Major stakeholders in the health care delivery system include: - Patients and the public who utilize health care services. - Health care professionals like doctors, nurses, and pharmacists working in hospitals and communities. - Hospital administrators and governing boards who manage hospitals and make strategic decisions. - Non-governmental organizations that provide various health services. - The government which regulates the health care system and provides funding. Stakeholders were classified as external, interface, and internal. Strategies must be formulated and implemented to manage relationships with different stakeholders, then evaluated for effectiveness. The key stakeholders all have an interest in quality, accessible health care.

1. MAJOR STAKE HOLDERS
IN HEALTH CARE
DELIVERY SYSTEM
PRESENTER:
TAJINDER KAUR
MSC NURSING 1ST YEAR

2. INTRODUCTION
The health care delivery system is intended to
provide services and resources for better health.
This system includes hospitals, clinics, health
centers, nursing homes and special health programs
in school, industry and community.
Stake holders encompasses a wide sector of society.
They include consumer or patient, community
health care professionals, hospital health care
professionals, pharmacists, nongovernmental
organizations, supplier etc.

3. STAKE HOLDER
Stake holder is a person,group,organistaion or system
who affect and can be affected by an organizational
action.

4. TYPES OF STAKE HOLDERS
EXTERNAL STAKE HOLDERS
INTERFACE STAKE HOLDERS
INTERNAL STAKE HOLDERS

5. EXTERNAL STAKE HOLDERS
External stake holders have three categories
in their relationship to the organizations
 Those that provide inputs to organization.
 Those that compete with it.
 Those have particular special interest.

6. EXTERNAL STAKE HOLDERS cont.….
Those that provide inputs to organization:
 The first category includes suppliers,
patients and financial community. There is
symbiotic relationship between
organization and external stake holders as
organization depends upon them for their
survival. In turn stake holders depends on
organization for output

7. EXTERNAL STAKE HOLDER cont.…
Those that compete with it:
 The competitor stake holders seeks to
attract organization dependents. There is
no mutual dependence. The competitor
may be direct competitor for patient or
they may be direct be competing for skilled
personnel.

8. EXTERNAL STAKE HOLDER cont.….
Those have particular special interest
 External stake holders in third category are
special interest group. These are the
government regulatory agencies, private
accrediting association, professional
associations, labor union, the media and
political action group. Conflict occurs
because of special interest.

9. INTERFACE STAKE HOLDERS
Some stake holders’ function on the interface
between the organization and its
envioremnt.it include medical staff, the
hospital board of trustees. The organization
may offer professional autonomy,
institutional prestige, special services and
benefits etc.

10. INTERNAL STAKE HOLDER
It typically includes management,
professional and non-professional staff.
Management attempts to provide internal
stake holders with sufficient inducement to
gain continual contribution from them.

11. STAKE HOLDERS IN HEALTH CARE
DELIVERY SYSTEM
 GOVERNMENT
 PUBLIC
 PROVIDERS
 HOSPITAL ADMINISTRATOR AND GOVERNING
BODIES
 NON-GOVERMENTAL

12. GOVERNMENT
The role of government in the administrator of health care
cannot be overestimated. Many federal government health
care efforts are headed by a cabinet level officer, the
secretory for health and human services who run
departments of health and human services. The federal
government makes budget and other planning related to
expenditure in health care. Therefore hospital have a great
incentive to comply with regulations promulgated by federal
government, because they can be fined or decertified a
provider of care to Medicare clients if they do not.

13. PUBLIC
The public has a stake in health care from several
perspectives. As consumers of health care services or as
patients, the public is concerned with quality, cost and
access to care. Now a days there are wide range of coverage
that can be customized to their specific needs. They also
look for the employs to fund the majority of cost of health
care insurance. Overall public values regarding health care
are changing.in addition public has a more positive view of
health promotion and illness prevention than in past.1% of
health care expenditure is going to public health.

14. THE PROVIDERS
 Community health care professionals: - it
includes nurses, health workers, Dias, doctors
of community health Centre’s, voluntary health
workers etc.
 Hospital health care professionals:- it includes
physicians, nurses and pharmacists.

15. COMMUNITY HEALTH CARE
PROFESSIONALS
 NURSES
 HEALTH WORKERS
 VOLUANTRY WORKERS
 DOCTORS OF COMMUNITY HEALTH CENTRE
 DIAS

16. HOSPITAL HEATH CARE PROFESSIONALS
PHYSICIAN
NURSES
PHARMACISTS

17. HOSPITAL ADMINISTERATORS AND
GOVERNING BOARDS
The chief executive, chief financial officer, chief
nursing officer and governing boards of hospitals
strongly influence health care delivery in their
institutions. The responsibilities are:
- Decision maker
- Leader
- Manager
- Executor
- Communicator

18. NON-GOVERMENTAL STAKEHOLDERS
 INDIAN RED CROSS SOCIETY
 HINDU KUST NIVARAN SANGH
 INDIAN COUNCIL FOR CHILD WELFARE
 TUBERCULOSIS ASSOCIATION OF INDIA
 BHARAT SEVAK SAMAJ
 THE KASTURBA GANDHI MEMORIAL FUND
 ALL INDIA WOMEN CONFERENCE
 ALL INDIA BLIND RELIEF SOCIETY

19. INDIAN RED CROSS SOCIETY
It was established in 1920 and has over 400 branches all over India.
It has been executing programmed for the prevention of diseases
and promotion of health. Its activities are:
 Relief work.
 Milk and medical supplies.
 Armed forces.
 Maternal and child welfare services.
 Family planning.
 Blood bank and first aid.

