Managing Quality in Patient Care

"I don't just do things, but analyze how they can be done more effectively" is how Nadine Nölte describes her tasks in a private Rehabilitation Company.

Nadine Nölte

  • International student from Germany
  • Master candidate in Health Economics, Policy and Management
  • Year of graduation: autumn 2008.
  • Occupation: Executive Assistant in a privately held Rehabilitation company, North Germany.

What you do in your current job?

I am working as an Executive Assistant in a privately held company with 5 Rehabilitation Clinics for neurologic, orthopedic, psychosomatic, cardiologic, dermatologic, pneumologic and pediatric diseases, ambulatory health care centers, several nursing homes and hotels all over North Germany.

If somebody has a car accident with acute head injuries, for example, he comes to a hospital first. There he gets the medical treatment for the acute condition in order to save his life. After his condition stabilizes, he comes to one of our Rehabilitation Clinics for neurologic diseases. Sometimes still on a ventilator. Now the patient gets different treatments like physiotherapy, eating and speech therapy, psychological therapy, optic therapy and a lot more. One example is basal orientation training in order to train the patient to be aware of place, time, person and situation again. If the patient gets better, he leaves our clinic in a few months and receives outpatient treatment in one of our ambulatory healthcare centers. If the patient isn’t getting better he might come into one of our nursing homes. In order to have relatives near our patients we have hotels next to the clinics. Hence it’s a huge connected system which needs to be managed. This is where I come in.

In my current job I assist the management in several projects. In order to look inside every aspect of the company I have lots of different tasks.
In the broader sense my work is called Controlling. So the main intention of the different projects I work on is not to just do things, but to analyze how they can be done more effectively. I check errors in current work flows and try to foresee emerging problems and discuss them with the management so that they can make the right decisions. The management sets standards and objectives and I measure and analyze actual performance, so that the management can take the correct actions.
In order to do that, I am responsible for different analysis (e.g. Probability Analysis, Work Flow Analysis). In order to have the correct information published for patients and insurers I am also responsible for the revision of concepts and reports from management or physicians. In addition, I respond to patient complaints and report them to the management if necessary. Furthermore, I deal with small cases of damage or loss (which are settled out of court) and talk to insurers and patients. Beside this regular work, I assist the management in the preparation of different events, e.g. negotiations with insurers. At the moment I am, among other things, collecting and revising content for our new WebPages.

How did you get the job?

I applied although the job wasn’t announced. A friend of mine knew somebody who said that I should try to apply to the company and he gave my application to the management director. I got a job interview and convinced them. Unfortunately a lot of jobs are found through personal connections, so my recommendation to all students is to start building a network early enough and to get to know a lot of people in the business.

To what extent is the knowledge you acquired through your studies at the Institute of Health Management and Health Economics relevant to your current job?

The knowledge I acquired through my studies at the International master’s program in Health Economics, Policy and Management is very relevant to my current job. First of all because I learned how to analyze, evaluate and structure processes and objectives. Beside knowledge of these different methods, I gained a lot of fundamental knowledge about health care systems in my studies that are an advantage now. For example information on structure, organization and financing of health care systems. The knowledge about health, medicine and health communication helps me now to think not only in business but also in medical terms, which helps me to better understand the thinking of our medical staff. In addition the studies at the master’s programme in Health Economics, Policy and Management broadened my view of health care systems and management systems. The most interesting part was that Norway with its Centralized Health Care system has a lot more decentralized management philosophy, while Germany with its semi-centralized Health Care System has a lot more centralized management philosophy. Often I catch myself with the thought: Why can’t we have flatter hierarchies like they have in Norway, in order to make it easier for the nurse or the physiotherapist to communicate their brilliant ideas to the medical director or the management?! Things that sounded so easy in our studies seem to be so difficult in practice.

How are the possibilities for developing your skills in your current job?

The main possibility for developing my skills is on-the-job training I learn from the different tasks and people I deal with every day. Because of too much work, there is unfortunately not enough time to take part in seminars or training very often, although I did take part in several information events of the German Hospital Federation. These events are undertaken in order to inform hospitals about new circumstances, especially new laws.

Published Nov. 22, 2012 1:34 PM