efficiency. Hospitals in particular face these challenges. In Germany, hospital organisation is based traditionally on the three columns medical service, nursing, and administration. Each of them developed its own complex expertise and contributes to the overall performance. There is, however, yet no professional cross-functional management to coordinate the whole and to take into account the interdependence of individual optimization measures. Most needed are management skills, which rely on factual knowledge of all three functionalities, their key success factors, and bottlenecks – enhancing communication and co-operation between them.

So far, medical doctors with their complex and challenging professional qualification to medical experts have no capacity to engage additionally in administrative and technical management of a hospital; the same is true for the operating officers of the nursing and technical services.

A contribution to the solution of this dilemma, a hybrid qualification model for future clinical management assistants was designed and tested by the authors. So far, an established function within the medical service line to assist physicians in Germany is the medico-technical assistant (MTA). Her/his qualification is in the responsibility of authorised clinical schools, leading to a state acknowledged professional degree (MTA) after a three years course (4,400 hrs of training), consisting of both profound theoretical education and practical training within medical institutions. The main qualification fields are basics in medical science (mathematics, chemistry and biochemistry, physics, biology, statistics, anatomy, physiology/pathophysiology, psychology, immunology, histology, haematology, microbiology) plus applied skills such as hygiene, use of data processing systems in medicine, legal obligations, first aid and clinical analysis incorporating the use and functionality of corresponding equipment, added up by internships in histology, clinical analysis, haematology and microbiology (alternative to the clinical analysis path a radiology specialisation can be chosen).

After the first year high potential students of this course have the chance with thorough assessment and career mentoring to enrol in a three and a half year Bachelor course in business administration at Provadis School of Management and Technology, University of Applied Science in Frankfurt. This curriculum is integrated into the university’s programmes and covers the theoretical knowledge needed to run a project, business, or department in the health care sector. Within various elective modules, including their thesis, the students can focus their general economic and management know how on cost and risk management, fulfilment of patient requirements, handling of insurance prerogatives, facility management and similar in the health care sector.

With support of the hospital general management, these medico-technical assistants will have the challenge to network the inter-phases between the classical functionalities, identify improvement potentials and to exculpate physicians, nurses, and administration alike.

It is hoped that this ambitious qualification model can comply with the Bologna aims of professional education in the health care sector and will contribute substantially on an operative level to an optimised patient care in Germany.