20. HINDU KUSHT NIVARAN SANGH
 It was founded in 1950 with its headquarters in New Delhi. Its
precursor was the Indian council of British Empire Leprosy Relief
Association (B.E.L.R.A) which was renamed as LEPRA in 1950. The
programmed of work of the sangh include rendering of financial
assistance to various leprosy homes and clinics, health
education, training of medical worker and physiotherapists
conducting research and field investigation. The Sangh has
branches all over India and work in close cooperation with the
Government and other Voluntary agencies

21. INDIAN COUNCIL FOR CHILD WELFARE
 It was establish in 1952. It is affiliated with
international union for child welfare. The services of
I.C.C.W are devoted to secure for Indian children
those ―opportunities and facilities, by law and
other means‖ which are necessary to enable
them to develop physically, mentally, morally,
spiritually and socially in a healthy and normal
manner and in conditions of freedom and dignity.

22. TUBERCULOSIS ASSOCIATION OF INDIA
 It was formed in 1939. It has branches
in all states of India. The activities of
this association comprise organizing T.B
campaign every year to raise funds,
training of doctors, health visitors and
social workers in anti tuberculosis work,
promotion of health education conferences.

23. BHARAT SEVAK SAMAJ
 The Bharat Sevak Samaj which is non-political and
nonofficial organization was formed in 1952.One
of the prime objective of the Bharat sevak is to
help people to achieve health by their own
actions and efforts. The B.S.S. has branches in all
the states and nearly all the districts.
Improvement of sanitation is one of the important
activities of the B.S.S.

24. THE KASTURBA MEMORIAL FUND
 It was created after the death of Kasturba
Gandhi in 1994,the fund raised with the main
objective of improving the status of women,
especially in the villages through gram
sevikas.the trust has nearly one crore of rupees
and is actively engaged in various welfare
projects especially in the villages, through
gram-savikas.

25. ALL INDIAN WOMEN CONFERENCE
 It is the only women‘s welfare organization in the
country. Established in 1962, it has now branches
all over the country. Most of branches running
M.C.H. clinics, Medical centers, and adult
education centers, milk centers and family
planning clinics.

26. The All India Blind Relief Society
It was established in 1946 with a view to coordinate
different institutions working for the blind.it
organizes eye relief camp and other measures for
the relief of blind.

27. MANAGEMENT OF STAKEHOLDERS
REALTIONSHIP
Diagnose
each
stakeholder
Classify each
stake holder
relationship
Formulate
generic
strategies
Implement
strategies
Evaluate
effectiveness
of strategies

28. DIAGNOSE OF STAKEHOLDER
STAKEHOLDER POTENTIAL FOR
THREAT
STAKEHOLDER POTENTIAL FOR CO-
OPERATION

29. DIAGNOSIS OF STAKEHOLDERS
Potential for threat:
 A health care organization
manager needs to anticipate
and evaluate systematically
the actual or potential threats
in its relationship with
stakeholders. These threats
may focus on obtaining
inducements from the
organization that may or may
not be provided. Stakeholder
power and its relevance for
any particular cause
confronting the organization
manager determine the
stakeholder potential for
threat.
Potential for co-operation:
 The stake holder dependence on the
organization and its relevance for
any particular issue facing the
organization determine the stake
holder’s co-operative potential.
Generally the most dependent
stakeholder on the organization, the
higher the potential for the co-
operation.

30. TYPES OF STAKEHOLDER RELATIONSHIP
MIXED
BLESSING
SUPPORTIVE
NON
SUPPORTIVE MARGINAL

31. Mixed blessing stakeholder relationship: in this health
care executive faces a situation in which potential both
threat and co-operation rank for stakeholder. Example
physician and hospital relationship
Supportive stakeholder relationship: in this type there is
low potential threat and high co-operation. Example
relationship of hospital with its trustees, its manager.
Non supportive stakeholder relationship: there is high
potential threat and low co-operation. Example competing
hospitals, employee union, the federal government and other
government.
Marginal stakeholder relationship: there is neither co-
operation nor threat. Example employees, volunteer groups
in community etc.

32. STRATEGY IMPLEMENATION AND OUTCOME
The fifth step of stake holder relationship is
implementation of planned ad articulated
strategies. With conscious, consistent
relationship and implementation of strategies,
a quite fully organized heath care system can
be developed. The outside of the strategy
implementation has to be evaluated.

33. REFERENCES
BOOK REFERENCES
 Marquis L Bessie and Huston J Carol. Leadership and management
function in nursing. 7th ed. Lippincott and Williams’s publishers. 2012.
P. 265-66
 Park.K. Textbook of social and preventive medicine. 18th ed.
Banarsidass bhanot publishers.p.701-02
 Khan S. Yaseen and Basheer. Shebeer. P. text book of advanced
nursing practice.1st Ed. EMMESS medical publishers. 2012. P.86-91
WEBSITE REFERENCE
 www.en.wikipedia.org/wiki/stakeholders
 www.investopedia.com/.../stakeholder
 www.stakeholders.force.com/

34. THANK YOU